Inspection on 11/07/07 for Ditton Priors Residential Home

This inspection was carried out on 11th July 2007.

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

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

Other inspections for this house

Ditton Priors Residential Home 27/06/06

Ditton Priors Residential Home 09/01/06

Ditton Priors Residential Home 27/09/05

Ditton Priors Residential Home 01/03/05

Ditton Priors Residential Home 07/09/04

Ditton Priors Residential Home 03/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Ditton Priors Residential Home Ashfield Road Ditton Priors Bridgnorth Shropshire WV16 6TW Lead Inspector Mike Moloney Unannounced Inspection 11th July 2007 10.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ditton Priors Residential Home DS0000020719.V340070.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. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ditton Priors Residential Home Address Ashfield Road Ditton Priors Bridgnorth Shropshire WV16 6TW 01746 712656 01746 712076 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) www.guardiancaregroup.co.uk Guardian Care Homes (UK) Ltd Mrs Margaret Alsop Care Home 23 Category(ies) of Dementia (10), Old age, not falling within any registration, with number other category (13) of places Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2006 Brief Description of the Service: Ditton Priors Residential Home is registered to provide care for a maximum of 23 older people, of whom 10 may be suffering from dementia. The Home is on the edge of the small Shropshire Village of Ditton Priors with most rooms enjoying uninterrupted views of the Shropshire countryside. It has extensive well-maintained grounds with many shrubs, trees, flower borders, lawns and patios, and an area where vegetable produce is grown for use in the Home’s Kitchen. The Home, purpose built as a residential care Home during the 1970’s, has since been extended to provide additional care places. Mrs Margaret Allsop is the Registered Manager. The Home is part of the Guardian Care UK Group. Guardian Care Homes (UK) Ltd make their services known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. Fees for Ditton Priors as of 1st April 2007 are: £320-£420 a week. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: To improve the service that the residents receive further the home must improve the levels of professional supervision that the staff receive so that issues relating to care and professional conduct can be discussed in confidence and on a regular basis. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 6 The home also needs to ensure that the needs of any new residents are established as soon as possible after they are admitted if this cannot be done beforehand. 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. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. Prospective residents and their representatives have the information needed to choose a home which will meet their needs as well as a contract which tells them about the service they will receive. However, they do not always have their needs assessed prior to or within a reasonable time of being admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of two new service users, both admitted in the previous ten days, were looked at. The file for the person who had a planned admission had all the necessary assessments in place. The family of this lady were visiting her at the time of the inspection and they and her all confirmed that she had been given a copy of the service user guide and the statement of purpose as well as various brochures containing information about the home as part of the introductory process. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 9 The records for the person admitted as an emergency the previous Monday contained little further information with no progress having been made on a care plan. A number of care contracts were seen and these contained details of the amounts paid by all parties. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of two service users who had been living at the home for some time were looked at. Risk assessments were seen to be in place and covered a range of activities including manual handling. Monthly care reviews were seen to have taken place. These were seen to include falls assessments, nutritional assessment and such like. Medical appointment charts showed visits to or by various healthcare professionals. Throughout the inspection staff were seen to be polite and discrete. Talking with service users and visitors confirmed that this was their usual experience. A number of service users confirmed that they get help to get up at times that Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 11 they prefer. Training in the care of people who are suffering from dementia was going on at the home during the morning of the inspection and new practices were being put into place to help them. The Manager explained that, for example, as part of the development of the home’s dementia care, the photo of the occupant’s key worker will be to put on the back of bedroom doors as a reminder to the service users of who they are. Medication procedures and storage were looked at and these were seen to be appropriate and watching the staff confirmed that they ensured that the home’s procedures were followed. They also confirmed that they had received training in the safe handling of medication. The home was seen to have appropriate storage for controlled drugs although there were none in the home at the time of the inspection. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirements and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of two of the service users were looked at. Risk assessments were seen to be in place with, for example, one containing guidance to staff about how to supervise one service user when they were walking around the home and another for when a person with memory problems was ‘wandering’ around the building. The records showed that these risk assessments were reviewed on a regular basis. Talking with a number of the service users confirmed that afternoon activities take place in the home on a regular basis and looking at the home’s diary Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 13 confirmed that major activities such as fetes and outings also happen periodically. The records seen confirmed that the preferred names of the service users are known and that arrangements had been made for the residents to use postal votes should the need arise. The Manager stated that community transport is arranged for those that need it. Kitchen records showed that a variety of meals are offered to the service users and they have two choices for each meal and the cook confirmed that special diets, whether for medical, cultural or religious needs, are catered for. The service user guide says that contact with clerics of any denomination would be made on behalf of individual residents. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records showed that one complaint had been made about the home since the last inspection. Discussions with the home manager and the service users showed that this had been resolved appropriately. Two issues are currently being dealt with through the local adult protection procedures. Talking with the Manager it was clear that she was aware of the requirements of the local policies and procedures for the protection of vulnerable adults. Adult Protection training for staff was taking place at the home during the afternoon of the inspection. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated in the village of Ditton Priors and is a property that has been developed to its present use in a sensitive and practical manner since it was originally built as a care home in the ‘70s. The rooms were all seen to be bright and airy and kept at a comfortable temperature. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 16 Various rooms were being decorated at the time of the visit. However, one service user commented and the manager confirmed that the service users were not given a choice in the colour schemes of their bedrooms. The laundry is now equipped with a washing machine that has a sluicing facility for dealing with heavily soiled items. This means that the sink can now be exclusively used for hand washing. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Throughout the inspection staff were seen to be polite, sensitive and friendly towards the service users and their guests with the residents spoken to during the visit saying that this was what they had come to expect. Staff rotas showed that staffing levels meet the needs of the service users. Service users said that staff are always available to help when they need them. The records showed that a variety of training courses are available to the staff on a variety of subjects from the basic mandatory safety training through to the dementia training given on the morning of the inspection and the adult protection training given during the afternoon. The staff confirmed that they are encouraged to undertake this training as well as to be part of the NVQ training programme run by the home. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 18 The home was seen to carry out appropriate pre-employment checks to ensure that new employees are fit to work with vulnerable people. New staff are then put through an induction programme that is designed for people who are new to the care industry. . Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 and 38 Quality in this outcome area is good. Although there are some shortfalls in record keeping and staff supervision the management and administration of the home is based on openness and respect and has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager confirmed that she is a qualified nurse and has the Registered Managers Award which are both qualifications that are considered appropriate for someone who is managing a service such as this. Clearly she keeps up with current care home practice by attending courses as she was attending the courses held at the home on the day of the inspection. A Deputy manager has recently been appointed to help her to manage the home. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 20 Records showed that senior managers of the company visit the home on a regular basis. The home has also carried out a formal user consultation exercise in recent weeks and is currently interpreting and responding to the results. Records showed and service users confirmed that residents meetings are held every two to three months where issues relating to the running of the home are discussed by the residents and their representatives with the management. The home holds cash for small number of service users. Records were available for inspection. The manager stated that she checks them weekly and the home is subject to regular audits by the parent company and these monies are included in their checks. The records showed that staff supervision sessions are taking place but not at the required intervals. Lack of dates and a confusing filing system made the records difficult to follow. A number of records were seen showing that safety checks had been carried out on such things as portable electrical appliances and fire safety equipment but the weekly records for bathwater temperature checks had not. However, the hot water from the bath taps was found to be at a comfortable temperature at the time of the inspection. Records of fridge and freezer temperatures were seen to have been kept in the ‘Making Food Safely’ format which is the system recommended for use in care homes. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 3 3 2 x 3 Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14(1)a Requirement Any person admitted to the home must have their needs assessed as soon as possible to ensure that those needs can be met. The registered manager shall ensure that staff are appropriately supervised. Timescale for action 30/08/07 2 OP36 18(2) 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations The occupants of the bedrooms should be given the chance to help choose the colour scheme for their room when they are redecorated so that their personal space is more personalised. Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ditton Priors Residential Home DS0000020719.V340070.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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