Inspection on 24/01/06 for Dene Court

This inspection was carried out on 24th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dene Court 21/02/08

Dene Court 23/11/06

Dene Court 31/08/05

Dene Court 07/02/05

Dene Court 05/08/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Dene Court Butts Road Heavitree Exeter Devon EX2 5HU Lead Inspector Sue Dewis Unannounced Inspection 12th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dene Court Address Butts Road Heavitree Exeter Devon EX2 5HU 01392 274651 01392 274651 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Willis Hall Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (31), Old age, not falling within any other category (31), Physical disability over 65 years of age (31) Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Dene Court is a home in a residential area of Heavitree, in Exeter. It is close to some local shops and public transport is available into the centre of the city. There are a variety of communal areas within the home. The home has areas of garden which service users enjoy sitting in and some car parking spaces. The home is registered to provide personal care for up to 31 older residents, though only one room registered as double is used as such. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours one day towards the end of January 2006. Five residents and two staff were spoken with in private, and Donna Dawson, care manager was available throughout the inspection. Three residents’ care plans and two residents’ financial records were inspected, as well as complaints records and some staff records. What the service does well: What has improved since the last inspection? Residents now receive confirmation that the home can meet their needs prior to their admission. Care plans are now being reviewed monthly. Two carpets that had offensive odours have been replaced. All staff working at the home now have satisfactory CRB (Criminal Records Bureau) checks, and have received POVA (Protection of Vulnerable Adults) training. Staffing levels have also increased Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents are assured that their care needs can be met. EVIDENCE: Evidence was seen on file that prospective residents now receive written confirmation, prior to admission, that the home can meet their needs. A newly admitted resident was spoken with, and though they could not remember if they had had any information about the home before they moved in, they were sure that their family would have. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Care plans are well formulated and give clear information to enable staff to meet residents’ health and social care needs. EVIDENCE: Three residents’ care plans were inspected, and are now being reviewed monthly. They contained general risk assessments and one contained a nutritional risk assessment. However there were no individual detailed moving and handling assessments. The care plans give staff the basic information they need in order to meet the day to day needs of the residents, and there is a lot of information held on each resident with daily recordings being made. However, the care plans do not give any detailed information and it is difficult to see where amendments have been made. Discussions with staff indicated that they found the care plans confusing and time consuming to keep updated. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 Social activities that are offered provide stimulation and interest for residents. EVIDENCE: Residents said that they generally spend their time as they please, reading, knitting or watching TV. Various activities are organised throughout the week, and Age Concern visit and take some residents on outings. One resident regularly visits local clubs for a social get together or day trips. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints are handled appropriately. Residents are protected from abuse by the home’s recruitment practices and staff training. EVIDENCE: The inspector saw details of a complaint that had recently been made by relatives. The home was dealing entirely appropriately with the complaint. The care manager is now a ‘trained trainer’ and all staff have now received training in the Protection of Vulnerable Adults. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The standard of the environment within the home is good, providing residents with a clean, safe, comfortable and homely place to live. EVIDENCE: The home is safe, comfortable, homely and well maintained, with several communal areas that are well used by residents. Two carpets in residents’ rooms that had strong odours, have now been replaced. There is also an improvement plan for the home and garden. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 The deployment and numbers of staff available throughout the day are sufficient to meet the needs of the residents. The procedures for the recruitment of staff are robust and offer protection to residents EVIDENCE: On the day of inspection there were 28 residents at the home. There were five care staff, one senior, a cook, a domestic and the care manager on duty. Residents said that they felt there were sufficient staff on duty to meet their needs. One resident said that staff were available ‘but are not around me all the time…I’m sure if I needed help they would give it to me’. Staff told the inspector (certificates were seen) that they had received training in POVA (Protection of Vulnerable Adults), Moving and Handling, Basic Food Hygiene and Fire Precautions. Staff files contained evidence of satisfactory CRB (Criminal Records Bureau) checks. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33,35 and 38 The home is generally well managed though some aspects of Health and Safety could be improved in order to promote and safeguard the welfare of the residents. EVIDENCE: The owner has worked with older people for many years. The care manager has also worked at the home for many years and is working for the RMA (Registered Managers Award) and NVQ 4. There is still no formal quality assurance system for the home, and ways in which this could be achieved were discussed. The home manages very little money on behalf of residents. Two residents monies were checked and the monies were correct. However, the recording Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 15 system did not have a running total, receipts were not numbered and there were not two signatures. Accident records were appropriately maintained in line with new legislation. Records relating to fire practices were well maintained in some areas, indicating that fire extinguishers and emergency lighting is being tested appropriately. However, there was no evidence that fire alarms had been tested since September 2005, though the care manager assured the inspector that alarms had been tested though not recorded. Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 1 Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 17 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP33 Regulation 24 (1) Requirement You are required to supply to the Commission a report in respect of any review of the quality of care at the home, and make a copy of the report available to service users (Timescale of 31/12/05 not met) You are required to make adequate arrangements for testing fire equipment at suitable intervals Timescale for action 31/03/06 2. OP38 23 (4) (c)(v) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP7 OP35 Good Practice Recommendations You are recommended to simplify and collate all information held on residents You are recommended to complete moving and handling assessments for all residents You are recommended to ensure financial records for residents contain two signatures, a running total and numbered receipts DS0000021924.V276558.R01.S.doc Version 5.1 Page 18 Dene Court Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dene Court DS0000021924.V276558.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!