Inspection on 26/07/06 for Dentholme

This inspection was carried out on 26th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dentholme 18/11/08

Dentholme 06/03/06

Dentholme 14/09/05

Dentholme 16/11/04

Dentholme 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Dentholme Cragg Road Cleator Moor Cumbria CA25 5PR Lead Inspector Liz Kelley Unannounced Inspection 26th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dentholme DS0000034982.V297850.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. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dentholme Address Cragg Road Cleator Moor Cumbria CA25 5PR 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) 01946 810831 www.cumbriacare.org.uk Cumbria Care Mrs Mary Catherine Watters Care Home 38 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (26), Old age, not falling within any other of places category (38) Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service must at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commission. A maximum of thirty eight older people (OP38) of whom 26 have dementia may be accommodated (DE(E)26) The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults by 1st April 2004. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. One named person under 65 years of age with dementia may be accommodated (DE1). 5. Date of last inspection 6th March 2006 Brief Description of the Service: Dentholme is a care home operated by Cumbria Care, an internal business unit of Cumbria County Council. The home is registered to provide personal and social care for up to 38 older people, 26 of who may have varying forms of dementia, one being under 65 years of age. The registered manager is Mrs Catherine Watters. The home is situated in the middle of a housing estate close to the centre of Cleator Moor and all its amenities. Dentholme is purpose built on two floors, the upper being serviced by a passenger lift. Accommodation for residents is in four units, each with its own sitting and dining areas and kitchenette. There are thirty-eight single bedrooms, four of which have ensuite facilities. There are accessible toilet and bathing facilities close to all the accommodation used by residents. There is a large room on the ground floor that can be used for activities, visiting entertainers and parties. This room is also used as a venue for Cumbria Care internal training courses. There is a garden area, which is accessible to all residents and is used by them in the summer months. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection where all the key standards were examined and included a full days visit to the home. In the month previous to the visit feedback cards had been sent out to service users, relatives and professionals to gain their views on the Home. The manager was on holiday, however a relief supervisor and staff were interviewed as part of the inspection. The home had returned a questionnaire which included the latest details of the service. Time was spent with residents and relatives in each of the units, and a tour of the building was undertaken. What the service does well: What has improved since the last inspection? Recent improvements have included re-decoration and refurbishment of some bedrooms. All the homes units have recently had new kitchens, and residents expressed how much nicer these were, some are dresser style for displaying ornaments. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dentholme DS0000034982.V297850.R01.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 Dentholme DS0000034982.V297850.R01.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): 2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has robust and well-established procedures in place to introduce new residents and this results in a high number of successful placements. EVIDENCE: Admissions are not made to the home until full needs assessment has been undertaken. Files contain relevant paperwork, including social work assessments and reports from health care professionals prior to a person choosing to stay at the home. The manager also carries out an assessment which includes visits to see the person in their own home or while in hospital. One resident described the introduction, which included a series of visits to the home prior to making a decision. Each resident is provided with a statement of terms and conditions prior to moving to the home. This sets out in detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the resident. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 9 These measures ensure that admissions to the home only take place if the service is confident staff have the skills and ability and qualifications to meet the assessed needs of the prospective resident. This results in placements to the home being appropriate and successful. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 10 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, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Dentholme provides a high standard of care which meets the needs of the residents living there. Staff are knowledgeable and skilled in meeting these needs. The medication at this home is well managed promoting good health. EVIDENCE: A District Nurse who visits the home stated that she, and the other nurses at the practice, were very happy with the Homes ability to manage the health care of residents. She reported a good working relationship with the home with identification of problems at any early stage and staff being good at following instructions. Medications in the home are well managed, with each unit having its own medicine trolley. These were examined and found to be well ordered and medication charts seen were accurate. The policy of having a second person to check on medications has proved beneficial, and the home has a good track record of accuracy in dispensing medications. An annual check is carried out by Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 11 the dispensing pharmacist. Dispensing is only carried out by seniors and the manager. Staff have received training in the care and dispensing of medications and this was an area well managed by the home. Staff were seen delivering care in a sensitive and respectful manner by: addressing service-users by their preferred name; knocking on doors and enabling residents to maintain as much independence as possible. For example for residents who chose to spend a lot of time in their rooms the home had helped to make these rooms feel like bed-sits, whilst also encouraging interaction with others in the Home. Positive and supportive relationships have been formed between staff and residents leading to a caring, friendly atmosphere. The home should develop its Pen Pictures and the background details of a person prior to living at the home to further promote a persons quality of life and to strengthen care plans. This is particularly good practice in the care of people with dementia and leads to a more person centred approach. Care plans are of a good standard and ensure that each person receives the care they need to be healthy and safe whilst promoting privacy and dignity. These plans show a clear link between a care need and the task to be carried out by the carer. Residents as a consequence were confident that their needs could be met and looked well cared for. The home should consider carrying out a more detailed assessment of nutritional need, to the same depth and quality that they already do with moving and handling assessments. Again this will further strengthen care plans and ensure that healthcare needs are promoted to the latest best practice guidelines. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 12 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): All the above standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good links and relationships have been developed with the local community and with relatives which supports and enriches residents’ social and leisure time. EVIDENCE: The Home endeavours to offer activities that interest and stimulates residents. For example twice per week formal activity sessions such as quizzes, bingo and gentle exercise. The open and warm atmosphere of the Home promotes and encourages visitors to the Home, and residents said they appreciated that their visitors were given such a warm welcome. Discussion with the cook and examination of menus demonstrated that meals were of a good nutritional quality, varied and home cooked. Service users stated that the meals were very good and they had plenty of choice. A menu board is displayed in each of the three lounges with the weekly menu. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a clear complaints procedure and residents and their families know action will be taken to resolve their concerns. Staff have a good knowledge and understanding of Adult Protection issues which safeguards residents from abuse. EVIDENCE: The home has a satisfactory complaints system with evidence of service users able to express their views on the home, and these being acted upon. All service users spoken to felt that they could speak up if they had any concerns or worries. Service users were observed freely expressing opinions to staff and other ways of expressing views more formally via the complainants procedure were seen. The open atmosphere created within the home ensures that service users feel free to express their opinions and are confident that they will be listened to and concerns acted upon. The home had the latest guidance on the local multi-disciplinary procedures for reporting abuse. Adult protection is an area covered in all staff induction programmes, and when spoken to staff had a good awareness in this area. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Dentholme provides a safe, clean and comfortable environment for residents to live in. EVIDENCE: Recent improvements have included re-decoration and refurbishment of some bedrooms. All the homes units have recently had new kitchens, and residents expressed how much nicer these were, some are dresser style for displaying ornaments. The home has a good amount of communal space both inside and outside. A separate smoking lounge is provided, as well as an additional large lounge for the whole of the home to get together. Each unit has its own lounge area which is pleasantly furnished. The manager is aware of the areas which require upgrading has developed an action plan, these are namely the lounge carpet in one unit, and the replacement of more of the old style commodes. Dentholme DS0000034982.V297850.R01.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment practices of the home ensure that service users are safeguarded and that staff have the qualities and aptitudes to work in social care. Staffing levels within the home are sufficient to meet the needs of residents. EVIDENCE: There were seven members of care staff, a supervisor, domestic, cook and a kitchen assistant on duty during the inspection to care for 38 residents. These staff were able to attend to peoples needs, keep the home clean and provide meals and snacks throughout the day. Residents said the care staff were helpful, kind and friendly, and that they didn’t have to wait too long when needing help with anything. The selection procedure includes obtaining two written references, a formal interview and an informal interview involving service users, wherever possible. All staff had enhanced CRB disclosure checks. Upon appointment staff are issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. Staff are also issued with the General Social Skills Council’s code of conduct handbook. These are all good practices and ensure that service users are supported by a carefully selected and vetted staff team. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 16 The home continues to demonstrate a commitment to providing staff with a thorough training programme. Since the last inspection staff have had training in Dementia care, and care of the terminally ill, as well as updates in areas such as moving and handling, medications and infection control. Training is arranged in response to the changing needs of service users. This ensures that Dentholme has a competent and well-trained workforce with a good mix of skill, experience and age. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Dentholme is well managed and residents’ interests, safety and welfare are protected. EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. Care staff reported that they received good support from senior staff and had regular supervision to discuss their role and personal development. This all leads to a stable and consistent service for people living in the home, which in dementia care is particularly important. The Home operates to Cumbria Cares Quality Assurance standards that includes physical aspects of running the Home as well as monitoring the Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 18 delivery of service. The provider, Cumbria Care carries out regulation 26 monitoring visits and sends a copy of these into the Commission for Social Care Inspection. The home has effective systems in place to ensure the safety and up keep of the physical environment, such as cleaning rotas and maintenance records. Fire Records, annual gas and electrical checks, and servicing of hoists were checked and these were all up-to-date. The financial interests of service users living at the home are safeguarded by the systems in place. Effective quality monitoring systems are in place to ensure a high standard of service is delivered to service users. The manager ensures that service users control their own money wherever possible, and if not then relatives assist with these tasks. The home does not act as appointee for anyone living in the home. Secure facilities are provided for the safe-keeping of money and valuables both in service users own rooms and on behalf of service users. The administrative systems within the home were found to be up-to-date and in good order, the manager is supported by an administration assistant, ensuring the home is run in an efficient and effective manner. Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 x x x x x x 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 x x 3 3 3 x 3 Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 OP8 Good Practice Recommendations Nutritional screening should be undertaken on admission and subsequently on a periodic basis, using a recognised nutritional screening tool, and appropriate action taken and recorded. The home should develop Pen Pictures and the background details of a person prior to living at the home to further promote a persons quality of life. 2 OP7 Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Dentholme DS0000034982.V297850.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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