Inspection on 16/08/05 for Dewdown House

This inspection was carried out on 16th August 2005.

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

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

Other inspections for this house

Dewdown House 25/01/07

Dewdown House 08/03/06

Dewdown House 16/02/05

Dewdown House 25/06/04

Dewdown House 10/02/04

Dewdown House 27/08/03

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Dewdown House 64 Beach Road Weston Super Mare North Somerset BS23 4BE Lead Inspector Juanita Glass Announced 16 August, 2005 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 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. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dewdown House Address 64 Beach Road, Weston Super Mare, North Somerset, BS23 4BE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01934 417125 01934 631064 Salvation Army Social Services Major Stephen Karl Symonds Personal care home only 40 Category(ies) of Old age (40) registration, with number of places Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16th February 2005 Brief Description of the Service: Dewdown House is a purpose built home, situated near the sea front of Weston-Super-Mare. The home proviodes non-nursing care for forty people aged 65 years and over. The home is close to local amenities and staff assist residents to maintain links with the local community. The accommodation is in single rooms over three floors, there is a lift providing access to all floors. The home maintains a Christian ethos. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and took place over 7 hours in the presence of the manager Major S Symonds. Ten comment cards were received from residents all of which praised the service and care provided, some of these comments included, ‘I could not wish to be anywhere else,’ ‘I’m over the moon with living here at Dewdown I could not wish for more,’ and ‘ an all round perfectly run home, food an excellent choice and well served.’ One GP comment card stated that, ‘ this is an excellent care home. They are well staffed, very caring and communicate appropriately with the surgery…’ Residents and visitors spoken to on the day of the inspection echoed the comments received. What the service does well: What has improved since the last inspection? What they could do better: Preadmission assessments need to contain more information than core care scores. The manager must obtain a POVA 1st confirmation before employing new staff. Identified areas in the home are in need of redecoration following the maintenance work carried out earlier this year. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 6 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. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 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 standard(s) 1, 3 and 5, standard 6 does not apply The home provides adequate information for relatives and residents to make an informed choice before taking up residence. A full preadmission assessment is carried out prior to admission, and a visit to the home can be arranged. EVIDENCE: The statement of purpose has been revised and a copy forwarded to the CSCI it contains all the required information. The service user guide is very clear and concise, it has been produced in large print and contains graphics and pictures, this was commended in the last report, copies are made available in each room and residents spoken to said that they all had a copy and found it helpful when first arriving at the home. All care records examined contained preadmission assessments, although important details were not omitted, it was discussed with the manager that the records could contain additional information, rather than the scoring system used. All residents had been offered the chance to visit the home although it is usually a relative who takes up this offer. The first four weeks is treated as a Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 9 trial period for the home and resident to be sure that their needs are being met. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Resident’s personal, social care and health needs are fully met. The homes policies and procedures for the administration of medication meet current requirements. Residents are treated with respect and their rights to privacy are upheld. EVIDENCE: Records reviewed provided very clear guidance for staff enabling them to meet the assessed needs of the residents, a key worker system is used and some residents spoken to were aware of the role of their key worker and who they were. Care records showed evidence of resident involvement in agreeing boundaries of care, and regular review. The home enables residents to access healthcare services appropriate to their needs and evidence was seen of appointments with Chiropodist, Dentist, Optician and Out Patient Clinics; District Nurse input is sought when necessary. A GP comment card stated that the staff communicate well with the surgery. Residents and visitors spoken to said that they received the support they required to see any other health professional, they also stated that staff were always polite and respected their privacy, it was noted that one residents door had a note stating staff and relatives only, this was at the residents request and was respected by staff, all Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 11 staff on duty were observed to knock on doors and talk to residents in an appropriate manner. The home has a very clear policy and procedure for the storage and administration of medication, staff were observed to administer medication in the correct manner and showed an awareness of the medication they were using. Following a random audit of medication in the home no errors were found. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15 Residents are offered a range of meaningful activities and links with their church and local community are maintained. There are no restrictions on visiting. Residents receive a wholesome appealing and balanced diet. EVIDENCE: Activities are carried out daily by an allocated carer for that day; these include board games, book club, quizzes and puzzles, flexicise, library and regular organised trips out. During the afternoon several residents were enjoying a book club event whilst a carer read to them. The home holds morning prayers daily and transport is provided on Sundays to take residents to Church, Chapel or Citadel. Residents spoken to said they felt they had adequate activities although one lady said ‘you can’t please everybody all the time,’ they were especially pleased that they could maintain their worship. Visitors spoken to said that they had not experienced any restrictions on visiting and were very grateful for the facilities on each floor to make a tea/coffee or small snack, the manager said they were currently risk assessing the provision of toasters in the kitchenettes. The home has a four weekly menu which is displayed in the dining room and residents make their choice at the appropriate mealtime so are not expected to remember a choice made earlier in the day. Resident’s comments on the food provided in the home were all complementary, they were very clear about the Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 13 good standard of food provided and the way in which it was presented. One resident repeated comments he had made at the last inspection, that his reason for selecting the home when he visited was the way in which the dining room was laid up with coordinating tablecloths and napkins. The menus observed showed that residents are offered a choice of nutritious and wholesome meals. The kitchen is clean and tidy and food was stored appropriately. