Inspection on 04/05/07 for Didsbury Court Rest Home

This inspection was carried out on 4th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Didsbury Court Rest Home 27/02/06

Didsbury Court Rest Home 15/11/05

Didsbury Court Rest Home 01/02/05

Didsbury Court Rest Home 28/07/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Belma

Hunters Care Centre

Manor Lodge

The Garden House

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

CARE HOMES FOR OLDER PEOPLE Didsbury Court Rest Home 17-19 Park Road St Marychurch Torquay Devon TQ1 4QR Lead Inspector Judy Cooper Unannounced Inspection 4th May 2007 9:30 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 Didsbury Court Rest Home DS0000018347.V330297.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. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Didsbury Court Rest Home Address 17-19 Park Road St Marychurch Torquay Devon TQ1 4QR 01803 329735 F/P 01803 329735 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) Mr Stuart Watson Mrs Ann Watson Mrs Ann Watson Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Didsbury Court is a large detached property located in the St. Marychurch area of Torquay within walking distance of local shops and amenities. Torquay town centre is approximately 1 mile from the home and can be reached by public transport. Didsbury Court provides accommodation with personal care to older people (65 ) both male and female. Following the completion of an extension to the home it is now registered to provide a service for up to 17 residents. A small day care service is also offered for up to three service users on a daily basis. The home is laid out over 3 levels, ground, mezzanine and first floor. It has a passenger lift, which facilitates full access to each level. Current accommodation is provided in 15 single bedrooms and 1 double (which is currently being used for single occupancy). All bedrooms have an en suite facility with two en-suites incorporating a bathing facility as well. In terms of communal space, the home offers a lounge, conservatory and a small coffee lounge area leading onto the dining room. Two communal assisted bathrooms are available one of which has a spa bath. The home also benefits from a disabled toilet, adjacent to the coffee and dining areas of the home, as well as a large kitchen and storage areas, including a new medication storage room, which have also been incorporated within the recent upgrading of the home. The gardens to the side and rear of the home have now been landscaped and have safe easy access providing lovely peaceful sitting areas for residents whilst the front garden remains level and also easy to access, leading on from the conservatory. The weekly fees range from £325 to £395. The inspection report is easily available within the home’s communal hall. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place on Friday the 4th of May between 9.30.a.m and 4.30 p.m. Opportunity was taken to observe the general overall care given to residents. The care provided for three residents was also followed in specific detail, from the time they were admitted to the home, which involved checking that all elements of their identified care needs were being met appropriately. A tour of the premises, examination of some records and policies, discussions with the owners, deputy manager, residents, and staff, as well as several visitors to the home, all formed part of this inspection. Staff on duty were also observed, in the course of undertaking their daily duties. Other information about the home, including the receipt of eleven completed questionnaires from residents, seven from the staff at the home and two from local G.P’s, has provided further feedback as to how the home performs, and this collated information has been used in the overall writing of this report. All required core standards were inspected during the course of this inspection process. What the service does well: Didsbury Court provides a comfortable, secure, excellently maintained environment, where residents’ individuality is encouraged and upheld. Basic residents’ rights, such as dignity, respect and privacy are upheld and the residents and, in some instances, their advocates confirmed this during the inspection. The residents receive very varied, nutritious meals prepared to an excellent standard. Visitors are welcomed and encouraged to the home. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 6 An extensive and varied amount of enjoyable activities are made regularly available to the residents at the home. The staff team are well trained and therefore able to meet the needs of the residents. One of the homes real strengths is the management of the home. The deputy has been employed for several years at Didsbury Court, having worked previously in a senior care capacity. The owners who have owned and run the home for many years, one of whom is currently the registered manager for the home, complete the management team. Both the registered manager and the deputy manager have a good working relationship as well as excellent knowledge, and understanding, of both the residents’ needs and of the staffs’ abilities to meet them and what training needs may be required to ensure the quality of care provided remains the best possible. All spoken with during this inspection, including residents, staff, and relatives praised the leadership skills of the management within the home and all spoken to felt supported by and happy with the management at the home. Residents spoken to confirmed that their opinions are always sought and acted upon and that they felt very comfortable and well cared for within the home. The home, overall, continues to have a very comfortable, welcoming atmosphere, where residents are freely able to choose how they spend their time. What has improved since the last inspection? The management have further amended their admission procedures to ensure that all prospective residents are informed, prior to admission, that their current needs can be met at the home. Resident’ files, inspected, contained copies of the home’s own terms and conditions, whether the resident was funded privately or by Social Services. