CARE HOMES FOR OLDER PEOPLE
Derwent House Ulverston Road Newbold Chesterfield Derbyshire S41 8EW Lead Inspector
Judith Beckett Unannounced Inspection 6th December 2005 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 Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 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. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Derwent House Address Ulverston Road Newbold Chesterfield Derbyshire S41 8EW 01246 347515 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) Derbyshire County Council Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th May 2005 Brief Description of the Service: The Home is situated in a busy residential area, close to local shops and services and on direct bus routes to Chesterfield town centre. The home is spread over 3 floors for up to 40 residents, all in single bedrooms, and with a lift to help access to the upper floors and a call system throughout the building in case of emergencies. There are assisted bathroom and toilet facilities on all floors and the home has several lounge areas on the ground floor, and smaller sitting areas on other floors. The home has a large garden that is easy to get into. A short stay respite service is available and a key worker system has been developed to help plan individual care with residents. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit which took place over 4 1/2 hours.37 residents were in the home. On arrival the acting manager was in supervision and the deputy manager was finishing off the morning drugs round. During the inspection documents were examined, as were care files and records. Time was also spent looking around the building. Residents and relatives were spoken to, also individual members of staff. Lunch was served during the visit staff were observed throughout the visit whilst looking after residents. Previous reports and documentation were examined before the inspection What the service does well: What has improved since the last inspection?
Five new members staff have been employed, this includes 27 hours for the activities organiser. Another one is to be appointed soon for a further 20 hours. The activities programme has been improved and a room has been allocated for activities. The care planning documentation has been updated which should result in improving overall safety of care. New furniture has been purchased and four metal bed frames have been replaced. The home is booked to have some redecoration after Christmas. A visit from the fire officer has been made which was satisfactory. The Home now has available, up-to-date written reports from the responsible individual, who visits on behalf of the provider.
Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 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. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 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 Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 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): These standards were not assessed on this occasion. EVIDENCE: Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. EVIDENCE: Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,15. Residents are given choice and helped to exercise control over their lives. They receive a balanced diet in pleasant surroundings. EVIDENCE: Following discussions with residents it was obvious that they have a choice of the time they get up in the morning and go to bed at night. They are given a choice of whether to join in activities and where they sit during the day. They are asked about their choice of food from the menu. The food served for lunch looked appetising and appealing. The menus appeared balanced and with a choice. A full cooked breakfast is available to all. The residents were highly satisfied with the food provided. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Staff have a good knowledge and understanding of Adult protection issues, EVIDENCE: The home has a clear complaints procedure. This is displayed in the hallway. There is a copy for each service user in an easy to read format in their service user guide. A record of all complaints or issues in the home are recorded. All the staff undertook an annual update of adult protection issues. The acting manager was aware of the correct procedures when asked. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26, Service users live in an environment, which is clean, homely and meets their needs. However, some aspects of the homes environment, particularly the exterior need attention in order to completely ensure safety and limit the deterioration of the building. EVIDENCE: All the residents spoken to were happy with how their room was looked after. The internal decoration was satisfactory and the home was seen to be clean and hygienic. The fire officer had visited recently and the report was satisfactory. Furniture throughout the building was domestic in style and in good condition. Four metal-framed beds had been replaced but six were still in use and require replacement. The exterior of the building requires urgent work. The woodwork paint on the windows is flaking and needs repainting, as do the fascia boards. The entrance door and kitchen door are indeed of redecoration also. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 13 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 Arrangements for staffing meet the minimum standard for a home of this size. Service users needs are met by appropriately trained staff. EVIDENCE: The duty rota was inspected and this indicated that there was always a minimum of three care staff on duty, plus a manager. This reaches the minimum standard agreed for the home but both residents and staff felt that sometimes this number was insufficient. It is therefore essential that dependency levels of residents are monitored carefully in order that extra staff can be allocated when it is deemed necessary. A new member of staff was spoken to and she indicated that she had completed her induction and Tops training, she stated that the home had excellent training opportunities and the staff had been very helpful in her induction. Most staff have now completed NVQ level 2 and one has completed NVQ level 3.One other member of staff is in the process of doing level 3. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 14 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. The Home is currently without a registered manager but has an acting manager in place .It is essential a registered manager is in post as soon as possible to establish leadership and remove uncertainty. EVIDENCE: The previous manager has left the homes employment, and an acting manager has been in place. Interviews have taken place to fill this position and hopefully in the New Year the new manager will commence duties. The person concerned must then apply to be the CSCI to be registered. Copies of the home’s service managers written reports, following regular visits were seen. The recording of resident’s finances and personal allowances were looked out these appeared to be satisfactory. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 15 The environmental health apartment had visited in January 05 and the report was satisfactory. A visit had taken place last week for random samples of food to be taken for analysis. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X 2 2 2 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 1 1 2 X 3 X X 3 Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 17 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 OP19 Regulation 23(2) Requirement External window frames must be repainted. Fascia boards, entrance door and kitchen door also. (Previous timescale of 30/09/04 not met). A programme for the replacement of the remaining six metal frame beds must be established. (Previous timescale of 30/11/04 not met). The registered person must appoint a manager for the home and that person must apply to register with the CSCI. Timescale for action 01/05/06 2. OP24 13(4) 01/05/06 3. OP31 8 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP11 Good Practice Recommendations The manager should ensure that the transition to new care planning systems is completed as soon as possible. The Home should consider ways of determining residents
DS0000035815.V275436.R01.S.doc Version 5.1 Page 18 Derwent House 3. OP33 wishes around funeral arrangements and record appropriately. Findings from any quality assurance and monitoring activities should be analysed and applied within the home. Derwent House DS0000035815.V275436.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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