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16 and 18 The home has a clear and robust complaints procedure. The homes policies and procedures protect residents from abuse. EVIDENCE: The home has a robust complaints procedure, which outlines the process to follow, and directs residents or relatives to the Commission for Social Care Inspection if they are not satisfied with the outcome. The complaints book was available for inspection and up-to-date. It was possible when reading the complaints book to follow the course of a complaint from the beginning to it being resolved and the eventual outcome. Residents and visitors spoken to the said that they felt at ease talking to the manager with any concerns, and felt any comments they made were listened to. The home has a very clear policy for the protection of vulnerable adults and elder abuse, and a clear whistle blowing policy. The No Secrets in Somerset folder, outlining the North Somerset policy and procedure for the Protection of Vulnerable Adults, was available for staff in the office. Staff spoken to knew where they could access the information and were aware of the policies and procedures to follow. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 20, 23, 24 and 26 Residents live in a safe well-maintained environment although some areas are in need of the decoration. Residents have access to comfortable indoor and outdoor communal facilities. All residents have private rooms, which suit their needs. The home is clean, pleasant and hygienic. EVIDENCE: All areas in Dewdown House are accessible to wheelchair users, one service user advises the home on the needs of those in wheelchairs. Extensive refurbishment has been carried out over the last year providing specialist amenities for disabled residents and visitors. A well-equipped disabled toilet has been provided in the entrance lobby, and the fire alarm system has been updated to be more accessible to residents with sensory impairments. Red flashing lights are in each room for residents with a visual impairment, and a vibrating pillow can be used for residents with a hearing impairment. Residents spoken to said that the rooms are adequate to meet their needs and it was evident in most of the rooms visited that residents are surrounded by Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 16 personal possessions and their own Furniture. Communal areas were all in use during the inspection including the small paved garden. Residents attending the book club were using one lounge during the afternoon. The dining room is spacious and is next to the kitchen with a serving hatch, the tables are laid on a daily basis with matching napkins and tablecloths. The home was clean and tidy and well maintained, however it was noted that some areas were in need of redecoration due to maintenance work carried out earlier in the year. A few residents commented on patches in the wallpaper, which had been left when the old appliances/switches had been removed. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The numbers and skill mix of staff on duty are appropriate to meet the needs of the residents. The homes recruitment policies and practices do not meet current requirements. Staff are trained and competent to do their jobs. EVIDENCE: Duty rotas for the past two months provided evidence to show that the home is adequately staffed; staffing levels at night was discussed with the manager who stated that they were appropriately supported by senior staff on call who only lived a few minutes from the home. However it was agreed that staffing levels at night would be reviewed if resident needs changed. Staff records reviewed contained all the required information, however it was noted that staff had been employed without a POVA first confirmation. This was discussed with the manager who agreed that the procedure currently followed does not enable POVA first to be obtained, it was suggested that this should be discussed at the next managers meeting with a view to Major Symmonds becoming a counter signatory. All new staff work supervised until a full CRB is received. Staff in the home have received training appropriate to the needs of the residents; 60 of the current care staff have obtained an NVQ 2 or 3, whilst others are registered on courses. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 35, 36 and 38 The manager is qualified, competent and experienced to run the home. All new staff are offered a full induction and all staff receive formal supervision. Resident’s financial interests are safeguarded by the homes policies. The implementation of health and safety is satisfactory EVIDENCE: The manager is a registered nurse and has the NVQ 4 in Care Management; he is currently doing the Registered Managers Award at Bridgwater College. The deputy manager has an Open University Managing Care level 3 and has now completed the NVQ4 in Care Management. Staff, residents and visitors all commented on the open approach that the manager adopts in the home. All comments were complementary and everybody agreed that they could approach the manager at any time. All new staff carry out a full induction to the home and are enrolled at Weston College on the TOPSS Induction which also includes basic first aid. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 19 All staff have a supervision contract copies of which were seen in staff records, evidence of regular staff supervision was also seen, and staff confirmed that supervision and appraisal identified training needs and personal development. A random audit of residents finances held by the home showed that residents signed personally for any transactions and were aware of balances held by the home on their behalf. The implementation of health and safety within the home was satisfactory; since the last inspection the fire log showed clearly that fire alarm tests are carried out on a regular weekly basis, all other required checks were also being carried out at the appropriate times. A fire risk assessment has been carried out for the home however a copy was not easily accessible. The home has a safety action group which continues to include all levels of staff and a resident representative; this group carries out a full audit of the home and advises the manager of any needs identified. COSHH data sheets are complete and reflected chemicals used in the home, and all staff handling food have food hygiene certificates. The kitchen and laundry areas were clean and tidy, and staff showed an awareness of appropriate infection control guidelines. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x 3 3 x 2 Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 21 YES Are there any outstanding requirements from the last inspection? 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 OP29 Regulation Requirement Timescale for action From 16/08/05 19(1)Sch2 New staff must be subject to robust recruitment proceedures including CRB/ PoVA first check 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 OP19 OP38 Good Practice Recommendations Identified areas of the home are in need of redecoration following the recent maintenance A copy of the fire risk assessment needs to be kept in an accessible place. Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier TauntonTA1 4AL 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 Dewdown House D53 - D02 S8038 Dewdown House V23364 160805 Stage 4.doc Version 1.40 Page 23 - 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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