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 7 There is now a sample signatory/initial sheet available for all staff that participate in medication administration to ensure that any staff member that gives out a medication can easily be traced through their signature. The home’s complaint procedure has been slightly amended to ensure that residents are aware that they can also raise any concern they may have with the Commission at any time should they wish to. The completed upgrading of the home to provide three new bedrooms, an additional coffee lounge area, a large new kitchen and landscaped gardens to the side and rear of the home as well as the general upgrading of several other rooms, within the home, has been completed to a very high standard. This has ensured the whole home provides excellent private and communal residential accommodation, which clearly met the residents’ needs and expectations. The home’s deputy manager has now completed the NVQ level 4 in care award as well as the Registered Manager’s award. 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. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 8 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 Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 9 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 (6 is not applicable). Quality in this outcome area is excellent. The admission process is thorough and well managed with prospective residents being made aware, prior to admission, that the staff at the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home continues to maintain its statement of purpose and service user’s guide appropriately with new information inserted as required. For example details about the extended and changed accommodation has now been incorporated within the home’s information. Three residents’ admission records were inspected with one being a very newly admitted resident. It was noted, by inspecting all of these residents’ records, that a full and detailed admission procedure was undertaken in all instances, which had ensured that Didsbury Court was the appropriate home for the residents. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 10 All had had quite specific, differing needs and it is to the credit of the owners and home’s deputy manager that these needs were fully explored, and an agreement reached that they could be met, before any final decision was taken from the home’s perspective as to whether admission would be appropriate. This ensured that the residents could be fully confident that their needs were known and would be met as required on admission. All three residents were able to confirm that they had been aware of what the home could offer before they chose to live at the home permanently. One resident who had been at the home for five years had been admitted following a visit to the home from her daughter. The daughter, who was visiting, confirmed that the home had met both her Mother’s and her expectations regarding the care that was provided and that little issues such as the fact that the resident sometimes preferred her own company had always been respected and acknowledged. Another resident, admitted five months ago, had come for a respite stay prior to choosing to come in permanently. She stated that coming to live at Didsbury Court: “has given me back my joy of living. I now feel the home is my family”. The resident admitted two weeks ago had chosen the home herself. She had come for a look around and had then decided, from this visit, that it would be right place for her. She said that on her initial look around the home with her son, she was shown all around and that they were given a cup of tea and all the questions she had were answered, which gave her the confidence to decide to come and live at the home. She had not been disappointed and was very settled and happy stating she had been made very welcome and made to feel at ease and comfortable within the first few days of her residency. Various relatives spoken with during the inspection also confirmed that the admission process had been handled in such a way as to relieve as much anxiety as possible when the admission took place and that the management and staff went out of their way to ensure the resident’s well being and comfort was maintained following admission. The home’s statement of purpose and service users’ guide was available within the communal hallway and also within each resident’s room. This ensures residents are fully aware of the services that they can expect from the home. The home is to become a smoke free premises from the 1st July and the management have already prepared the information to put into the home’s documentation as well as having notices ready to put up in the home to inform all visitors etc. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 11 (Only one resident currently smokes and she has already been fully consulted and is aware of the changes, with the owners making other provision available for her to smoke, outside of the main building). Didsbury Court Rest Home DS0000018347.V330297.