Inspection on 31/08/05 for Dene Court

This inspection was carried out on 31st August 2005.

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 24/01/06

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 EX2 5HU Lead Inspector Sue Dewis Annual Inspection 31st August 2005 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 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 D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dene Court Address Butts Road, Heavitree, Exeter, EX2 5HU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01392 274651 01392 274651 Mr John Willis Hall Care Home 31 Category(ies) of DE(E) Dementia - over 65(31), registration, with number MD(E) Mental Disorder - over 65(31), of places OP Old Age (31), PD(E) Physical Disability - over 65 (31) Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7 February 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 for 31 residents, though only one room registered as double is used as such. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day at the end of August 2005. The home had been informed that an inspection would occur within the next three months and they had submitted a pre-inspection questionnaire. Six comment cards were received from relatives and five from residents. This information has been used in writing this report. Two residents were spoken with in private and several others in a group setting. Two staff and one visitor were also spoken with. Mr Hall (owner) and Donna Dawson (manager) were available throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: There is an ongoing unpleasant odour in one area of the home; the owner assured the inspector that this would be addressed immediately. All new staff employed must have a new CRB (Criminal Records Bureau ) check prior to starting work, and all staff should receive POVA (protection of Vulnerable Adults) training and updates. The home must confirm in writing to prospective residents that it can meet their needs, and carry out a review of the quality of care at the home. Though care plans are comprehensive, they may benefit from a thorough review and simplification. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 6 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 D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 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 standard(s) 3 There is a full and proper assessment made prior to people moving into the home, giving an assurance that care needs will be met. EVIDENCE: The files of the two most recently admitted residents were looked at both contained detailed pre-admission assessments. Due to their frailty, neither resident was able to tell the inspector if they had seen a copy of the Statement of Purpose. A visitor told the inspector that they had visited the home prior to the admission of their relative. It was a requirement of the previous inspection that the home confirm in writing to prospective residents that it can meet their needs. This is not being done and therefore the requirement is carried forward. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet the needs of the residents. However, this could be improved by simplification of information. EVIDENCE: Three residents’ care plans were inspected and all contained good directions to staff on the care each resident needs on a day-to-day basis. Two showed evidence of resident involvement and contained detailed risk assessments. There was evidence of daily recordings for each resident and also regular summaries made by the key workers. Detailed information is maintained on all service users, though it is kept in several places and though reviewed fairly regularly is not reviewed monthly. Discussions were held with the manager about reviewing and simplifying the plans and making them more user friendly for the staff who use them. Plans contained evidence of involvement of health care professionals, and it was possible to track where a concern had been identified and investigated. The manager reported good relationships with health care workers, with District Nurses visiting regularly. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 10 Medication was appropriately stored and records were well maintained. Staff who administer medication have received Boots Foundation Module training. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 11 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 standard(s) 12, 13, 14 and 15 Social activities that are offered provide stimulation and interest for residents. Residents are able to maintain contact with family and friends. Meals are nutritious and offer a healthy and varied diet for residents. EVIDENCE: Two residents were spoken with in private and several others in a group setting. All were happy with their lifestyle and made comments like ‘Make you feel as if you are in your own home’ and can get a cup of tea anytime. Regular activities are on offer including games and entertainments, and residents commented how much they enjoyed these, and having staff spend time with them individually. One visitor was spoken with and they told the inspector that they were always made to feel welcome and offered refreshments. They also said that they were involved in drawing up their relatives care plan and were always informed of any changes in needs. They also commented that the ‘staff are wonderful, best thing here by a long way and incredibly caring’. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 12 One resident has a lock on their bedroom which they use each time they leave the room. They told the inspector they get up and got to bed when they choose and that ‘often go to bed at midnight’. Menus are generally prepared by the chef who is aware of the likes and dislikes of the residents. Residents are also able to have an input into the menus through residents’ meetings. The chef told the inspector that he ensures residents receive a balanced diet and also prepares diabetic and high fibre meals. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 13 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 standard(s) 18 Staff training does not at present ensure residents are protected from abuse. EVIDENCE: Though neither of the staff spoken with had received training on POVA (Protection of Vulnerable Adults) issues or specifically in recognising and dealing with abuse, they were both booked on courses, one on the afternoon of inspection and the other the next day. The home should ensure that all staff receive regular training and updates on POVA matters. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 14 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 standard(s) 19, 24 and 26 Though the standard of the environment within the home is good, and provides residents with a safe, attractive and homely place to live, there was an offensive odour in one room. EVIDENCE: The environment is comfortable and well maintained, with several communal lounge and dining areas, where most residents spend their time. One resident’s room that was seen was rather shabby and in need of decoration, though the resident was adamant that they thought it was lovely. The owner told the inspector that he and the resident’s relative had been trying to persuade them to have their room decorated for some time, without success. Though the home is generally clean and hygienic, there was one bedroom that had a severely unpleasant odour. The owner agreed to replace the carpet in this room. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 15 A copy of a report (23/08/05) by the Environmental Health Officer was seen. No requirements had been made, though there were several recommendations. All of the recommendations were being addressed by the owner. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The deployment and numbers of staff available throughout the day are generally sufficient to meet the needs of the residents. Residents’ needs are met by well motivated staff. EVIDENCE: There has recently been some difficulty in recruiting staff. Though some new staff have been appointed there are still vacancies within the home. Agency staff have been used on occasions. The home should ensure that there are sufficient numbers of staff on duty at all times to meet the needs of the residents. Since the last inspection two CRB (Criminal Records Bureau) checks have been obtained and these were seen by the inspector. One member of staff who has been employed at the home for some time has not got obtained a satisfactory CRB check. Two other staff had been employed with recent checks from previous employers, CRB checks are no longer portable and in all cases new CRB checks must be obtained by the home immediately. Staff that were spoken with had received a variety of training including, moving and handling, first aid and fire precautions. They are due to do a ‘Dementia Care’ course with Age Concern in the New Year. One staff had NVQ 3 and the other was working for it. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 36 There is good leadership, guidance and support for staff to ensure residents receive consistent quality care. EVIDENCE: Staff told the inspector that the manager listened to them if they had suggestions or concerns and included them in decision making. Both staff also felt strongly that they were part of a team, which made them feel valued. One resident said that they felt the home was ‘so homely, you don’t feel restricted’. Staff also confirmed that they receive regular supervision and appraisals. It was a requirement of the previous inspection that a copy of the review of quality of care at the home is sent to CSCI with a copy available to residents. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 18 This has not been achieved and therefore this requirement has been carried over to this report. Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 1 STAFFING Standard No Score 27 2 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x 3 2 x x 3 x x Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 20 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 OP 3 Regulation 14 1 (d) Requirement You are required to confirm in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare (timescale of 27/05/05 not met) You are required to replace the carpet that is causing the offensive odour in the identified room You are required to obtain new CRB checks for three staff identified at inspection 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 for action 31/12/05 2. OP 26 16(2)(k) 20/10/05 3. 4. OP 29 OP 33 19 sch 2 (7) 24 (1) 20/10/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Dene Court Refer to Standard Good Practice Recommendations D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 21 1. 2. 3. 4. 5. OP 7 OP 7 OP 18 OP 27 You are recommended to review all care plans at least monthly You are recommended to simplify and collate all information held on residents You are recommended to ensure all staff receive POVA training and updates as required You are recommended to regularly review staffing levels in order to ensure service users needs continue to be met Dene Court D54-D06 S21924 DeneCourt V238049 310805 Stage4.doc Version 1.40 Page 22 Commission for Social Care Inspection Suite 1, 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. 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