Inspection on 08/05/08 for Denewood House Care Home

This inspection was carried out on 8th May 2008.

CSCI found this care home to be providing an Adequate service.

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

Denewood House Care Home 03/12/07

Denewood House Care Home 06/09/06

Denewood House Care Home 04/11/05

Denewood House Care Home 21/07/05

Denewood House Care Home 28/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Denewood House Care Home 12-14 Denewood Road West Moors Ferndown Dorset BH22 0LX Lead Inspector Unannounced Inspection 8th May 2008 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 Denewood House Care Home DS0000061333.V361914.R01.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. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Denewood House Care Home Address 12-14 Denewood Road West Moors Ferndown Dorset BH22 0LX 01202 892008 01258 841255 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) Samily Care Ltd Mrs Caroline Anne Bleach Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd December 2007 Brief Description of the Service: Denewood House is a detached house in a residential area of West Moors, local shops, churches, pubs and a library are available close by following a level walk. The home is registered with the Commission for Social Care Inspection to accommodate a maximum of 21 older people. It is privately owned by Samily Care Ltd and the Registered Manager is Mrs Caroline Bleach. However Ms Caroline Cooper manages the home on a day-to-day basis. The bedrooms are located on the ground and first floors. There are two double bedrooms and 17 single rooms. The home does not have a passenger lift but a stair lift operates to the first floor. Due to the layout of the home the service users are assessed on admission to determine that they are independently mobile. Public transport is available from outside the premises. The rear garden has seating available for service users; some of the rooms have patio doors opening out to the garden. At the time of this inspection the weekly fees range from £ to £. Additional charges are made for hairdressing, chiropody, newspapers and personal shopping. See the following website for further guidance on fees and contracts www.oft.gov.uk (Value for Money and Fair Terms in Contracts). Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. Two inspectors carried out the unannounced key inspection over approximately four hours on the 8th May 2008. This was a statutory inspection and was carried out to ensure that the residents who are living at Denewood House are safe and properly cared for. Requirements and recommendations made as a result of the last inspection visit were also reviewed. The manager, Ms Caroline Cooper, was on hand throughout to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • 2 questionnaires completed by residents, 2 by relatives and visitors and 2 from visiting GPs. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. During the course of the inspection four residents, one visitor and four members of staff were spoken with and asked their views on the service provided at the home. Comments received through the questionnaires and discussion included: “The care staff are very good.” “The carers are amazing and look after my relative extremely well.” “It is a good place to work.” “They look after us very well.” What the service does well: Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 6 All the residents spoken with were very complimentary of the care they received and the friendly nature of management and care staff. Residents are only admitted to the home following a full assessment of their needs and having confirmed that the home can meet those needs. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents like the food provided and enjoy the choices offered at each meal. The complaints procedure can reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff can easily follow. The house and gardens are maintained to provide residents with a comfortable place to live. Residents are encouraged to personalise their rooms with items of furniture, pictures and a variety of mementos. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. Staff training programmes are in place to ensure they keep up to date with the necessary skills required to meet residents’ needs. Financial procedures within the home also ensure that residents’ interests are protected. What has improved since the last inspection? Generally care-planning documentation has improved so that staff are given sufficient information to be able to meet the needs of residents. However there is still room for improvement to ensure that all aspects of care are addressed appropriately. The home has an ongoing maintenance programme and since the last inspection a number of areas in the home have been upgraded, including the painting of main corridors and some bedrooms. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 8 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 Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure enables prospective residents, and/or those acting on their behalf, to make informed decisions about admission to the home and ensures that only residents whose needs can be met by the home are offered places there. EVIDENCE: The care files for two residents were inspected. These showed that the home has a good procedure in place. Prior to anyone moving into the home a full assessment of needs was undertaken with the prospective resident. Sufficient information was obtained so that a care plan could be drawn up and made available to staff. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 10 Residents spoken with confirmed that they or a family member had visited to the home and were given sufficient information about the home before making a decision as to whether to stay. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of care was adequate although the care documentation does not always ensure that staff have sufficient information upon which to base their care practice. The principles of respect, dignity and privacy were put into practise. Documentation relating to medication administration was not sufficiently robust to protect residents. EVIDENCE: Since the last inspection the standard of care planning had improved. However there were still some shortfalls in some areas of recording. The care files for three residents were reviewed. Files contained a variety of assessments. The information from the assessments was used to formulate a Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 12 plan of care for each resident and they contained sufficient detail so that staff could give the appropriate care. However shortfalls included: • In one file a pressure sore risk assessment indicated a “very high risk” but this had not been reviewed in seven months. • A falls risk assessment had been completed in one file and indicated a “high risk” but the only action documented was for staff to complete a falls diary rather than look at ways of minimising risks to this resident. • Generally the daily written statements in the care files lacked detail about what sort of day the resident has had, how they have been occupied and whether they were in a state of wellbeing. Residents appeared well cared for and people spoken with confirmed this. “Staff are very kind and caring.” “Denewood House staff are very caring to my relatives.” They also confirmed that staff treated them with respect. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, the district nurse, chiropodists, opticians and dentists. The medications policies and procedures were reviewed. Medicines were stored securely. However there were shortfalls in recording which included: • Where instructions for medications were handwritten on the medication administration records they were not countersigned. • Where a resident was self-medicating no risk assessment had been completed. • There were gaps where the medication administration records had not been signed. • It was noted that the policies for administration and disposal of medicines gave conflicting guidance on the length of storage of a person’s medicines by the home following their death. One stated 9 days and one stated 7 days. Examination of records indicated that generally medicines are properly administered in accordance with the prescriber’s instructions. All staff responsible for the administration of medication were appropriately trained to do so. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 13 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. 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. The home provides some individual and group activities and opportunities, which includes links with relatives and family members and respect for individual preferences promoting a good quality of life for residents. EVIDENCE: Residents spoken with said they were happy with the lifestyle that living at the home afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. Activities included: • Extend • Bingo • Flower arranging • Cake making • Arts and crafts • Quiz Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 14 • Memory lane. Residents are able to attend church services if they wish. Visiting clergy are made welcome. There was evidence from residents and visitors that visitors are made welcome at any time and that they are able to spend time privately in residents rooms if wished. One visitor said, “They make visitors feel very welcome”. Most rooms viewed were personalised with pictures, some ornaments and items of furniture. At lunchtime residents were seen to be enjoying the meal of steak and mushroom pie and stewed apple and custard. Staff seen to be giving appropriate assistance to those who needed it and required more time to eat. One person said, “The food is very good.” Kitchen appeared clean and tidy, with all equipment in working order, however was seen to be left unattended for a short period of time whilst several hot foods were left cooking on the hob and kitchen knives were left on the side. The kitchen door to the main communal lounge was left open and there was a risk that people could have wandered in and injured themselves and as a result a requirement has been made under standard 38 in this report in relation to health and safety in the care home. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 15 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. 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. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. EVIDENCE: Residents said that they knew how to complain and felt confident that if they had concerns or complaints they will be listened to and taken seriously. No complaints had been received since the last inspection. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Care staff spoken with during the inspection confirmed that they had received such training and demonstrated a clear understanding of the home’s procedures. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment at Denewood House is good providing residents with an attractive, homely and safe place to live. EVIDENCE: The home has a programme of routine maintenance. Records show the equipment and facilities with the home are regularly serviced. Since the last inspection several areas in the home have been upgraded, including repainting the main corridors and some bedrooms. All communal areas inside and outside of the home are accessible to residents. The gardens were very attractive and had ample garden furniture for residents to sit out in the good weather. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 17 There were still some maintenance that could be undertaken to increase the safety and wellbeing for the people living at the home. This would include the provision of radiator covers to reduce the risk of scalds and burns to people in the home. Several of the en-suite bathrooms did not have toilet roll holders. Should a resident have to reach or turn to get toilet paper this could increase the risk of falls and subsequent injury. The home appeared clean and free from any unpleasant odours. The laundry was well managed and adequate supplies of clean linen were seen to be available. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 18 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. 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. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a good standard of care to the residents living at Denewood House. EVIDENCE: At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. Residents spoken with confirmed that staff were available when they needed them and they were not kept waiting, “Staff are very attentive.” The home has an ongoing training programme, which includes NVQ level 2 and 3 in care and at the time of inspection 25 of the care staff hold the minimum of a level 2 award in care. A further 6 members of staff were working towards this award. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 19 Three staff recruitment files were reviewed. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Training files demonstrated that staff were receiving induction training. Staff confirmed that they were encouraged them to take up training opportunities provided. Recent training including: • Fire safety • Moving and handling • Dementia care • Protection of vulnerable adults • Medication management • Mental health advocacy. Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the daily management and running of the home centres round the care of residents. Generally good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: At the time of inspection Mrs Caroline Bleach was the registered manager of the home. However she has appointed Ms Caroline Cooper to manage on a day-to-day basis. Ms Cooper is suitably experienced and qualified to manage Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 21 the home and had made significant improvements since taking up her post, which included better care documentation; staff supervision; recruitment and training of staff and quality assurance. Through discussion it was evident that residents, visitors and staff enjoy the way the home is run. Should they have any concerns they would be happy to talk to the manager, knowing that they would be listened to. The home has submitted an annual quality assurance assessment to the Commission for Social Care inspection, which indicated that steps were taken to review the way the home is run, taking in consideration the views of people living and working at the home. The manager and residents spoken with confirmed that residents either deal with their own finances or have a representative to do so. The home will hold a small amount of money for residents if they so wish. Records showed that staff are appropriately supervised and this was confirmed by staff spoken with during the inspection. Records showed that staff had received recent training in fire safety and manual handling updates. Staff spoken with confirmed this. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and analysed and appropriate action was taken as necessary. However the health and safety of residents was compromised in the kitchen area when, during a period of observation, it was noted that the area was left unattended for a short period of time whilst several hot foods were left cooking on the hob and kitchen knives were left on the side. Residents had access to the kitchen during this time. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 22 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 2 8 2 9 2 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(1) Requirement The registered person must, after consultation with the service user, or a representative of his, prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. (This must include all aspects of physical, psychological and social welfare and give accurate information to staff as to how needs are to be met.) The Registered Person must ensure that the home promotes and makes proper provision for the health and welfare of residents and ensure that the needs of residents are reviewed on a regular basis. The medication policy must be updated so that staff have clear procedures to follow on all aspects of handling medication. The Registered person must appoint an individual to manage the care home where there is no DS0000061333.V361914.R01.S.doc Timescale for action 08/08/08 2. OP8 12(1)(a) 08/08/08 4. OP9 13 08/08/08 5. OP31 8(1)(a) & 9 08/08/08 Denewood House Care Home Version 5.2 Page 24 registered manager in respect of the care home. (1)The Registered Manager must not manage the care home unless he is fit to do so. (2)(a) he is of integrity and good character; (b) having regard to the size of the care home, the statement of purpose, and the number and needs of the service users— (i) he has the qualifications, skills and experience necessary for managing the care home; and (ii) he is physically and mentally fit to manage the care home; and (c) full and satisfactory information is available in relation to him in respect of the following matters— the matters specified in paragraphs 1 to 5 and 7 of Schedule 2; The Registered Person must make proper provision for the health and welfare of the residents. This must include the provision of radiator covers to minimise the risk of burns and scalds. 6. OP38 12(1) 08/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 25 1. 2. OP28 OP38 A minimum of 50 of care assistants should hold the NVQ level 2 Award in care. The kitchen area should not be left unattended when there is a risk of residents wandering in and hurting themselves. Denewood House Care Home DS0000061333.V361914.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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