Inspection on 09/08/05 for Dinsdale Lodge Nursing Home

This inspection was carried out on 9th August 2005.

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

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

Other inspections for this house

Dinsdale Lodge Nursing Home 17/01/07

Dinsdale Lodge Nursing Home 19/01/06

Dinsdale Lodge Nursing Home 17/01/05

Dinsdale Lodge Nursing Home 30/06/04

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

CARE HOMES FOR OLDER PEOPLE Dinsdale Lodge Nursing Home 42 - 44 Station Lane Seaton Carew Hartlepool TS25 1BG Lead Inspector Vicky Hargreaves Unannounced 4th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dinsdale Lodge Nursing Home Address 42-44 Station Lane Seaton Carew Hartlepool TS25 1BG 01429 863440 01429 863440 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Finchworth Limited Mrs Nora Dolores McKittrick Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 One named individual who is under the age category is allowed to reside in the home. 18/03/2004 Date of last inspection 17th January 2005 Brief Description of the Service: Dinsdale Lodge is a large Victorian building which has been extended and redesigned to provide a two storey residential care home, with nursing, for up to 28 elderly frail users. The home has twenty two single and three double bedrooms. All the rooms are very individual in shape, size and decor. The rooms have wash-hand basins but no en-suite facilities. There is a ground floor dining room, a smoking and non-smoking lounge, and a small quiet room that can be used by visitors. There is a small passenger lift, which can take a single wheelchair, between the ground and first floor. There is flat access into the home and parking on site. The home is in a pleasant residential area close to local bus routes. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was one of the two inspections to be carried out on every registered home in a year. In line with current CSCI policy of ‘Proportionality’ the inspection focussed on a number of key standard outcomes for residents. The key standard outcomes not assessed on this occasion will be assessed during the next inspection of the home. The inspection took place over six hours when the inspector looked at a number of records, had a partial tour of the premises (not every room was looked at), and spoke to three members of staff, as well as the manager. During the inspection five residents gave their views about the home. The Manager, explained that since the last inspection she had not been able to spend time ‘managing’ because the home was having great difficulty employing nurses and she had to work as a nurse to cover the vacancies. What the service does well: What has improved since the last inspection? Since the last inspection the home has reduced the number of residents it will take, so that more residents can enjoy single bedrooms while double ones are still available for couples. The number of staff who have got their National Vocational Qualification in care at level 2 has increased and there have been four new care assistants started since the last inspection. The home has employed a private consultant to identify any fire risks and the manager was Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 6 ready take action on the recommendations. Work was also being carried out to meet the guidance of the local fire Department. 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. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed during this inspection but the key standards will be assessed in the next inspection. EVIDENCE: Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed during this inspection but the key standards will be assessed in the next inspection. EVIDENCE: Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed during this inspection but the key standards will be assessed in the next inspection. EVIDENCE: Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a complaints’ procedure but it was not written, or recorded, in a way that would give people confidence to complain, or confidence in the way the complaint would be investigated. The Home’s policy and procedure on Abuse did not follow the locally agreed procedures for dealing with allegations of abuse and there was no regular staff training on abuse. EVIDENCE: The Complaints’ Procedure displayed on the notice board, did not have the Darlington address or the (new) name of the Commission for Social Care Inspection. The procedure said that anyone who wanted to complain should do so in writing which could discourage people: however, the two residents who were asked, said, ‘If things weren’t going right I would feel quite confident about telling them’ and ‘I feel I could tell staff if I had a problem’. The last complaints that had been written in the complaints’ book, did not give any details about how they were investigated or, in the case where there was a ‘not substantiated’ outcome, if the complainant was satisfied. The Home’s Abuse Policy was very limited and did not include any reference to the inter-agency policy on dealing with allegations of abuse, although there was evidence that a recent incident had been correctly dealt with through this procedure. There was no evidence from the records seen that staff had had abuse training, but a long term staff member said she had had training in abuse and whistle-blowing in the last four years. She had not had training in dealing with aggression. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 12 Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. The cleanliness was good but the décor and lack of storage made the home less attractive than it should be. Fire safety was being improved, however the lack of proper facilities could put some residents’ comfort or safety at risk when using their bedrooms. EVIDENCE: At the time of the inspection, building work was being carried out in response to Fire Officers requirements and the home had a privately commissioned fire safety assessment that was going to be followed. Residents described the home as ‘comfortable’. The house had a homely feel but the general decoration in the corridors, hallways and some rooms was becoming shabby and the pieces of coloured paper (showing the fire zone) stuck on bedroom doors, looked scrappy. Certain toilet seats were chipped around the side and it is of concern that these could scratch a resident’s skin. Staff said that the building and equipment met the needs of the residents. The home was generally clean and there were no odours from the rooms that had been cleaned when the inspection took place. A resident stated that the home was, ‘Very meticulous, everything is washed every day’. Protective Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 14 gloves, aprons and hand gels (because of lack of space) were at points around the home, hanging over the corridor handrails. This arrangement was very convenient and reminded staff, but was out of place in a domestic setting. There was a suitable system for dealing with clinical waste. Although Standard 24 was not looked at as part of this inspection it was noticed that the bedroom doors did not have suitable locks. Residents could not lock their door from the inside but in some cases there were chain bolts fitted on the doors which would stop staff getting in, in an emergency. Although Standard 25 was not looked at as part of this inspection it was noticed that a few bedrooms had extremely large windows with no secondary glazing and the manager acknowledged that, at least one of these, needed an additional heater in the winter. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30. The home’s recruitment process was not rigorous enough to protect residents from unsuitable employees. Staff were given training but there was no efficient system to check the training of the staff group as a whole. EVIDENCE: The sample of three staff files which were seen had a range of discrepancies including: no photo; no evidence of identity; unexplained gaps in work history; lack of two references; and no record of starting date (so it could not be confirmed that the Criminal Record Bureau check had been done before being employed). The application form did not ask for the person’s last employer to be given as referee. There were no records of interviews. New staff were given induction training by an outside agency and by working through a checklist with senior staff. There was some evidence that statutory training was done but, as the records were only kept for individual staff, the manager could not easily confirm that all staff had had the training or they were up to date. A long-term carer in the home thought that her First Aid training may have lapsed, and was unsure whether she had done a course in infection control. A resident said that he, ‘felt staff understood their needs and had experience’ and another said, ‘Staff know my needs. They come and check if I’m all right’. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38. The home did not have any systems to check that it was being run in the best interests of the residents and some aspects of health and safety were not being managed effectively so residents could be at risk. EVIDENCE: The Manager admitted that there was no system to get the views of the service users, and a resident confirmed that he ‘didn’t think that anyone had asked him about the service’. No other evidence was put forward of checks being made on the quality of the care being provided. Maintenance records were available for the hoists and shaft lift. Fire records were in place, and there were very regular fire drills but, without the names of the staff involved, the manager could not be sure that all staff had had two each year, as required. There were a number of bed-rails being used in the home, but records showed that there had been some accidents when they were being used. Risk assessments for the rails were seen but they were not sufficiently detailed. Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 1 x x 1 x x x x 2 Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 18 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 Requirement The Registered Person must produce an up to date Statement of Purpose setting out the aims and objectives, facilities and terms and conditions. The Registered Person must establish and maintain quality assurance and monitoring systems. The Complaints Procedure must give the correct name, address and telephone number of the local CSCI office. The procedure should be more user friendly and include details of the investigation and satisfaction of complainant. The Abuse Policy must be linked to the local inter-agency policy on dealing with allegations of abuse and there must be a system to ensure all staff receive periodic training on this. The Registered Person must ensure that no person is employed in the care home before all the documentation in Schedule 2 has been collected and a POVA and CRB has been returned. Bed-rails must only be used after Timescale for action 30.8.05 2. 33 24 30.9.05 3. 16 22 30.9.05 4. 18 13 30.8.05 5. 29 19 Schedule 2 30.8.05 6. 38 13 30.8.05 Page 19 Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 7. 25 23 a comprehensive risk assessment has been carried out by a person qualified to do so. This must be regularly reassessed particularly after any accidents involving bed-rails. In rooms where the heating system has been found to be inadequate to meet Winter temperatures, a more effective heating system must be installed or other action taken to address this problem. 30.10.05 8. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 31 19 Good Practice Recommendations The Manager should complete the NVQ4 in management. Halls, corridors and stairways should be redecorated,and there should be a routine programme of redecoration for other rooms. The chipped toilet seats should be replaced. More presentable signs should be put up to denote the fire zone for each room, and ways to make the protective clothing available, but less obtrusive, should be considered. The manager should keep an up to date record of all the training done by staff so that gaps can be identified and future training can be planned effectively. All bedrooms should be fitted with locks suited to residents capabilities and accessible to staff in emergencies. 3. 4. 30 24 Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dinsdale Lodge Nursing Home B54 S0164 Dinsdale Lodge NH V232495 040705 stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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