Inspection on 11/10/05 for Dial House Nursing Home

This inspection was carried out on 11th October 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 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

Dial House Nursing Home 31/01/07

Dial House Nursing Home 13/07/05

Dial House Nursing Home 12/03/05

Dial House Nursing Home 15/09/04

Dial House Nursing Home 04/03/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Dial House Nursing Home 7 - 9 Dynevor Road Bedford Bedfordshire MK40 2DB Lead Inspector Sally Snelson Announced Inspection 11th October 2005 12:00 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 Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dial House Nursing Home Address 7 - 9 Dynevor Road Bedford Bedfordshire MK40 2DB 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) 01234 356555 01234 402444 dialhousecare@aol.com www.dialhousecare.com Dial House Care Limited Mrs Vanessa Simic Care Home 50 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number disorder, excluding learning disability or of places dementia (10), Old age, not falling within any other category (50), Physical disability (5) Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home can accommodate a maximum of 50 service users of either sex. No one falling into the category of younger adults (40-65 years) may be admitted to the home when there are already 5 persons in this category. No one with a diagnosis of dementia may be admitted to the home when there are already 20 persons in this category. No one with a diagnosis of mental disorder may be admitted to the home when there are already 10 persons in this category. 13th July 2005 Date of last inspection Brief Description of the Service: Dial House has been developed from two large Victorian properties to provide care for 50 service users over the age of 65 years who require care with or without nursing. The registration also allows for up to 20 of the service users to have a diagnosis of dementia and 10 a mental health condition. Five service users over 40 years but under 65 years can also be cared for. Those service users under the age of 65 years have been assessed by the manager as having similar needs to those service users already being cared for. The home is situated a short walk away from the town centre of Bedford, and close to its rail and bus services. There are a number of domestic properties in the area that have been converted into care establishments. The home has an area at the front that can be used for parking as the road outside has zoned parking. The home also has attractive well-maintained gardens and sun terraces to the rear, which can be accessed easily by service users. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of Dial House was announced and took place on 11th October 2005 over a period of four and a half hours from 12.00 midday. The inspectors were Sally Snelson Lead Inspector, and Louise Trainor, observer. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views of the services provided. The process considers the home’s capacity to meet regulatory requirements and minimum standards of practice. This was the second inspection of the year, therefore this report should be read in conjunction with the report from 13.7.05. During the inspection service users, staff and visitors were spoken to and care practices were observed. At the end of the inspection, feedback from the assessments of the standards was given to Mrs V. Simic the owner and registered manager. The inspector would like to thank all the staff and service users for the help and time they gave to this inspection. What the service does well: Dial House provides a pleasant and safe environment for service users to live. Service users confirmed that they had a choice about daily routines, such as when they got up and when they went to bed. One service user told the inspector that he had a wonderful room and he was not going to leave it. Staff confirmed that there had been no suggestion that he should leave and the comment was because he had settled so well and was pleased to be living at Dial House. The wife of one service user told the inspector “ I have high standards and I have always been pleased with the care provided.” She went on to say that if there were any issues she was concerned or unhappy about she mentioned them to staff and they were always successfully resolved. A variety of different activities were organised such as pottery, card making, choir practise and shopping trips. Those service users who could not join communal activities were given periods of one-to-one activity time. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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 Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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): 1,4,5,6 Pre-admission visits offered service users and/or their relatives the opportunity to make an informed decision before moving into Dial House. EVIDENCE: The Statement of Purpose and Service Users Guide had been regularly updated. These documents provided service users with information about the home, including how to make a complaint and what extra charges could be incurred, for example hairdressing and chiropody. Service users and visitors confirmed that they had taken the opportunity to look around the home before making the decision that they or their relative could settle in Dial House. All service users were admitted to the home for a trial period in the first instance. The home did not have the category of registration to offer care for service users with a terminal illness. There were adequate key staff who had the relevant qualifications and experience for this registration category to be added to the current certificate following this inspection. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 9 Dial House did not offer intermediate care. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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): 7,8,9,10 Some care plans required additional information to ensure that all the care needs of a service user would be met at all times if the permanent staff were off-duty. EVIDENCE: It was evident from sampling care plans and from speaking to service users that care plans had been sensitively written and were shared with the service user if appropriate. The care plans had a number of pre-written statements that were pertinent to all service users and space for the nurse writing the plan to individualise the plans with additional information. However, in the care plans sampled, it was noted that some aspects of care had not been included. For example a service user with a colostomy did not have a plan to support this aspect of his care. This did not detract from the care he received as he was self-caring and only required staff to prepare the bag for him. A plan should have reflected this so that any member of the team providing care for him would be aware of the support he would or would not need. Also a service user with a catheter did not have a plan to support how the catheter was Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 11 managed and cared for although there was documentation recording when the catheter had last been changed. All of the care plans had been reviewed monthly or more frequently if care needs suggested it was necessary. It was noted that where any problems were identified during routine assessments the appropriate support or equipment was provided. For example a raised Waterlow score indicated the need for a pressure-relieving mattress. All service users had monthly recordings of their blood pressure and weight that were linked to risk assessments for tissue viability and nutrition. Medication had been appropriately signed into the home, was stored well in a secure room that was air conditioned and remained at the correct temperature of less than 25 degrees Celsius at all times. The home had correctly complied with the new requirements for the destroying of unused medication. Sampling of the medication records confirmed that staff were correctly signing the medication records when medication was administered; this had been a requirement from the last inspection. Service users were noted to be treated with respect and dignity by the staff. The home offered service users the opportunity to meet with visitors in one of the communal areas or in their own bedrooms. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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): 13,14 Service users were confident that their visitors were made welcome in the home at any time of the day. EVIDENCE: On the day of the inspection an entertainer was providing musical entertainment for the service users. It was noted that all of the service users were encouraged to take part but left to make their own choice as to whether they attended or not. A visitor reported that she was looking forward to accompanying her husband to the ‘show’ and was aware of the positive effect singing had on some of the service users. An activity co-ordinator was employed Monday to Friday from 10am to 6pm. She provided a varied activity plan each week that included group activities and one to one time. The activity co-ordinator arranged trips out, entertainers into the home, produced a monthly magazine and encouraged a range of crafts from bread making to pottery. As part of her role she also spent time asking the service users about their hobbies and interests and produced a care plan for them. Following participation in an activity the activity co-ordinator documented how the service user had responded to a specific activity. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 13 The inspectors did not witness a mealtime during the inspection however all the service users spoken to reported that the food was excellent and that they were offered a good choice and alternatives were always available. One of the visitors said that she had been offered a meal when visiting her husband and that it had been very enjoyable. She also reported that she was encouraged to make herself a drink, if she wanted one, during a visit. A small kitchenette was provided on each floor for service users or visitors to use for drinks outside the usual times. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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 the following standard(s): 16,18 The home’s policies for complaints and for adult protection should safeguard the service users living at Dial House. EVIDENCE: During the previous year the home had investigated three complaints and substantiated one of them. The complaints procedure was available to service users as part of the Service Users Guide and was also displayed in the home. It was noted that there was a discrepancy between the timescale in the publicised procedure and that in the homes policy. This discrepancy would not alter the outcome for the complainant and either timescale would be acceptable. The manager immediately made the necessary alterations. A complaint made recently to the CSCI office had been passed to the manager for investigation. The complaint was discussed during the inspection and the inspector fed the outcome back to the complainant following the inspection. The inspector was satisfied that the manager had investigated the complaint following the homes complaints procedure. The majority of the trained and care staff had completed training on adult protection (POVA). Two staff had completed the POVA train the trainer course and were supporting the rest of the staff with this area of learning. Staff spoken to during the inspection confirmed that they had an understanding of Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 15 POVA. The manager was intending to roll POVA training out to the ancillary staff once care staff had completed their training. The manager had been part of the committee that had produced the Bedfordshire POVA policy. She believed that there was a need for multidisciplinary workshops to ensure that all staff had the same understanding of not only the various forms of abuse but also how to respond to and report any allegation of abuse. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 16 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): EVIDENCE: These standards were not assessed as the core standards had been met or exceeded at the last inspection and there had been no obvious alterations. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 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 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): 29,30 Safe robust recruitment procedure ensured that service users were safeguarded. EVIDENCE: Staff files sampled confirmed that prospective staff were asked to complete an application form for any position in the home and were then interviewed prior to being offered a job subject to successful references and Criminal Record Bureau checks. Staff files also indicated that the manager or the personnel officer had looked at and checked qualifications and work permits as necessary. A qualified nurse took responsibility for providing a rolling programme of training for all the staff. The computer system was set up so as to flag up the mandatory training that staff needed as it became due. The nurse in charge of the training confirmed that she could source training internally or externally as necessary. Some of the staff had completed train the trainer course and were happy to provide peer training. The matron and the deputy matrons took responsibility for different areas of care and would provide up-to-date information and training for other staff members, for example wound care or nutrition. The manager reported that the home had recently employed staff from the Philippines and as an assurance that the staff had understood the induction Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 18 training the induction booklet had been translated into Filipino. The home was registered to support and train nurses who had qualified in their own country and wished to become registered with the UK Nurses and Midwifery Council (NMC), known as adaptation nurses. At the time of the inspection there were no adaptation nurses in training. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 19 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): 35,36,37 Safe working practices and regular staff supervision ensures that service users welfare and safety are safeguarded. EVIDENCE: The Service Users Guide suggested that small amounts of money could be held by service users either in their own bedrooms or, on their behalf, in the homes safe. The inspector sampled the one account that the manager was appointee to (this was a long-standing agreement that would not be repeated). The manager had investigated ways in which the service user could hold the account himself but as he was unable to move enough to make a signature this was difficult. The four accounts into which Social Services paid money via the Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 20 home were also sampled. All these monies were held in accounts that were linked to the service user and for which they received the interest. Service users could opt to pay a £10.00 monthly charge for toiletries or could supply their own. The manager confirmed that those service users who choose to have their toiletries provided by the home could request particular brands if they wished. This additional payment would be added to their monthly account. Staff were divided into teams for the purpose of supervision. They confirmed that they were having a meaningful supervision session every two months and appraisals annually. The manager reported that she had recently changed the focus of the supervision and required the supervisors to introduce more work and performance related topics with an emphasis on training. All of the appropriate records in the home were provided for the inspection. It was noted that records were accurately kept and where necessary securely stored. Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 21 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 3 X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 4 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 3 X Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 22 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. 1 Standard OP7 Regulation 15 Requirement Care plans must include all the detail of the action staff must take to ensure that all aspects of the health, personal and social care of a service user are met. Timescale for action 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Dial House Nursing Home DS0000017673.V257548.R01.S.doc Version 5.0 Page 24 - 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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