Inspection on 22/08/06 for Dene House

This inspection was carried out on 22nd August 2006.

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 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 House 11/12/07

Dene House 01/11/05

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 Key Unannounced Inspection 22 August 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 House DS0000018346.V309253.R02.S.doc Version 5.2 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.V309253.R02.S.doc Version 5.2 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.V309253.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/11/05 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. Physical frailty is expected, but the service is not for people with major mobility or behavioural problems. Dene House is a Victorian villa, close to the centre of Torquay. Residents occupy two of the four floors, and there is 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 bedrooms are single. 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 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 selfdetermination. Fees range between £250 and £450 dependent on the need of the individual resident. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken over one day in August 2006. The focus of this inspection was to inspect all key standards and to seek the views of residents, staff, relatives and professional visitors to the home, the latter mainly using comment cards and survey forms. At the time of writing this report five staff returned the “Care Workers Survey” form. Six “General Practitioners Comments Cards” were returned. Five “Health and Social Care Professionals in Contact with the Care Home” returned a form with that title and one “Relatives/ Visitors Comment Card” was returned. Four survey forms were received from residents, and all residents who were home at the time of the inspection were consulted. Considerable time was spent with the Registered Provider / Manager and his daughter who acts as his deputy examining documentation, particularly that relating to client assessment and care planning, staffing and health and safety. A full tour of the building was undertaken, and a Pre-Inspection Questionnaire received. What the service does well: What has improved since the last inspection? There was only one requirement made at the last inspection, that the Registered Provider / manager achieve NVQ4 in Care and Management and the Registered Manager’s Award. He is now part way through this course and should qualify during this year. The Registered Provider’s daughter, who acts as his deputy, already has her Registered Manager’s Award. This training is Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 6 aimed at promoting greater professionalism in the quality of care offered. Some rooms have been decorated since the last inspection. This helps to create a more pleasant living environment for the residents and make them feel more valued. 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.V309253.R02.S.doc Version 5.2 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.V309253.R02.S.doc Version 5.2 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, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. The systems for admission are reasonably thorough and comprehensive and allow residents and their relatives to be confident that their needs can be met. EVIDENCE: The assessment documentation is quite well designed, reasonably thorough and comprehensive, and works for the home. The home’s practice is good in using this documentation to ensure that only those residents whom the home can help are admitted. 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. Prospective residents are also encouraged to visit before deciding to move in. The home does not offer intermediate care. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents’ health, personal and social care needs are met and service users are treated respectfully. The home’s practices relating to medication administration protect the residents from risk. EVIDENCE: Residents have quite good care plans, generated from the assessments, documenting their personal care needs. 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. The home has good policies, procedures and practices for the proper administration of medication. Residents are able to self-medicate on the basis of risk assessment and their own wishes. The home operates a “Boots style” medication administration system, though the MAR sheets are replaced by the home’s own design of “month-at-a-glance” spreadsheet which is a simple tool designed to reduce the risk of drug errors. Medication requiring refrigeration is properly kept in a locked medication fridge with a separate cool compartment. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 10 Residents were observed to be, and reported that they were, treated with respect by staff. One resident very powerfully and poignantly contrasted the genuine care and respect shown to residents at this home by comparing the experience of living in a previous care home in which residents were not respected. The other home “broke my spirit”, which took some time for this home to restore. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Social activities provide daily interest for the residents. Contact is maintained with friends and families. Residents are encouraged to exercise choice and meals are nutritious and varied. EVIDENCE: Residents are encouraged and enabled to do as much for themselves as possible. Dene House operates rather like an extended family. Residents consulted over the pleasant lunch (with a choice of menu) expressed their satisfaction that the home “suits” them. 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. They have a range of activities from which to choose whether or not to partake. Recently most residents went out into town together to watch the Red Arrows aircraft display. Residents said that every resident’s birthday, or a couple’s wedding anniversary, is celebrated with a cake. 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. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. 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 home has a complaints policy, process and notice, which includes the contact details of the Regulation Inspector should a resident or visitor to the home 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. The home follows the good practice promoted in the National Minimum Standards that issues are resolved before they escalate to become complaints. Residents consulted reported that they were listened to and expressed confidence that appropriate action would be taken if they were to make a complaint. The provider / manager and his deputy demonstrated that they knew how to respond appropriately should there be a suggestion of abuse. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 13 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents live in a “lived-in” style of home that is far from luxurious but meets 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 suit the needs of each resident and often reflect the occupant’s characteristics, which themselves are sometimes non-standard. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 14 Residents can bring into their rooms more or less whatever they wish, so they can have their possessions (which could include furniture) around them. Several bedrooms are kept as storage rooms. There is a large lounge and good-sized dining room, both with pleasant outlooks. The huge window in the lounge overlooks the pleasant garden and provides lots of light inside. Unfortunately this light has discoloured the carpet and exposes its need for replacement. Dene House is a comfortable “homely home”, with a need for on-going maintenance, refurbishment and redecoration throughout. Much of the furnishings, decoration, furniture, fittings and tidiness could be described as poor. 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, though one of the WC’s (on the landing) does not benefit from a wash-hand basin, which would probably prove impossible to fit. 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 on the day of inspection free from any unpleasant odour. The house is safely protected from fire. All fire doors are properly fitted with “Dorguard” type devices and closed when the fire alarm (or other loud noise!) is sounded. The home benefits from 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 DS0000018346.V309253.R02.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents are cared for by staff in sufficient numbers and competence to meet the needs of those currently living in the home. Recruitment processes protect vulnerable residents. EVIDENCE: Staff, some of whom are family members, are appropriately recruited, inducted and trained, as evidenced by the employees’ file. Numbers and competence of staff, by reason of experience and increasingly by training, is good at this home. The home undertakes CRB checks and undertakes proper references. The home provides training in health and safety topics as required, and enables staff to undertake NVQs. The Registered Provider / Manager and his Senior Care daughter who acts as his deputy both have NVQ level 2. The Senior Carer has NVQ 2 and 3 in care and the Registered Manager’s Award, the Assessors’ Award and is currently engaged in NVQ4. Another care assistant has NVQ2, while a third is nearing completion. Three of the six staff will therefore shortly have achieved NVQ2 or above, meeting the 50 requirement. Achievement in these qualifications will add professionalism to the instinctive caring qualities of owner and staff. The Registered Provider lives on the premises and so is available throughout the day and night. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 16 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, 35, 38, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service and takes into account the views and experiences of people using the service. Residents live in a wellmanaged home run in their interests. 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, and is now part way through a course with Dartington Tec which leads to NVQ 4 in care and management and the Registered Managers’ Award. The Senior Carer has NVQ 2 and 3 in care and the RMA, the Assessors’ Award and is currently engaged in NVQ 4. Achievement in these qualifications will add professionalism to the instinctive caring qualities of the management staff of the home. Samples of relevant documentation examined were found to be in Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 17 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. Records inspected were in order, though it is recommended that the provider / manager studies all the National Minimum Standards (not just those inspected) and Schedules and satisfies himself that the home fully complies. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 18 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 Standard No Score 16 3 17 X 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 X 3 X X 3 Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP31 Regulation 10 Requirement The Registered Provider must achieve the NVQ4 in Care and Management by (the end) of 2005. This was a requirement at the previous inspection, the date specified in the National Minimum Standards. Timescale for action 31/12/06 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. Refer to Standard OP19 Good Practice Recommendations I recommend that the home could benefit from some updating of furniture, furnishings and decoration. Dene House DS0000018346.V309253.R02.S.doc Version 5.2 Page 20 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.V309253.R02.S.doc Version 5.2 Page 21 - 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. 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