CARE HOMES FOR OLDER PEOPLE
Dial House Nursing Home 7 - 9 Dynevor Road Bedford Bedfordshire MK40 2DB Lead Inspector
Carol Mitchell Unannounced Inspection 31st January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dial House Nursing Home DS0000017673.V328526.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. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 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 Vanessa.simic@dialhousecare.com www.dialhousecare.com Dial House Care Limited Mr Mark James Rycraft 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), Terminally ill (5) Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 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. No one with a diagnosis of Terminal Illness may be admitted to the home when there are already 10 persons in this category. 11th October 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 residential 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. The following information about fees was obtained on 31st January 2007:Lowest fee (residential) £425.88. Lowest fee (nursing) £650; Highest fee (residential) £550. Highest fee (nursing) £670. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 5 The following are not covered by the fees:Hairdressing (£5 wash and set); Private chiropody (£15 per session); Special outings (cost varies); Bingo club contribution to prizes (£8 per month); Toiletries are provided by residents or are provided at a cost of £10 per month. Further information about this home can be obtained by phoning or visiting. There are also email and website addresses. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This report takes account of any information received by the Commission since the last inspection visit in October 2005, and considers the evidence obtained during the inspection visit made on the 31st January 2007. The unannounced visit took place over a period of 4 hours and 40 minutes. During the visit the inspector spoke to and spent time with residents, staff, the matron, manager and the owner. Staff interviewed included the training manager and the activities coordinator. The inspector also spoke with a visiting specialist nurse, checked some records, and looked around some parts of the building. The inspector would like to take this opportunity to thank all those involved with the inspection visit. What the service does well:
This is a very well organised home, with a committed owner, a strong management team, and well trained and well supported, competent staff. The atmosphere at the home is very open and friendly, and people there are relaxed and comfortable. The home is clean and well maintained. People living at the home feel well looked after. Some residents made the following comments, “People are kind”; “Staff are always polite, kind, and good”; “They move me gently”. The home has very good links with local family doctors and other health care professionals. Staff know about how to look after people with special health needs. The Parkinson’s nurse told the inspector that she “has very good links with the home. I do a lot of training, the staff are very enthusiastic, welcoming, and organised. They always escort residents when they come to clinic, and staff are careful to check my identification when I arrive.” The food provided at the home is very good. Residents said, “The food is very good”; “I’m picky but there is always plenty of choice”; “I have egg and bacon for breakfast every morning”; “It’s lovely food here”. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 7 People at the home are listened to. One resident said, “I will tell people if there’s something wrong.” Another said, “I can speak to anyone, people are in and out all day.” The owner is good at thinking about what needs improving at the home and taking action. For example she makes sure that work is done to decorate and improve the building. She also thinks that the skills and roles of carers and seniors at the home need to be further developed, and has therefore made sure that suitable training and development is in place for these staff groups. Two very capable people at the home are employed to try to make sure that residents can carry on with their lives in the way they want to, and get the most from living at the home. The home is busy and there is a lot going on there for residents. People do not have to join in with group activities however. A registered nurse commented that when she came to the home she was impressed because of the importance given to people’s rights and choices at the home. “Whatever people would like to do, we try to make it happen. People do not have to do things because of routines”. A resident said “no one could have a better life under the same circumstances.” Staff at the home feel well supported and happy in their work, and they are well organised. Training and development of staff at the home is given very high priority. A care assistant commented, “There are plenty of staff, you feel like you’ve really achieved, it’s a really rewarding job”. Staff whose first language is not English are also supported. Important information for staff has been translated into Filipino and Polish, and relevant workers attend a course run by one of the home’s staff who is a qualified teacher of English as a second language. Families are made welcome at the home, and they are asked to tell the home about what they think by filling in questionnaires (as are residents and staff). The owner takes action if she needs to after reading what people have to say. Comments from the last questionnaires include the following:“There has been hard work and effort put into meeting my mother’s needs”; “My aunt frequently comments on the kindness of staff”; “My relative is happier than she has been for some time”. What has improved since the last inspection?
