Inspection on 25/01/07 for Dewdown House

This inspection was carried out on 25th January 2007.

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 08/03/06

Dewdown House 16/08/05

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 Unannounced Inspection 09:30 25 January 2007 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 Dewdown House DS0000008038.V318951.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. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 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 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) 01934 417125 01934 631064 Salvation Army Social Services Major Stephen Karl Symonds Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: Dewdown House is a purpose built home, situated near the sea front of Weston-Super-Mare. The home provides 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 DS0000008038.V318951.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Current fees: £350 to £421 This inspection took place over six hours. Eight service user surveys were received and seven service users were spoken to. Other service users made passing comments about being very happy living at Dewdown House. As well as talking to service users a review of records maintained by the home was carried out. These included care records, staff personnel files, staffing rotas, medication policies and procedures, service records and the firelog. On arriving at the home some residents had decided to attend morning prayers which are held daily by staff members or a resident. One resident commented on being able to go to morning prayers if she wished. Comments received following a survey of residents in the home were all complimentary. Residents praised the level of care, the food and high standard of cleanliness. All residents said they were happy and could talk to the manager or any member of staff. Some residents also understood the key worker system and who their key worker was. Comments included meals are excellent, I would not wish to be anywhere else and we have very helpful staff. Residents spoken to confirmed these comments stating that they felt well looked after and well cared for. They all felt they were offered appropriate activities and could exercise personal choice and control over their own life. What the service does well: What has improved since the last inspection? The décor of communal areas and corridors in the home has been addressed since the last inspection. Stairwells have been painted and decorators were preparing surfaces on the walls on upper floors. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 6 The manager follows a robust recruitment procedure ensuring all the required checks are carried out before a new member of staff commences work. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dewdown House DS0000008038.V318951.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 Dewdown House DS0000008038.V318951.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5. 6 does not apply Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. The home then confirms that they can meet the needs of the individual. Prospective residents are given the opportunity to spend some time in the home. EVIDENCE: Care records reviewed contained very clear preadmission assessments. These were supported by medical reports and social services care plans where necessary. The preadmission assessment is carried out by the manager in a prospective residents home or at the hospital. The information gathered forms the basis for temporary care plans, which are reviewed as staff get to know the resident. Prospective residents are offered the chance to visit the home. This is often done by a friend or relative on their behalf. One survey received stated that Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 9 the resident had previously stayed on respite at the home then had decided to return. Residents spoken to did not comment on the admission process. Dewdown House DS0000008038.V318951.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents personal, social care and health needs are fully met. The homes policies and procedures for the administration of medication meet current requirements. It was noted that Medication sheets need to be signed. Residents are treated with respect and their rights to privacy are upheld. The home takes into account residents personal preferences at the time of their death. EVIDENCE: Records reviewed provided very clear guidance for staff enabling them to meet the assessed needs of residents. A key worker system is used and some residents spoken to were aware of the role of their key worker and who their key worker was. Care records showed evidence of resident involvement in agreeing boundaries of care and regular reviews. The home enables residents to access health care services appropriate to their needs and evidence was seen of appointments with the chiropodist, dentist, optician and outpatient Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 11 clinics. One resident survey commented on the homes support when attending outpatients’ appointments. District nurse input is sought when necessary. Residents spoken to said they received the support and care they required. One resident said that this is carried out in a very helpful and caring manner. Residents spoken to said that staff were always polite and respected their privacy. One survey stated that they are supported by very caring staff. The home has a very clear policy and procedure for storage and administration of medication. Staff were observed to administer medication in the correct manner. Following a random audit of medication no errors were found. The manager or senior carer carries out a regular audit of medication in the home. This was evident in the minimum stock required being in the cupboards. It was noted that several handwritten entries on medication sheets had not been signed. This was raised at the last inspection and all handwritten entries must be signed by the person making the entry. Dewdown House takes into account residents’ personal and religious preferences when facing terminal care. They treat residents, relatives and staff with sensitivity and respect. Dewdown House DS0000008038.V318951.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a range of meaningful activities and links with the church and local community are maintained. Residents are assisted to exercise choice and control over their lives. Residents receive a wholesome appealing and balanced diet. EVIDENCE: Meaningful activities are carried out on a daily basis. These include board games, book club, quizzes and puzzles, flexicise, library and regular organised trips out. Residents spoken to said that they had plenty to do within the home if they chose to do it. Management recognise the need to look at the types of activities offered and residents were asked to put their own ideas across at a resident meeting. The home holds morning prayers daily and transport is provided on Sunday to take residents to Church, Chapel or Citadel. Residents spoken to said they felt they had privacy, respect and were encouraged to maintain choice and control over their own life. Residents are also included in meetings such as the health and safety group. They have a representative say in the running of the home. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 13 The home runs a four weekly menu, which is displayed in the dining room. Residents make their choice at the appropriate mealtime so they are not expected to remember a choice made earlier in the day. Residents’ comments on the food providing by the home were all complimentary. They were very clear about the good standard of food provided and the way in which it was presented. The menus observed showed that residents were offered a choice of nutritious and wholesome meals. The kitchen is clean and tidy the food was stored appropriately. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 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. 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 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. 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 spoken to said that they felt at ease talking to the manager with any concerns. A large print copy of the complaints procedure is displayed in the hall and the dining room. The home also has a very clear policy for the protection of vulnerable adults and elder abuse. A clear whistleblowing policy is also available in the staff room. No Secrets in Somerset, outlining the North Somerset policy and procedure for the protection of vulnerable adults was available for staff to consult in the office. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe well maintained and environment. 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. Specialist amenities are provided for disabled residents and visitors. Residents spoken to said that they had adequate rooms and could use any of the communal areas throughout the home. The home was clean and tidy and well maintained. During the inspection decorators were in redecorating the upper floors. Residents spoken to said staff maintained high standards of cleanliness, one resident said if cleanliness is next to godliness this must be a very religious home. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Rotas show that the home is staffed efficiently. Staff receive training relevant to the care needs of the current resident group. The organisation encourages staff to obtain their NVQ in care. The home has a good recruitment procedure that clearly defines the process to be followed. EVIDENCE: Rotas for the past month showed that the home is adequately staffed. Extra staff can be rostered in to cover activities, hospital appointments or to meet extra needs required by a resident. The organisation encourages staff to obtain their NVQ In Care. Of 17 care staff employed by the home 12 have an NVQ In Care. This relates to approximate 70 of the workforce. A review of staff personnel files showed that they contained all the required information. Since the last inspection it was noted that all new staff had a CRB or POVA notification before they commenced work. All new staff work supervised until the full CRB is received. Staff are encouraged to obtain training appropriate to meet the needs of the resident group. Staff personnel files showed evidence of training in areas such as dementia, diabetes and continence care as well as all mandatory training. Dewdown House DS0000008038.V318951.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is qualified, competent and experienced to run the home. The registered manager provides a quality assurance and monitoring process, which takes residents points of view into consideration. . The home has a rigorous system for protecting resident’s money. The implementation of health and safety is satisfactory. With the exception of the provision of fire training and fire drills for all staff members. EVIDENCE: The manager is a registered nurse and has the NVQ 4 In Care. He has completed the Registered Managers Award and is currently doing a degree in Management Studies. Residents and staff spoken to all said that they felt they Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 18 could approach the manager at any time. Both resident surveys and residents spoken to said they felt well supported and listened to by the manager. The home carries out an annual residents survey and they hold regular resident meetings. A resident representative is also on the health and safety panel. Staff were awaiting replies to the latest quality assurance survey sent out to residents and relatives. All staff have supervision contracts, copies of which were seen in staff records. It was difficult to evidence that regular staff supervision had taken place although staff spoken to said they did get regular supervision. The manager needs to look at ways in which supervision is recorded. The implementation of health and safety within the home was generally satisfactory. 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 streets were complete and they reflected chemicals used in home. All staff handling food had food hygiene certificates. The kitchen and laundry areas were clean and tidy and staff showed awareness of appropriate infection control guidelines. The firelog showed clearly that fire alarm tests are carried out on a regular weekly basis. All other required checks are also being carried out at the appropriate times. It was noted that although staff receive in-house fire training there was no evidence to show that they had received training from an accredited source since 2002. Staff spoken to could not recall having received training from any other source than the in-house video. Records also did not show evidence of regular fire drills being carried out by staff. Staff must have annual fire training provided by an accredited trainer followed by regular in-house updates through the year. Staff must attend regular fire drills this is to include both day and night staff. Dewdown House DS0000008038.V318951.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 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 20 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 OP9 Regulation 13 (2) Timescale for action The registered person shall make 23/02/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of of medicines received into the care home Handwritten MAR sheets must be signed by the person making the entry. Previous date of 08/03/06 was not met 2 OP38 23 (4.d.e) The registered person should after consultation with the fire authority-(d) Make arrangements for persons working at the care home to receive suitable training in fire prevention and (e.) To ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as practicable, service users are aware of the procedure to be followed in case of fire, including the procedure for saving life All staff must have annual DS0000008038.V318951.R01.S.doc Requirement 08/03/07 Dewdown House Version 5.2 Page 21 fire training provided by an accredited trainer followed by regular in-house updates through the year. Staff must attend regular fire drills this is to include both day and night staff 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 OP36 Good Practice Recommendations The manager needs to look at ways in which supervision is recorded. Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dewdown House DS0000008038.V318951.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!