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 The quality in this outcome area is excellent. All residents are looked after very well in respect of their health and personal care needs. Residents’ privacy and dignity is upheld and their life style choices fully respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were seen in respect of the three residents whose care was inspected in detail. The care plans examined were thorough and covered all required care needs as well as social and psychological needs. There were appropriate risk assessments in place including a general risk assessment and a moving and handling assessment. Residents had been fully involved in the drawing up of their care plan and continued to be involved in the regular monthly review process. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 13 The resident’s named key worker undertook the reviews with the residents for whom they have special responsibility and staff reported back that they fully understood their role as a resident’s named keyworker and that being responsible for maintaining care plans gave them a sense of responsibility in their role. Staff spoken to were well aware of the care planning processes operating within the home and of the need to ensure that they kept care plans up to date and that the resident should always be involved to ensure that they were in agreement with any care that was to be given. The residents’ health care needs were known and were noted as being appropriately provided for, including any specialist needs. One resident spoken with stated since coming to live at the home she had had two hip replacements and that the care provided to her both during this time and at all times had: “been excellent”. The resident’s daughter also confirmed this to be the case, stating that when the resident entered the home she couldn’t mobilise very much at all but now is able to walk independently into the nearby shopping area. The resident stated that the management and staff always make sure she has the name and address of the home on her in case she needs to let a member of the public know this information quickly. It was also pleasing to note that there was a risk assessment in place in respect of this aspect of the resident’s care needs so that all staff are aware of the resident’s desire to be independent but also ensures that staff are aware that any identified risks are minimised as far as possible. Some examples of the many small ways the home helps maintain a resident’s independence include such things as the provision of turning cushions on the dining room chairs for any resident that may have mobility problems and there is a hearing loop provided in the home’s lounge to aid those residents with hearing impairment. A new disabled toilet being installed near the communal areas of the home to aid those with mobility problems and the hallway widened to accommodate a wheelchair if necessary. The home’s gardens being provided with raised flower beds for those residents that may wish to continue to garden. The clock in the conservatory having very large easy read dial to allow residents to be able to easily identify the time without asking. There is also a mobile hoist available if required and the home has adequate aids and adaptations including grab rails, assisted bathing facilities etc. Medications were well managed within the home. Medication recording systems were seen to be accurate and complete. Signing systems are in place to ensure that staff have read and understand the homes’ policies and procedures including the ones associated with medication. There is now a sample signatory/initial sheet available for all staff that participate in medication administration to ensure that any staff member that gives out a medication can easily be traced through their signature. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 14 There are no controlled drugs currently in use but there is suitable storage in place for them. The home’s newly created large and secure medication room was inspected and the home’s medication procedures were noted as being in order with medications stored and administered appropriately. The drugs fridge is now located inside the medication room, storing creams and eye drops etc that require cold storage. Only the senior staff member on duty holds the keys to the medicine storage area, therefore ensuring residents’ medications are held securely within the home. Other measures that ensure residents’ are protected by the correct administration of medication include having named spaces in a cupboard for the storage of any spare medications. The management makes sure that the staff have access to patient information about the medications they are administering which helps them be aware of any adverse reactions etc and so helps protect residents. Staff have easy access to the very in depth homes’ medication procedures which also include the administration of household remedies. The home receives regular visits and advice from its supplying pharmacist with the last inspection from the home’s pharmacist not noting anything as being needing to be improved upon. There is a photograph of each resident on their medication record and all staff involved in medication administration receive medication training either inhouse or from the local supplying pharmacist. Other professionals, such as local G.P’s, District Nurses etc are also asked for medical advise as required. The home’s accident recording was inspected and all details were noted as being in order. Residents’ individuality and dignity was noted as being upheld throughout the inspection and all the residents spoken to confirmed that this is always the case. One of many complimentary comments from the residents included: “I am very happy here, I think everyone else is too, they really take good care of us”. A comment received from a resident’s relative who had now moved on to a nursing home as Didsbury Court felt that they could no longer meet this resident’s needs stated: “ Many thanks for all the hard work, support and dedication you have all shown whilst looking after X. You all have undoubtedly made his last few months as comfortable a possible”. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 15 Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 16 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. The quality in this outcome area is excellent. Residents continue to enjoy living at the home, with visitors encouraged and welcomed, and a very varied programme of activities/events provided. Excellent, nutritious, well planned and presented meals are also provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents spoken with stated that they were happy at Didsbury Court and enjoyed living there. There were full details of all activities that had been/were planned to be made available. There were also details on each staff member contained within the staff file in the main hallway. This gave a little personal history of each staff member and their qualifications and therefore allowed residents to know a little more about those who are providing care to them. A special note must be made regarding the huge effort put in by all staff and management to provide the residents with a wide variety of themed activity days. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 17 The last one had a Caribbean theme, which involved the staff dressing up in appropriate costumes, the residents having Caribbean food and the home being decorated accordingly. All the residents and some visitors spoken to were keen to state what a good day it had been and that they were now looking forward to the Home’s V.E day, next week, when the theme of the day would be focussed on war time memories. The next big event following this is on the 4th July when celebrations would include a marquee being put up with relatives and friends being invited and staff again dressing up in appropriate costumes. Weekly prize bingo is provided every Sunday, and one resident stated that they enjoyed this as it broke up what, sometimes, could be a long day. External entertainment is also provided on a regular basis. Residents are also offered the opportunity to attend entertainment venues outside the home with five residents recently having seen a show at the local main theatre. The activities on offer were discussed at the last full residents’ meeting in January and it was noted that they replied that they were happy with the current choice of activities and outings provided. A resident’s comment included: “We never want for anything at any time they even do something special for everyone’s birthday”. Some residents are still relatively independent and as such come and go as they so choose. The home operates an open visiting policy and during the day at least three visitors came and went, whilst the visitor’s book clearly showed that the residents had many visitors at varying times throughout the day. Visitors are welcomed and come and go as they wish. Two visitors spoken with stated that: “Didsbury Court is a wonderful place. X has improved greatly since coming to live here. It is just like a family home”. Residents are encouraged to be as independent as possible with help available if required. Individuality is upheld by the staff and it was noted that residents chose exactly how they spent their time. Small examples of how the management and staff promote independence was noted in the provision of two bar stools that allow residents to raise and lower themselves easily, therefore allowing them the opportunity to maintain the experience of sitting in a social manner at the home’s small bar. Also there are plans in hand to allow residents increased T.V viewing in their own rooms with installation of a digital receiving box in each bedroom. A comment received from a resident included: Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 18 “We’ve all got our freedom and can choose what we do”. Residents are asked for any ideas of what activities they wish to see provided. A resident’s comment included the following: “I am aware of all the events that are going on, they have talked about what will happen. They make a great deal of effort to entertain us and things like bar-b-ques take place in summer which relatives are invited to”. All visitors to the home confirmed that they were always made welcome and it was noted that they all received a warm and personal greeting. The owners have recently provided residents with the option of having the use of an audio book library. A great deal of thought has gone into this provision with one of the owners researching audio books from the internet, writing up a little resume of each book and then providing the book on cd, along with the provision of a cd player if needed. The home’s audio library has been built up and includes a very wide range of different books, which cater for all tastes. It has been running for twelve months and is very popular. This is seen as excellent practice in ensuring that residents can have easy availability to a variety of different books, provided in a form that they may find more accessible than the conventional book. However for those residents that still wish to utilise this choice the home operates a small library facility, with regular changes. The home also has three resident cats and the owners’ two dogs, one being a very new puppy who visit regularly. Excellent meals continue to be provided. All residents spoken with stated that they thoroughly enjoyed their meals and that there was always choice available if they wanted to have something different. The meal on the day of the inspection was very appetising, hot and well presented and was enjoyed by the residents. Feedback comments received from residents regarding the meals provided included the following: “The meals are excellent”, and “there is always plenty of choice”. The home’s menus were discussed at the last resident’s meeting as to whether any additions or deletions were required. However all were quite happy with the present menus on offer. It was noted, in the minutes of the meeting, that one resident would like more roast potatoes when they were on the menu and also more crackling with the roast pork”. It was pleasing to note that the comment following this was that this request: “will be immediately activated”. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 19 Residents can also make use of the newly created coffee lounge, where a water cooler is situated and where they can have a snack at any time. Residents were asked at the residents’ meeting if they were aware of this facility however the minutes record the residents’ answer as being: “we have enough to eat at meal times but know the facility is available if we want it”. The home’s dining room is beautifully laid out with linen table cloths, and matching accessorises and it was obvious a great deal of thought had been put into making the room attractive so ensuring that having meals at the home provide a pleasurable experience for the residents. The home operates four weekly menus with a wide variety of main dishes and options available and these menus are printed out in a large, easy read booklet form, which is placed on each table. During lunch residents took pride in pointing the menus out and were obviously very satisfied with the standard of the meals, with all spoken to giving the meals provided the highest praise possible. It was also noted that for any resident that required it help was provided discreetly with adapted cutlery being readily available and gentle staff support provided in an unobtrusive manner. During lunch residents enjoyed listening to music suited to their tastes with many joining in singing. They all said that this was something they did daily and thoroughly enjoyed. Wine is provided regularly for those residents, which wish to have this, and the wine even has the home’s own label! The cooking at the home is undertaken by either the home’s deputy manager or one of the owners with a substitute cook being available if necessary. The recent completion of an excellently equipped kitchen has helped the staff members responsible for the meals at the home, by ensuring there is the space and the necessary equipment to create high quality meals. The information contained in the home’s menus provided on each resident’s table states: “All sweets are accompanied by appropriate sauce, custard or ice cream. Cheese and biscuits or ice cream is always available as an alternative to sweet. Fresh fruit is always available. Dislikes and special diets are catered or. Vegetables are fresh and therefore may vary according to season. Menus are reviewed according to seasons. At supper a selection of cakes and the cheese board is always available in addition. Coffee/snack lounge available all day and in the evenings”. Menus are printed off for residents as souvenirs of any special occasion so that they can show their families etc. There is also a water cooler and cups situated in the dining room for resident use and a resident stated that: “we all get plenty of drinks all day”. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 20 On the day of the inspection it was noted that in addition to afternoon tea, residents also could enjoy an ice cream cone and choosing from a variety of flavours. Residents stated that this was a common occurrence on a warm day. Also residents continue to enjoy an authentic fish and chip lunch on occasions, direct from the local fish and chip shop, which is something they have told the management they want to maintain for as the management said: “Its’ something they used to have before they came into a home” Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 21 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. The quality in this outcome area is excellent. Arrangements for protecting residents and responding to their concerns are good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents’ and visitors’ comments confirmed that they would all feel comfortable discussing any concerns they may have with the owners, deputy manager or the staff at the home. The CSCI have not received any complaints about the home since the last inspection or within the past two years and more. However to facilitate residents and their visitors with the opportunity to complain, if they wish to, or allow them to raise any issues anonymously, the home does provide a suggestions box, sited in the main hallway. The home maintains appropriate, updated adult protection policies, which included a whistle blowing policy, the appropriate use/consideration of restraint, managing challenging behaviour as well as routine documentation as to what constitutes various forms of abuse. Staff have both regular internal training on adult abuse issues as well as attending external training being provided with staff having recently attended a training session in this area given by the Local Authority. Staff at the inspection voiced their awareness of what would constitute to abuse and confirmed that they had received the required training. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 22 The home’s complaint policy is communally displayed and is also contained within the home’s statement of purpose and other home’s documentation, which each resident has an individual copy of. Residents spoken with were clear as to how to complain and felt they could easily approach the manager or any staff member should they have any cause to. At the last residents’ meeting in January it was noted that all residents were asked if they knew how to make a complaint to which the unanimous response was: “of course we do the format is displayed in the main hallway”. Residents also stated that they would not hesitate to talk over any concern they may have with a member of staff and it was noted that residents had further said at the same meeting: “who would want to make a formal complaint anyway, this is our home and as such a formal complaint should not be needed” Returned questionnaires from residents and relatives indicated that they were aware of the home’s complaints policy and would feel confident to speak to the manager if necessary with such comments as: “I could always speak to the management with any problem”. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 23 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. The quality in this outcome area is excellent. Didsbury Court is very comfortable, clean, excellently maintained and provides a safe standard of accommodation for the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The tour of the home confirmed that the owners maintain excellent environmental standards within the home. Routine general upgrading continues to take place, including re-decorating, refurbishment and re-carpeting etc, which ensures that the accommodation is maintained to an excellent standard. The new works to create three new bedrooms and extend and improve some existing facilities have been undertaken to a very high standard ensuring that Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 24 residents benefit from a very pleasant environment overall which is in keeping with their needs. The home’s fire precautions are maintained to the required standard. The home’s fire log book was inspected and found to be in order. The management also ensure that fire awareness training is provided specifically to residents as well as to staff, to ensure that they are also fully aware of what to do in the event of a fire. This is seen as excellent practice and allows residents to feel responsible for their own welfare. New fire extinguisher stands have been provided to ensure that the extinguishers are easily located throughout the home. There is also an air freshener system located throughout the home which results in the home smelling very pleasant. Privacy locks to residents’ bedroom doors are in place and the management confirmed that all hot surfaces are protected and all hot water outlets regulated to a safe temperature with a sample seen and tested confirming this. At the last residents’ meeting it was noted that an agenda item had been raised regarding the residents’ own rooms and they had all been asked if they were happy with their rooms to which they had responded that they all were. However the management then further informed them that if there was anything else they wanted/needed in their rooms they only had to ask. Minutes of the meeting confirmed this as did individual residents’ comments. All residents are provided with a lockable facility within their rooms to store valuables etc. Communal areas were excellently presented and were being enjoyed by the residents. Again attention to detail has enhanced residents’ lifestyles. For example, there is an electrical operated photo screen which displays a different picture every minute or so. This allows the owners to have the many photographs taken of the residents, undertaking the wide variety of activities within the home, easily available and provides both a focal and talking point which residents find stimulating and enjoyable. There are also many other photographs and resident information scattered throughout the home, which ensures that anyone entering Didsbury Court can be assured that it is very much classed as the residents’ home. There is a small proper bar area situated within the recently created coffee snack area, which was provided at the residents’ request. The home presented as very clean and feedback given from various parties, during the visit, indicated that this was normal. There were no unpleasant odours what so ever throughout the home. The laundering needs of the residents are met appropriately with a new improved laundry system having recently been provided which ensures that all residents’ laundry is laundered and returned as effectively as possible. Residents also stated that their clothes were washed and returned to them quickly. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 25 During the visit staff were noted as observing routine health and safety procedures, such as using gloves and washing hands which helps prevent any unnecessary cross infection within the home. All staff also carry individual anti-bacterial hand gel for their own personal use and there is a bottle in the entrance to the home for visitors to use, therefore helping prevent the risk of cross infection within the home which ultimately protects residents. The home has a weekly collection of clinical waste and any heavily soiled linen is washed in red laundry bags which then disintegrate within the washing machine to prevent as little handling as possible by the staff, and thus help prevent cross infection within the home. Staff have also received cross infection training. The home’s external gardens have been landscaped and provide a relaxing safe area for residents to enjoy with the garden being full of lovely flowering plants along with a summer house which is available for residents’ use. New gates are to be provided to the entrance to the home to further enhance the home’s security and appearance. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 26 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. The quality in this outcome area is excellent. Staff at the home are well trained and sensitive to residents’ needs being supported and employed in sufficient numbers to meet the residents’ needs at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents and visitors spoken with during the visit confirmed that the staff cared for the residents well. Staff were also noted as being well presented and polite. A resident feedback comment stated that: “ independence is encouraged but help is always readily available”. Another resident stated that: “they are good at choosing staff they are all so friendly”. The staffing rota was discussed and it was noted that there were sufficient staff rotered on duty to provide the necessary care as well as provide for the sixteen residents’ social needs. Domestic cover is provided each weekday and there is always a designated cook rotered to be on duty Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 27 Both external and internal training is provided regularly. Recent training provided has included updated statutory training which has included such areas as fire safety, moving and handling, health and safety, infection control (which was an in-depth course run by the N.H.S.) as well as first aid. Other work related topics such as care of the bereaved has been provided by a local undertakers, whilst falls collaborative training, diabetes training and training in anxiety and depression and holistic care have been provided by the local Primary Health Care Trust. Safer food, better business training has recently been provided by the local Environmental Health Department. The management also ensure that all of the training provided is also relevant to the nationally recognised NVQ awards, which the staff undertake. This helps ensure that staff are familiar with their caring role before they commence this training and are supported throughout their training with additional complimentary training which helps each staff member gain valuable knowledge to enable them to carry out their work to ensure the best interests of the service users are maintained. The provision of NVQ level 2/3 training in care is made available with seventy percent of the current staff currently being trained to these levels, which exceeds the current requirement of having fifty percent of trained staff available. It was also very pleasing to note that the domestic member of staff had also been trained to be a first aider so that she could also respond appropriately in an emergency. This has the effect of further protecting residents. The management maintain a training needs development plan, which, clearly identifies what training, has been provided to staff and when this training needs to be reviewed/updated. The robust recruitment procedures within the home ensure that there are suitable staff working within the home and that residents are protected. Two staff members spoken with confirmed that their recruitment procedures had been very thorough and that they had not been allowed to work unsupervised within the home until the management had had their enhanced Criminal Record check back. The management also undertake a personal risk assessment in relation to each staff member’s role which helps ensure that they are aware of how each staff member is expected to perform and if any staff member has any known weaknesses these are also known and worked with to ensure that at all times resident welfare is upheld. One staff member stated: “I look forward to coming to work, everyone is so friendly it’s just like a family, all the residents and staff get on well together”. Staff on duty were spoken with and it was evident that they took pride in their role and felt that ensuring residents had a good quality of life, irrespective of need or diversity, was the most important part of their role. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 28 One staff member, who had been recruited a as domestic staff member, stated that during her interview she had been told that an important part of her role was just to talk with to the residents which she felt was an important part of her role and allowed residents the opportunity to discuss anything they felt they wished to without her feeling pressurised due to the time this may take. Consequently the communications within the home towards the residents was supportive and respectful from all staff. Another staff member stated that: “the staff team was really good and that there is a nice relaxed atmosphere in the home”. This was also echoed by the residents who were spoken with. All staff spoken to felt well supported by the management and it was evident, from watching the verbal communications that took place during the day, that the owners, the home’s deputy manager , staff and residents communicate well with each other each other in a friendly relaxed manner. There were written records of the supervision that had been provided by the management to each staff member and each staff member has their own personal development plan. Staff also confirmed that they found their supervision sessions helpful and productive and supported them in their caring roles. Staff further reported that they appreciated being recognised by the management when they undertook good work and this encouraged them and made them feel valued. Again this positive staff attitude was reflected back by the residents in the very high praise they gave regarding the care they received. There are also regular staff meetings held with minutes kept. Information that may be useful to staff, including the home’s policies and procedures are made easily available to all staff, which allows them to have an awareness of all issues surrounding their roles and therefore maintain a pride in their role. The management also undertake an annual appraisal for each staff member where their whole performance is assessed and discussions take place as to how their strengths could be best used and any weaknesses built on. The home maintains a mostly stable staff group, which allows residents to feel secure and confident of the carers’ ability to care for them. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 29 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. The quality in this outcome area is excellent. The home is managed efficiently and well, with the management of the home being easily available and approachable. The management team are very professional and have an awareness of all residents’ needs and the staffs’ abilities to meet them. The home provides a safe, secure environment where residents’ safety and well being is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 30 The owners have owned the home for many years and Mrs Watson is a qualified NVQ assessor, holding the D32/33 award as well as having obtained the Advanced Care Management qualification. The home’s deputy manager has now achieved her Registered Manager’s Award and NVQ level 4 in care. She also undertakes other role related training and keeps her training portfolio up to date. This ensures that the staff and residents continue to be managed by an aware and experienced management group. The deputy mananger has been in post for the past four years, having worked as carer and senior carer in the home previously. She is now to apply to become the registered manager of the home, taking over from the owner who currently undertakes this role. She has been in post for several years and is well acquainted with the day to day running of Didsbury Court. She is well liked and respected both within the home by residents and staff, and visitors to the home. All those spoken with stated how confident they were with the overall management of the home and how they all led by example being always available, approachable and ensuring that residents’ needs are met on a daily basis, as well as planning for their long term needs/goals. A resident’s comment included: “The management are excellent we would all be able to speak to them with any concerns and they are always very attentive”. The overall management of the home undertake the required management tasks efficiently and professionally maintaining all required records to an excellent standard. All records inspected were up to date, concise and detailed. Polices and procedures were easily available, very in-depth and are updated yearly, of before if there is any changes needed to them. All staff have access to them and are expected to read them and be aware of them. The home’s internal risk assessments are also available to all staff and are comprehensive yet easy to understand. They cover all necessary areas including a building risk assessment, moving and handling, security of the building and maintenance of window restrictors (the owner stated that all upper and middle floor windows are restricted accordingly). Health and safety polices are comprehensive and again include all necessary information. During the inspection it was noted that when a laminated floor was being washed an appropriate warning notice was put in place to help minimise the risk of anyone, including service users or staff, slipping on the wet floor. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 31 The management will hold small amounts of monies for residents and is involved with the finances of two service users, collecting monies on their behalf. There were detailed records in respect of these and one of the two residents was spoken with who confirmed the she was aware of how much money the home held for her and what the level of payment was. These systems and the residents’ awareness ensures residents’ monies are protected at all times. The management holds regular residents’ meetings with the last one being held in January this year and from which much evidence was seen as to how all the residents are involved in the general decision making processes operating within the home. Some examples of issues discussed were how residents would like to spend some monies that may be awarded through a Government grant. Residents chose to have new large LCD television in the home’s communal lounge to ensure all were more easily able to view the television, and also to have blinds installed in the conservatory and dining room as well as to redecorate the lounge. It is anticipated that the home’s bid for the monies will be successful, having already passed the first vetting, however the owner also confirmed that the work would be undertaken regardless. The home has excellent quality auditing systems and maintains its “Investors in People” award. The home operates thorough internal quality monitoring systems with residents’ and relatives’ etc feedback invited as part of the overall process. The management of the home undertake a full yearly audit as well as regularly updating the running of the home, following on from resident and other feedback obtained. The management produce an annual development plan and it was pleasing to note that this was now taking into account what may be viable to provide in 2008. Possible provision of using solar power is currently being considered for this date. These processes ensure that the home continues to be run in the best interests of the residents and continues to meet their needs at all times. The management confirmed that health and safety issues also continue to be well managed within the home and records inspected supported this. Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 32 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 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 33 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 Didsbury Court Rest Home DS0000018347.V330297.R01.S.doc Version 5.2 Page 34 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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