Inspection on 01/11/05 for Dene House

This inspection was carried out on 1st November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dene House 11/12/07

Dene House 22/08/06

Dene House 18/05/05

Dene House 12/01/05

Dene House 21/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOMES FOR OLDER PEOPLE Dene House Dene House 12 Cleveland Road Torquay Devon TQ2 5BE Lead Inspector Peter Wood Announced Inspection 1st November 2005 09:30 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 House DS0000018346.V258298.R01.S.doc Version 5.0 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 House DS0000018346.V258298.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dene House Address Dene House 12 Cleveland Road Torquay Devon TQ2 5BE 01803 293077 NO FAX 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 James De`Ath Mrs Madeleine De`Ath Mr John James De`Ath Care Home 12 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12), Old age, not falling within any other category (12) Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th May 2005 Brief Description of the Service: Dene House provides residential care for up to twelve older people who may also have a mental health problem or mild dementia. Residents with a slight physical frailty can be accommodated, though the home is not suitable for people with major mobility or behavioural problems. Dene House is a Victorian villa, close to the centre of Torquay. Residents live on two of the four floors, connected by a stair lift. There is a large lounge and good-sized dining room, both with pleasant outlooks. There are other small rooms which may be used as lounges in combination with some of the smaller bedrooms. All residents’ rooms are single, some configured as a small bedroom with a separate small sitting area. The bath has a seat which lowers the occupant into the water, and there is a wheel-in shower. There is an accessible garden with suitable garden furniture, a marquee and a barbeque, and a small level lawn. There are at least two people on duty at all times. Outside the hours of 8am – 6pm the Registered Provider / Manager takes on all duties, with back-up from his wife who is also a Registered Provider and is involved in social but not personal care. Care and accommodation are offered in an informal atmosphere which promotes Service Users’ feeling of self-determination. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place on a weekday in November 2005. A tour of the home was undertaken and a sample of relevant documentation including that relating to client assessment and care planning, staffing and health and safety was examined. The resident Registered Provider / Manager and his daughter who acts as his deputy assisted throughout the inspection. All residents were asked for their views of their experience of living at the home, and several had completed Comment Cards. What the service does well: What has improved since the last inspection? Several rooms have been decorated and / or re-carpeted since the last announced inspection while two elevations of the outside have been repainted. This helps to create a more pleasant living environment for the residents and make them feel more valued. The Registered Provider has put his name down on the list to go on the course which will lead towards achieving NVQ4 in Care and Management and the Registered Manager’s Award. The Registered Provider’s daughter, who acts as his deputy, already has her Registered Manager’s Award and has gained further modules towards her gaining her NVQ in Care Management. This training is aimed at promoting greater professionalism in the quality of care offered. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 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 House DS0000018346.V258298.R01.S.doc Version 5.0 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 House DS0000018346.V258298.R01.S.doc Version 5.0 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): 1, 3, 4, 5, 6 Quite thorough systems for admission allow prospective residents and their relatives to be confident that their needs can be met. EVIDENCE: The Statement of Purpose and Service User Guide are sufficient though rudimentary rather than comprehensive and glossy, which reflects both the physical environment of Dene House and its philosophy and style of care. The documentation does not do justice to the care and attention paid at the prospect of admitting a new resident. The first consideration is how the prospective resident will impact upon the security and stability of the incumbent residents. The owner would rather leave rooms empty and his home therefore under-occupied to safeguard that priority. A reasonably comprehensive pre-assessment is undertaken prior to admission to ensure that the service is appropriate, and residents encouraged to visit before deciding to move in. The home does not offer intermediate care. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 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, 8, 9, 10 Resident’s health, personal and social care needs are met and residents are treated respectfully. The home’s practices relating to medication administration protect the residents from risk. EVIDENCE: All residents have quite good care plans documenting their personal care needs. Appointments are recorded separately. Appropriate daily records are kept, and typed up weekly by the Senior Carer, who also up-dates care plans monthly. Specialist advice is sought regarding residents’ physical and mental health problems. Residents are able to self-medicate on the basis of risk assessment and their own wishes. The home has properly operated a “Boots style” medication administration system for about a year. Medication requiring refrigeration is properly kept in a locked medication fridge with a separate cool compartment. It was observed that staff treated residents with respect at all times. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 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, 13, 14, 15 Social activities are managed well and provide daily interest for the service users. Meals are nutritious and varied. EVIDENCE: Dene House operates rather like an extended family. Residents expressed their satisfaction that the home “suits” them. The owner described the ambience he successfully attempts as one where the residents “feel comfortable in themselves”. Residents are obviously “at home” here, demonstrated by, for example, laying the table themselves. They can come and go as they please while many enjoy the regular activities such as twice weekly physical exercises, weekly visiting musician, regular quizzes, etc. Residents said that every resident’s birthday, or a couple’s wedding anniversary, is celebrated with a cake. Seasonal events such as Halloween recently are marked by staff and residents dressing up. The day is as structured or as flexible as any resident wants it to be, and is able to accommodate the differing needs of the individuals who live here. Some wish to join other residents in the lounge, or remain in their room most of the time, or spend most of their time away from the house. The home retains it’s (20 year old?) notice: “Visiting time – any time.” Dene House DS0000018346.V258298.R01.S.doc Version 5.0 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, 18 Complaints and suggestions from service users, relatives or other visitors to the home, are treated seriously. Service users are listened to and issues resolved promptly EVIDENCE: The ethos of this home is that complaints are dealt with before they get to the formal stage. Residents consulted during the inspection had every expectation, based on their experience, that the owner would put right anything they were unhappy about. The home has a complaints policy, process and notice, which includes the contact details of the Regulation Inspector should a resident have a wish to contact the Commission. There is also a Complaints and Suggestion Book, though nothing is recorded in this, reflecting the informal nature of this home. There have been no complaints. Residents told me that they would tell the Registered Provider if they were worried about anything. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 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, 20, 21, 23, 24, 25, 26 Residents live in a comfortable, “lived-in” style of home that provides sufficient facilities to meet their needs. EVIDENCE: Dene House is a Victorian villa on four floors, the middle two of which contain resident’s bedrooms. There is a stair lift up the main flight of stairs. People with mobility problems can be accommodated on the ground floor, but the house is not suitable for people who are dependent on wheelchairs. The house has undergone considerable remodelling over the years which provides valueadded character but has resulted in some non-standard features, such as several different levels and rooms which have been divided at the large windows. Some “bedroom” accommodation actually consists of a couple of rooms which some residents keep divided as a bedroom and a separate lounge. Bedrooms reflect the occupant’s characteristics, which themselves are sometimes non-standard. Several bedrooms are kept as storage rooms. There is a large lounge and good-sized dining room, both with pleasant outlooks. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 13 There is an accessible garden with a lawn, suitable garden furniture, a marquee and a barbeque. Access to the garden is via ramps from the front door and round the side of the house. The staff and residents enter the annual ‘Torbay in Bloom’ competition, and usually win in one or other category. Every resident who takes part receives their individual certificate, which they proudly display. The home often receives a commendation for its floral display in pots at the front of the house, a favourite spot for residents to sit in the summer as it is a sun trap. Dene House is a comfortable “homely home”, with a need for on-going maintenance, refurbishment and redecoration throughout. There is not a written programme of improvements, but the Registered Provider has worked steadily to meet the environmental standards and maintain the building. All radiators considered to be hazardous to residents have been covered following a risk assessment to minimise the risk of residents receiving a burn. Likewise, hot taps considered to be hazardous have been fitted with thermostatic valves to minimise the risk of residents receiving a scald. Although the office / boiler room / laundry room does not meet the detail of the National Minimum Standards, the lack of such as impermeable floor and wall coverings does not detract from the outcome directly affecting residents of an efficiently run, warm home which provides a good laundry service. There are WCs in reasonably easy reach of all bedrooms, the dining room and the lounge. Two ground floor bedrooms have an en suite WC, and one has its own bath. There is a bath with a hydraulic bath seat on the first floor, and an accessible shower on the ground floor. There is a call bell in each bedroom and bathroom. Although the house could benefit from brightening up, it is clean and virtually free from any odour, except in and adjacent to the room of a resident with incontinence problems. The house is safely protected from fire as was demonstrated during the inspection when the alarm went off, probably triggered by humidity rather than fire. All fire doors are properly fitted with “Dorguard” type devices and closed when the alarm sounded. Staff acted appropriately during this time, though not in accordance with the home’s policy and procedure in the event of a fire. This was taken as an opportunity to remind the owner to overhaul this and other policies, procedures and notices to reflect actual good practice. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 14 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, 29, 30 Service users are cared for by caring staff in sufficient numbers to meet the needs of those currently living in the home. Recruitment processes protect vulnerable service users. EVIDENCE: Staffing is sufficient for the current small group of residents who have regular and predictable care needs. The Registered Provider / Manager and his Senior Care daughter who acts as his deputy both have NVQ level 2 (the Senior Care has additional qualifications). Another member of staff also has NVQ2. The three other members of staff do not have relevant qualifications. The Registered Provider lives on the premises and so is available throughout the day and night. The home has a good recruitment procedure, including obtaining CRB Disclosures, to ensure that only appropriate staff are employed. However, staffing at this home is stable; no new staff have been required for some time. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 15 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, 32, 33, 38, This is a good, well-managed home. The owner and his staff team strive to provide an accepting, stimulating and safe environment that respects and protects residents’ rights and best interests. EVIDENCE: The Registered Provider has over 22 years experience in managing residential care, but needs NVQ4 in care and management and the Registered Managers’ Award. The Senior Carer has completed the NVQ3 in care and the RMA, and is engaged in NVQ4 and the Assessors’ Award. Achievement in these qualifications will add professionalism to the instinctive caring qualities of owner and staff. Samples of relevant documentation examined were found to be in good order, though much of the documentation could benefit from updating, addition of further detail and to reflect actual good practice, such as the fire policy, procedure and notice. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 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 3 x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? NO 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 31 Regulation 10 Requirement The Registered Provider must achieve the NVQ4 in Care and Management by (the end) of 2005. Timescale for action 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. 1 2 3 Refer to Standard 1, 25 19, 20, 23, 25, 26 28 Good Practice Recommendations The Registered Provider should ensure that documentation including policies, procedures and notices be updated, some with more detail, and to reflect actual good practice. The Registered Provider should ensure that the home benefits from some updating of furniture, furnishings and decoration. The Registered Provider should ensure that he encourages more care staff to engage in NVQ training. Dene House DS0000018346.V258298.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 House DS0000018346.V258298.R01.S.doc Version 5.0 Page 19 - 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. 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