Work has been done to improve the care plans since the last inspection, and new wound care assessments have been developed. The “Investors in People” award has been granted, and the emphasis on high quality training and development in many areas has continued. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 8 By working together with the Macmillan nurses, there is a real commitment to improve the care given to people in their final days, through the use of a special written tool. A third deputy, and a new chef with hotel experience have been appointed to the staff team. Substantial decoration has been done including the painting of the whole exterior of the building, window replacement, and the fitting of a shower room. Equipment such as new hoists and air mattresses has been purchased. 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. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 9 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.V328526.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The matron makes sure that she checks whether the home can meet a person’s needs before the resident moves in. Therefore people living at the home can be sure that their needs will be met. EVIDENCE: The matron or one of her deputies is responsible for assessing that the needs of a prospective resident can be met prior to admission. Needs are recorded in a structured way. Visits to the home are also welcome, and there is a brochure with useful information. A gentleman who had been recently admitted to the home voiced satisfaction with the way his admission had been dealt with.
Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 11 The owner is currently reviewing the contracts issued to ensure that these meet all of the requirements set out by the Commission. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 12 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, 11 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are very strong links with family doctors and many other professionals, and residents’ care needs are written down. Staff are trained about health and other matters, and they know when to call for help. Therefore people living at the home can be sure that their health care needs will be met. EVIDENCE: Health care at the home is well organised with regular input from a family doctor, and close liaison with many health care professionals including Parkinson’s disease nurse, diabetes specialist, dietician, skin care nurse, stoma care nurse, and Macmillan nurses. The services of a dentist, chiropodist, and optician are also provided.
Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 13 The Parkinson’s disease nurse was at the home during the inspection visit. She told the inspector that the staff are very welcoming and make the right checks when she enters the home. Staff are very helpful and the home is organised. She has an excellent relationship with the home which she described as a partnership. Staff have been given training by her about the disease process and care needs, and they enthusiastically receive the training. Staff know when to call her, and she does not have to make special visits to check up on them. Residents from this home are always escorted when attending the nurse’s clinic. A training package covering the fundamentals of caring has been devised and is being used to complement induction and ongoing training for care staff. Residents seen during the inspection visit were comfortable and relaxed, and were happy with the way staff care for them. A resident confirmed that she is moved in the right way, and with a hoist in certain situations, and she is being nursed on a special mattress. Information about care needs is written down within well organised care planning records. Individual and detailed plans are written following a structured assessment, and risk assessment process. Monthly reviews are undertaken by specific registered nurses with responsibility for this (“primary nurses”). A small sample of care plans was checked, and on isolated occasions care instructions were not recorded in the expected place within the care plan. Examples of this were discussed with the matron and owner at the time of the inspection visit, and it is clear that work to continually improve care planning is ongoing at the home, and is being given high priority. The providing pharmacist inspects the medicines twice every year, and the medicines at the home are organised by the matron. The manager regularly audits the medicines, and actively looks for and deals with issues such as unexplained blanks on administration sheets. Additional training in medicines management for registered nurses has been arranged. During the visit a nurse was briefly observed administering medicines in a safe and professional manner. There were no unexplained blanks within a small sample of medicine sheets checked on the day of the visit. A resident said that her medicines are well organised. The home greatly emphasises to staff the importance of privacy and dignity to residents. At the time of inspection a “Dignity awareness week” had been prepared with training sessions to take place for all staff on specific dates during February. Information cards have been issued to staff, and a lesson plan has been prepared by the home’s training manager. The profile of the issue has therefore been raised with commitment and in an organised way. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 14 The death of a resident in December of last year was discussed with the matron. The family had been involved, and satisfied with the care given, and how everything had been dealt with. The home has strong links with Macmillan nurses. One of the deputies has undertaken special training in palliative care, as have some others working at the home. Training by the Macmillan team is underway to develop staff knowledge of a specific care pathway covering the needs of people when in their final days. The care pathway is to be introduced on completion of the training. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 15 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, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Skilled people are employed at the home to make sure that residents have the best chance of carrying on with their lives in the way they wish. Staff know how important choice is for residents in all aspects of life, and high quality food is provided. Therefore people at the home can be sure that their expectations about life there will be met. EVIDENCE: The home employs two experienced activities organisers, both work 4 days a week with some overlap. This allows for a structured approach to the provision of individual attention for some residents as well as group activities for others. Alternate Saturdays are also covered. One activities organiser spoke to the inspector. She has trained as a social worker and expressed very clearly the home’s aim to provide a wide range of activities, to find out what people like doing and to provide this, and importantly to develop self confidence.
Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 16 There is an active programme of activities and events at the home. On the day of the inspection visit a church service was held in the morning, and in the afternoon an Occupational Therapist was visiting and was preparing games for residents’ enjoyment. Other activities include crafts, team crosswords, quizzes, music afternoons, champagne and strawberries afternoons, pub nights with quiz, picnics, pub lunches, and trips out. Professional entertainers also visit regularly. There are links with local organisations such as a nursery school which gave a concert at Christmas time. Owls are brought in by the Raptor Society twice a year and these visits are much enjoyed by residents. The activities organiser also has knowledge regarding dementia care, and she trains staff in this area. Information about residents’ lives which would help to develop meaningful occupation for people with dementia is sought from relatives in an efficient way. A resident in her room was enjoying the company of her loose bird, and said that staff were in and out to talk to her all day and that her life is as good as it possibly can be given her circumstances. A nurse commented that people at the home do not have to do things because of routine, and this had impressed her when she started work at the home. A gentleman commented that the food is excellent at the home, there is always a choice, and something is cooked for him without any bother if he does not fancy any of the planned options. He loves cooked breakfast and is able to choose bacon and eggs every day. Another resident said that the food is very good and there is always plenty of choice. She said that even though she is a “picky” eater, her needs are very well catered for. A staff member described the food at the home as “lovely”. On the day of the inspection visit lunch was served in the dining room and in individuals’ bedrooms. The lunch was hot, and looked and smelt appetising. Those who needed help with eating were given this by staff who were caring, unrushed and considerate in their manner. Liquidised meals were presented so that component parts could be identified, and where necessary special equipment was used to help residents maintain their ability to feed themselves. Choices regarding a range of personal matters such as retiring and rising times are recorded in a “Likes and dislikes” section in the care plans. Residents questioned said that their visitors are made to feel very welcome indeed, and that they can come to the home at any time. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 17 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, 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 complaints procedure, and staff know that adults in their care are vulnerable. The relationship between residents and staff is warm and friendly. Therefore people living at the home can be sure that they will be listened to. EVIDENCE: The home has a complaints policy, and when a complaint is received it is taken seriously, investigated, and the outcome of the complaint investigation is documented in the records. The matron is well supported by the manager and owner when a complaint is received. In conversation, residents felt that they can speak to staff about anything with which they are not happy. Staff questioned were able to say what they would do if they should witness anything about the treatment of a resident with which they are not comfortable. Staff spoken to had also received training about the protection of vulnerable adults, and records confirmed a robust system for making sure that everyone is kept up to date. Training in other areas (for example dementia
Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 18 care and dignity) includes reiteration of matters to do with the protection of vulnerable adults in a specific and structured way. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 19 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are people employed to make sure that the home is kept comfortable, clean and safe and that improvements are made when necessary. Therefore people at the home can be sure that they are living in a safe and well maintained environment. EVIDENCE: The home is comfortable, and all areas seen on the day of inspection were clean. Housekeeping staff are employed. In conversation residents were happy with the accommodation, and with their rooms. Residents’ personal possessions were displayed in the bedrooms visited. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 20 The home also employs two maintenance men to undertake ongoing maintenance and decorative duties in the home, and also to maintain the large, well kept garden. The garden has hard paths so that the different sections of it can be easily accessed, and there is good quality garden seating situated within the different areas. Since the last inspection a shower room has been fitted on the first floor, and another may be fitted at the home depending on its popularity with residents. Recently a bedroom has been decorated, and the whole exterior of the property has been painted. Windows have been replaced, and the lighting in some areas has been improved. New furniture for the lounge had been ordered at the time of the inspection visit. There are plans for a future extension which would reduce the number of shared rooms and provide extra facilities including a day room over looking the garden, and a training room. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 21 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, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are very well trained, supervised and supported. Therefore people living at the home can be very sure that they are in safe hands. EVIDENCE: Staff are organised at the home. Primary nurses and key workers with specific areas of responsibility are identified. Residents spoke highly of staff during the inspection visit, and staff were noticed to be polite, friendly, caring, and attentive to detail in their dealings with residents. When questioned, staff were able to describe in detail how they care for or support individual residents. A visiting specialist nurse described the staff at the home as knowledgeable, well trained, helpful and organised. Staff meetings are held, and staff receive formal supervision sessions every 2 months. Staff questioned had received supervision. A training manager is employed, and training at the home is very well organised, resourced, and recorded. The training manager has undergone special training for the post. Staff spoken to had received induction and ongoing training, and were very pleased about the home’s clear commitment
Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 22 to their development. Training includes essential topics such as moving and handling, and clinical care for example medicines awareness, nutrition and dementia. The training manager has a robust system for making sure that everyone receives necessary training updates, training sessions are planned, repeated according to need, and all training is formally evaluated to check that it is useful. External speakers also visit the home to deliver training sessions to staff by arrangement. For example the Parkinson’s nurse confirmed that she has given training sessions at the home. The home recognises and gives due emphasis to the importance of delivering high quality care basics, and a training package covering the fundamentals of caring has been developed for staff to work through. Every month there is a planned subject area for learning and awareness. During the month of inspection training in dignity awareness was being delivered. National Vocational Qualification (NVQ) training is very well established at the home. 80 of care staff already have a NVQ certificate and the remaining staff have start dates for their training. Some staff have a level 3 certificate, and a further 12 are starting this level of study soon. NVQ training at the home will include housekeeping and catering staff, and NVQ training in customer service is planned. There is a commitment to developing staff and making sure they are well prepared candidates for more senior positions at the home should they arise. Senior staff at the home are soon to start a management training package which will also lead to a NVQ certificate. A small sample of staff files showed that proper procedures are in place when staff are recruited, including equal opportunities monitoring. One staff member at the home is qualified as a teacher of English as a second language, and the home has started courses for any staff members for whom this would be beneficial. The home’s induction manual for staff has been translated into Filipino and Polish. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 23 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, 32, 33, 36, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The owner and the managers think that it is very important to do everything right and to the best of their ability at the home, and they make sure that the staff are very well trained and supported. The owner makes sure she finds out what people think about the home and makes changes when she needs to. Therefore residents can be very sure that the home is run with their best interests at heart. EVIDENCE: The home is well organised and has a strong management team supported by an owner who is currently heavily involved in the day to day running of the
Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 24 home, and who is keen to maintain and improve standards. Members of the management team are clear about their roles in the home. The matron described frequent checks done by the owner. Verbal feedback is given following such checks and an action plan drawn up to address any required improvements. The manager is well supported by the matron who has a thorough grasp of priorities at the home and clinical expertise. There are also three registered nurse deputies, one of whom has responsibility for training at the home. Administrative staff are also employed. The home makes sure that staff are well supported and developed. Staff appraisal and supervision is well established, and training for staff in all relevant areas is well catered for. Staff spoken to felt well supported and were very pleased with the emphasis given to training and development at the home. The owner takes direct responsibility for evaluating training to ensure its effectiveness, and important topics such as accountability are included in training programmes. The “really useful manager’s toolkit” training is being introduced for senior staff at the home. Staff meetings are held, and newsletters for staff are published. The atmosphere at the home is relaxed and friendly. In conversation residents were happy with the way the home is run, and they feel able to speak about their views. Feedback is obtained from users of the service (including staff) through the use of questionnaires, and results referred to in monthly newsletters for residents. A sample of recently completed questionnaires indicated that residents and families are pleased with life at the home, and showed that people are able to write down any problems they may be experiencing. The owner assesses all of the information received and takes action or feeds back to staff as appropriate. The manager is developing his role and makes sure that he works very closely with the matron, and the owner. He makes checks in important areas such as medicines recording and feeds back to staff as appropriate. The owner is developing her role and others, so that she will become less “hands on” than has been the case in the past. A format has been devised to make sure that monitoring visits undertaken by her in the future will be recorded in line with the relevant regulation. Due emphasis is given to the health and safety of residents at the home. Maintenance staff have responsibility for areas such as hot water monitoring, and fire checks. The owner has worked with other homes to make sure that evacuation procedures for residents at the home are developed. Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 25 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 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 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 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 x x 4 x 3 Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dial House Nursing Home DS0000017673.V328526.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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
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