Inspection on 13/07/06 for Dennyshill

This inspection was carried out on 13th July 2006.

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

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

Other inspections for this house

Dennyshill 11/05/09

Dennyshill 11/10/07

Dennyshill 15/03/06

Dennyshill 18/10/05

Dennyshill 11/03/05

Dennyshill 05/07/04

Dennyshill 15/03/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOMES FOR OLDER PEOPLE Dennyshill Glenthorne Road Duryard Exeter Devon EX4 4QU Lead Inspector Louise Delacroix Unannounced Inspection 9.50 13 July and 8 August 2006 th th 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 Dennyshill DS0000021926.V296095.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. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dennyshill Address Glenthorne Road Duryard Exeter Devon EX4 4QU 01392 259170 NO 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) Mrs Tracey Victoria Anne Hibberd Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (9), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (9), Physical disability (9), Physical disability over 65 years of age (9) Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Main client group MH (E) mental handicap who are elderly Client group MH mental handicap (learning disability) [40 years and over] Client group MH (PH) mental handicap with physical disability [40 years and over] 15th March 2006 Date of last inspection Brief Description of the Service: Dennyshill is situated in a quiet area of Exeter, close to the university. Nine older people with a learning disability live at the home. All accommodation is provided on one level. There are two double rooms and five single bedrooms. There is one bathroom with a level entry shower and a bath, which is not assisted. The manager/owner lives on site. The cost of the service is £340 per week, with additional changes for hairdressing, chiropody, transport at 40p per mile per resident, toiletries and clothes. The statement of purpose/service user guide has been stored in the office but the manager has decided to display it by the visitors’ book. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days as on the first day the key for the safe was not available and the residents’ finances could not be checked. On the first day of the inspection, eight people were living at the home with two members of staff on duty. On the second day of inspection, nine people were living at the home. The manager also provided extra ‘hands on’ support at key periods throughout the day; for example, providing transport for day care. Three members of staff and the owner contributed to the inspection, as did five of the residents out of the eight residents that were met. This report also includes feedback from comment cards received from general practitioners and health and social care professionals. Surveys were also received from the majority of the staff group and two residents. As part of the inspection, three people were case tracked; this means that two residents were asked about their experience of living at the home, their rooms were visited and the records linked to their care and stay inspected. One resident was unable to give their views. During the inspection, a tour of the building took place and records including fire, care plans, medication, and safety checks were looked at. An immediate requirement was made during the inspection to ensure that cleaning products i.e. washing powder, disinfectant and cleaning sprays are stored appropriately to ensure the safety of residents. On the second day of inspection, cleaning products were safely stored in a locked cupboard. What the service does well: The home strongly encourages prospective residents to visit before moving in and the manager also visits people prior to them moving in and completes an assessment once they have moved to the home. The information that is provided about the home is written in a friendly and informative style. Staff demonstrate a caring attitude, and recognise the individual communication needs of residents. One GP wrote in response to a survey that, ‘Dennyshill provides the warm atmosphere of a caring home and a high standard of care’. The staff team are stable and the manager and her staff team show a commitment to the residents to meet their changing care needs. This includes buying equipment to enable them to stay living at the home. Medication is generally well managed. Contact with friends and relatives is actively encouraged, which includes providing transport to enable residents to visit friends and family. Staff show a Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 6 good knowledge of the individual needs of residents and help promote choice in their day-to-day lives. The care is homely and provides a comfortable environment for residents with level access throughout. A social care professional wrote that they found the home clean and friendly. The manager has invested in specialist equipment. There is a stable staff group, who have received recent training in first aid, food hygiene and moving and handling. The home is well run and staff are well supported. Safety checks looked at during the inspection were up to date. What has improved since the last inspection? What they could do better: Recommendations have been made to improve practice in the home in the following areas. Currently prospective residents are provided with information about the home and how to make a complaint but not necessarily in a format that is accessible to them. Initial assessments of prospective residents are not currently recorded so the home cannot demonstrate that they ensured they could meet the person’s needs. The home should ensure that it has local guidance around adult protection issues. All radiators should be covered to help protect residents, and key policies should have further information added to them to make them working documents for staff. Four requirements have been made in the following areas for changes in practice that must be made. Care plans still require further work to ensure that risk assessments and moving and handling plans reflect the needs of the residents. One area of medication storage must be improved to ensure safety. Hand washing facilities must be improved to help prevent cross infection, and staff need to undergo training in infection control. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 7 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. Dennyshill DS0000021926.V296095.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 Dennyshill DS0000021926.V296095.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a statement of purpose, which sets out the details of the service offered in a clear style. The service user guide is not written in a style accessible to current and prospective residents, which could prevent them making an informed choice about the home. However, visits are actively encouraged to enable prospective residents to make a decision about moving to the home. Information is gathered by the home about the needs of prospective residents, which help them ensure that their experienced staff group can meet their needs. EVIDENCE: The statement of purpose is well written in a friendly informative style. However, the service user guide is not written in a style accessible to the client group. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 10 The manager obtained assessments from Social Services for a new resident, and information from the resident’s previous home, which were seen on file and is good practice. The majority of staff have worked with most of the residents for many years and those observed during the inspection showed a good knowledge of their needs. The staff were seen to be interacting appropriately with residents, and understanding their individual communication methods. One resident felt that not all staff understood them well, but identified two staff members who did. Staff and the manager explained how they had visited a prospective resident in their own home, and that the resident had visited twice before moving in, which again is good practice. Two residents said they had received enough information about the home before they moved. This practice is also promoted in the statement of purpose. However, these visits and resulting information has not been recorded. The home does not offer intermediate care. Dennyshill DS0000021926.V296095.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the health and personal care needs of residents, which is generally well documented in care plans, and provide care in a caring and individual manner to meet residents’ changing needs. A minor improvement is needed to promote safe medication practice. EVIDENCE: Three care plans were looked at and these residents were met. The manager and staff have worked to continue the improvement in care planning, ensuring that essential information is available to guide staff when delivering care. Goals have been set for maintaining good health. All staff who contributed to the inspection had a good knowledge and understanding of residents’ individual needs and preferences, which was confirmed with residents. It was appreciated that it is difficult for all residents to be involved in the care planning process but the home has made positive steps towards this previous Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 12 requirement. Where this is not possible, a relative or advocates are being involved. Risk assessments were generally good but when discussed with the manager there appeared to be conflicting views over some information. For example, residents being at risk of leaving the building and the action to be taken by staff. A manual handing assessment for one resident was looked at in detail; it did not contain guidance to manage the actions of this resident and did not address the risks identified by staff and the manager during the inspection, and recorded in daily notes. Three GPs and two health and social care professionals wrote in their surveys that there is always a senior member of staff to confer with and that staff demonstrate a clear understanding of the care needs of service users. One GP wrote, ‘I am extremely impressed with the level of care delivered at Dennyshill. Staff are consistently caring, helpful and very sensitive to patients’ needs. One resident has been cared for in bed for a number of years and looked well cared for and records show that a district nurse visits them regularly. Staff said they were well supported by health services. Clear records are kept regarding the contact with health professionals and the advice given. Discussion with the manager shows that the mental health needs of residents, as well their physical health needs are recognised and residents are supported to attend appointments outside of the home. Two residents said in their surveys that they always had access to medical care. Medication training is up to date and the records show good practice. A staff member was clear about what steps to take regarding homely medicines and could discuss the side effects of drugs. GPs and health and social care professionals confirmed in their surveys that the residents’ medication is appropriately managed. A discussion took place about a prescribed drug and how it is stored. It was confirmed after the first day of inspection that storage arrangements must conform to those for a controlled drug for this particular prescription. The registered manager and a member of staff could give examples when the GP would be called. For example, if a change of medication might be linked to a negative change in the service user’s well-being. During the inspection, residents’ dignity was observed as being respected and residents were dressed appropriately. The home’s statement of purpose stresses that there is no communal wardrobe and this was further evidenced by the minutes from a residents’ meeting with residents being asked about what clothes they wished to buy and the colours they wanted and style. In their conversation with residents, staff were affectionate and responded in a humorous manner, while also respecting residents as individuals. Residents were gently reminded about inappropriate behaviour or comments and an explanation given. However, on two occasions a resident was described as ‘naughty’, which is inappropriate as it infantilises residents and does not acknowledge the possible reasons behind the behaviour. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 13 The committed staff group strive to enable residents to remain at the home until their death. Residents spoke about the loss they felt since the death of a resident, and staff were sensitive to this. Staff support residents to attend funerals if they wish to, and funeral wakes are held at the home, if relatives wish this to happen. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 14 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. Contact with families and friends is actively encouraged and supported, as are social groups. Residents are encouraged to maintain their independence and exercise choice in their daily lives. Residents enjoy the food, and the home endeavours to ensure individual preferences and needs are met. EVIDENCE: One resident spoke about how much they enjoyed attending a social club several times a week and another person attends a Mother’s Union group. A resident went out for the day to a social group during the inspection but was too tired afterwards to contribute to the inspection. Residents said they were also supported to go and stay with friends/family by the home providing transport, which includes travelling long distances. One resident said they did not go out much but did not seem unhappy with this arrangement. Their records showed they had been out to the beach in the last Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 15 fortnight, which they confirmed, and mileage records show that trips out take place approximately once a week. Two residents said that the television was on throughout the day but were happy with this arrangement. The home has a large selection of videos and two residents spoke about their favourites and their loves of the ‘soaps’. They also said they liked to knit. One resident said they liked to sit outside, and another said they liked to sit by the window and watch the birds. Some residents confirmed during conversation that they were visited by friends/family, which was confirmed by the visitors’ book and by staff. In a written response, a resident said that there are sometimes activities arranged by the home that they could take part in. Another resident was less clear about what they did and their daily records did not record activities. The manager said that as some residents’ care needs had increased it was becoming more difficult to go out on trips and was concerned about the impact on others. A visiting health professional wrote in their survey that ‘I am always made very welcome and given relevant information regarding individual clients’. Another visitor said, ‘as always staff very welcoming and friendly. Cup of tea always offered on arrival and today a fresh cream cake’. Another visitor wrote, ‘always very warmly welcomed by everyone’. Staff were observed recognising the individual needs of residents through their interactions by providing verbal and physical reassurance to meet the emotional needs of people living at the home. A visiting health professional wrote in their survey that ‘the clients’ needs are met to a very high individual standard’. Another wrote there is ‘responsive and interactive staff’ and staff who are ‘in touch with service users’ needs’. One resident talked about their bedroom, which is in the process of being redecorated. They said that they would be getting a new bed and expressed their views on the colour scheme to a member of staff who then shared this with the manager. The resident was positive about the changes being made. A resident was described as being ‘fiercely independent’, and staff were seen respecting this strength of character during the inspection, whilst also making sure that the resident knew they were available to help. Another resident said they chose where to sit because it was comfortable and another person said they loved to sit outside. One person said they liked having two showers a week, but would also love a bath. Staff had said that all residents were happy with the shower and that the bath was not used. The manager said that they would check again with all the residents about their preferred choice and ensure that they have a bath if this is their choice. The dining area is attractively decorated and furnished in a bright, light room with views onto the decking. Since the last inspection, residents have been asked about their likes and dislikes for food and staff showed awareness of Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 16 their individual preferences. Three residents who were asked were positive about the food, as was a fourth person who sent in a written response who said they always liked the food. A fifth person said they sometimes liked the food. Residents were seen being encouraged to drink throughout the day, which is good practice especially in the hot weather. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. Minor improvements to the complaints policy and guidance for staff would help ensure all residents have access to the complaints procedure and provide more robust protection for residents. EVIDENCE: The manager has confirmed in their pre-inspection questionnaire that the home has not received any complaints in the last twelve months. None have been received by CSCI. Five GPs and social and health care professionals said that they had not received any complaints about the home. Residents appeared relaxed with staff and generally able to express their views. One person said they would turn to people outside of the home if they wanted to make a complaint. There is a clear complaints policy in the service user guide but is not in a format accessible to residents. Staff have now attended the protection of vulnerable adult training provided by Devon County Council, and the manager explained how they discussed reported cases of abuse in the Press as a staff team, which was evident in staff discussion. The home does not have a copy of the multi-agency document for the protection of vulnerable adults. This contains important local information and promotes good practice and the role of the alerter. The home’s policy on this area of care also lacks local contact information. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 18 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): 19,21,22,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing the residents with a homely place to live, which contains aids and equipment, which generally promotes their independence. Further attention to safety measures would help improve the safety of residents. The home is clean and odour free and staff are hygiene conscious. However, current hand washing facilities compromise infection control and have the potential to put residents at risk. EVIDENCE: Dennyshill provides a homely and comfortable environment for residents; there is a communal sitting room and a dining area in the kitchen. The home has level access throughout and an accessible doorway can be used to reach the outdoor decking area for people using wheelchairs or frames. The decking area is attractively decorated by tubs of flowers, which residents appreciated. One resident was seen enjoying the sun during the inspection. Since the last Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 19 inspection most bedrooms have been recarpeted, and residents commented positively on their new curtains and bed linen. One bedroom has an en-suite toilet. There is a communal toilet, which is accessible to residents using a frame, and a communal bathroom with a toilet. The communal bathroom has a bath, which is not assisted, and a walk in shower. All the bedrooms have a sink. The home has some specialist equipment including a hoist, walking aids, wheelchairs, grab rails and the manager has recently invested in a pressure relieving electric adjustable bed in order to meet the long-term care needs of residents. Another resident is also being cared for in a pressure-relieving bed with bed rails. There are several falls logged in the accident book and in the daily records of a resident. Only one bedroom has a protected radiator but other rooms lack protective covers, which could compromise the safety of residents, especially those people who fall regularly. The hot water regulator was being checked at the time of the inspection. The manager confirmed that windows with a steep drop below them have been restricted. The home was clean and smelt fresh throughout and residents confirmed this was always the case. A small laundry room off the hallway has the necessary equipment to meet the requirements of the residents’ laundry. Two staff spoken with were aware of the principles of good infection control and knew how to deal with soiled linen. Staff also explained that the necessary equipment for protection was available, for example disposable gloves and aprons. Staff were seen washing their hands throughout the inspection and were conscientious about hygiene. However, the environment does not help them prevent possible cross infection. For example, the staff toilet does not have a sink and the staff have to walk through the hall to use a hand-washing sink at the opposite end of the kitchen. This sink does have liquid soap close by but only a fabric towel for staff to dry their hands on. The communal bathroom had a bar of soap and a fabric towel and the communal residents’ toilet had no liquid soap or hand drying facility. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 20 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. Residents benefit from a skilled and friendly staff group who have a good understanding of their needs, and who have undertaken training in key areas of care. The procedures for staff recruitment now promote the safety of residents. EVIDENCE: There were suitable levels of staffing on the day of the inspection and these reflected the duty rota. Two staff members were on duty in the morning, afternoon and early evening. There are sleep–in night staff; one based in the home and the second in the adjoining building. This person can be alerted through the home’s call bell system. The manager is included on the duty rota to provide hands-on care, but also provides extra cover when needed, as well carrying out her managerial duties. This was the case on the day of inspection. At the moment, she explained that she was providing extra cover because of the increased care needs of one of the residents. Two residents said that staff were always available when they needed them. The pre-inspection questionnaire states that two members of staff out of seven staff have an NVQ 2 or above, which is below the recommended minimum of Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 21 fifty percent. However, the manager said that two members of staff have recently enrolled for NVQ training. There have been no changes to the staff group since the last inspection, and the requirement made on the last inspection for staff records has now been met. The residents’ benefit from the home maintaining a stable and committed staff group. Staff training records were looked at, which demonstrated that staff are up to date in moving and handling, first aid and medication training. One staff member felt that the moving and handling training had made a positive impact on the staff group by promoting the use of appropriate equipment. Three staff said they had received induction and training. The manager said that infection control training had been booked for last November but had been cancelled by the training company. The care staff do not hold any specialist training in working with people with learning disabilities but between them have many years of experience in working with this client group. One resident has been diagnosed with dementia, an illness which the manager confirmed has not been covered by training; she was open to undertaking a course in this area of care. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 22 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. The home is well run by a supportive manager. Residents’ finances are safeguarded and they are involved in how the service is delivered. Safety checks are in place but currently inadequate storage of cleaning products has the potential to put residents at risk. EVIDENCE: The registered manager has a number of years experience of managing a care home for people with a learning disability, and clearly knows the residents well. She has completed a national vocational qualification in care (NVQ 3) and confirmed that she has a City & Guilds management qualification. She has a ‘hands on’ approach and works as a member of the team regularly throughout the week. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 23 A visiting health professional wrote in their survey that the home is ‘a good well run home’, and three GPs said that the management/staff take appropriate decisions when they can no longer manage the care needs of a service user and this was evidenced in discussion during the inspection. Staff responded in their surveys that ‘Tracey is an absolutely wonderful employer, really exceptional and is totally dedicated to both her staff and residents’ welfare’, and ‘I am extremely fortunate to work for and alongside, Tracey’. During in the inspection, staff said the manager was approachable, and could be seen in private if this was needed. All four staff who returned surveys said that they were well supported, and received supervision. Since the last inspection, the manager has promoted quality assurance within the home through staff meetings, a residents’ meeting as evidenced by minutes, questionnaires about the service which have been collated and sent to CSCI, and through informal on-going consultation as listed in the statement of purpose, and evidenced through discussion with staff and residents. The manager is currently appointee for most of the residents. Finances are well managed and recorded with double signatures and receipts kept. Records can be easily audited, and two residents balances were checked and found to match the records. The manager is going to look into bank accounts for people to enable them to gain interest on their savings. A member of staff on duty demonstrated a positive attitude towards the home’s policies and the way they influenced and reflected day-to-day practice. This was not the case with all staff, who did not recognise the value or need for some changes to practice within the home. A comment from a staff member’s survey states that, ‘Dennyshill has always prided itself on being a homely caring home and with all the paperwork now it is becoming more difficult’. The manager has acknowledged that the home is working hard towards meeting national minimum standards and a changed way of working with regards to recording care. Three key policies were looked at for moving and handling, protection of vulnerable adults and fire. All were written in an accessible format but needed extra information added to make them more informative. Fire records were looked at during the inspection; these were all up to date and showed that staff had received training from an external trainer and inhouse on a regular basis. The hoists have been serviced and portable electrical appliance testing is up to date. The bed rail which is fitted to one resident’s bed is inspected monthly and accident reports were appropriately completed. However, on the day of the inspection an immediate requirement was made because cleaning chemicals, including a large bottle of disinfectant were left on Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 24 display and not securely stored. This had been rectified by the second day of inspection when cleaning products were seen to be securely locked away. Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 25 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 2 X 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 17 X 18 2 3 X 3 3 X X 2 1 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 1 Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 26 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 (2) (b) Requirement Timescale for action 30/08/06 2. OP9 13 (2) The registered person shall keep the residents’ plans under review. (Risk assessments must be improved to ensure that they are accurate, and provide guidelines to manage the moving and handling needs of residents, and provide strategies to manage the psychological needs of residents, which may help prevent risks.) This is a repeated requirement from the last inspection. The timescale of 12/4/06 has not been met. The registered person shall make 28/07/06 suitable arrangements for the safekeeping of medicines received into the home. (The home must provide a metal cupboard, which complies with the Misuse of Drugs (Safe Custody) Regulations 1999 and keep the required records when appropriate). Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 27 3. OP26 13 (3) 4. OP30 18 (1) (c) The registered person shall make 15/08/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. (The home must provide handwashing/ handcleansing facilities in the staff toilet. Paper towels and liquid soap must be also be provided in other identified areas). The registered person shall 30/10/06 ensure that the persons employed to work at the care home receive training appropriate to the work they perform. (All staff must complete infection control training) 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. 4. Refer to Standard OP1 OP5 OP16 OP18 Good Practice Recommendations The service user guide should be written in a style that is appropriate for the client group. Specialist advice should be sought, if necessary. The home should record visits to and from prospective residents, including the information gathered from these visits. The complaints policy should be written in a style that is appropriate for the client group. Specialist advice should be sought, if necessary. The home should purchase the local Alerter’s Guide and additional information should be added to the home’s POVA policy i.e. police, social services and CSCI contact details, plus the local POVA teams contact details. It is strongly recommended that all radiators should be covered to promote the safety of residents. 5. OP25 Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dennyshill DS0000021926.V296095.R01.S.doc Version 5.2 Page 29 - 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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