Inspection on 26/06/06 for Donnington House

This inspection was carried out on 26th June 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Donnington House 11/02/10

Donnington House 14/12/09

Donnington House 18/11/09

Donnington House 21/08/07

Donnington House 21/09/05

Donnington House 03/05/05

Donnington House 14/10/04

Donnington House 09/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Donnington House 47 Atlantic Way Westward Ho! Bideford Devon EX39 1JD Lead Inspector Andy Towse Key Unannounced Inspection 10:00 26th June 2006 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 Donnington House DS0000053386.V293348.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. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Donnington House Address 47 Atlantic Way Westward Ho! Bideford Devon EX39 1JD 01237 475001 01237 424540 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) Stonehaven (Healthcare) Ltd Mrs Jennifer Mary Burrows Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25), Physical disability (25) of places Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: Donnington House is a large detached property situated in the seaside resort of Westward Ho! It is registered to accommodate 25 older adults who may also have dementia or physical disability. The accommodation is on three floors. There is access between the floors by stairs and there is a chairlift between the lower ground and ground floor. The majority of residents are accommodated in single occupancy rooms but there are two bedrooms which have shared occupancy. Fees charged range from £274 to £395 per week. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which took place over a period of 9 hours. Prior to the inspection information was obtained through confidential questionnaires and in some instances telephone conversations, with residents, staff, relatives of residents and professionals who had involvement with the home. Further information was supplied by the manager in response to a questionnaire forwarded by the CSCI. The information was used in the planning of this inspection, combined with further discussion with the management, staff, relatives of residents, residents and visiting professionals together with the inspection of relevant records including care plans in order to compile this report. What the service does well: The home has an effective admissions process involving the registered manager compiling a comprehensive pre admission assessment and wherever possible arranging for prospective residents to visit the home in order that they can make an informed choice about living there. Care plans are reviewed regularly. Medication was seen to be administered in a manner that was respectful and protected service users’ welfare. The home promotes contact with family and friends by having a flexible and friendly approach to visitors. The home has a good percentage of staff with required qualifications; therefore ensuring staff are able to meet service users’ needs effectively. The home operates a good Quality Auditing system and has recently employed a Care Industry Consultant to carry out an audit of the home, which was underpinned by reference to the National Minimum Standards. Staff feel supported and there is an appropriate system of supervision in place. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Donnington House DS0000053386.V293348.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 Donnington House DS0000053386.V293348.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s admissions procedure ensures that only residents whose needs have been assessed and can be met are admitted. Whenever possible residents can make an informed choice about moving into the home. EVIDENCE: The files of three residents, one of whom had recently been admitted to the home, were examined. Records relating to the admissions process showed that the registered manager had carried out a full assessment on the most recently admitted resident in order to ensure that the home would be able to meet his/her needs. This process had involved an initial telephone conversation with the relatives of the prospective resident, who were acting as his/her carers. This had been followed by a home visit by the registered manager to see the prospective resident at his/her home where she had compiled a written Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 9 assessment. The assessment was seen to be comprehensive, including biographic information, lifestyle choices, intellectual, emotional, physical and risk assessments. This resident was able to make an informed choice about moving into Donnington House as he/she had visited it previously and had expressed the wish to live there. Donnington House does not offer intermediate care. Donnington House DS0000053386.V293348.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Well-formatted care plans combined with regular reviews ensure that the needs of residents are met. Medication administration, storage and recording protects residents. EVIDENCE: Three residents’ files were case tracked. All were seen to contain care plans. These care plans were seen to be regularly reviewed and contained relevant information relating to maintaining the health and well being of the resident. Whilst the existing plans are adequate the home is now introducing a new system of care planning, which has been designed by a consultant taking into account suggestions made by the registered manager. This is intended to be a corporate system of care planning which will be common to all homes within the Stonehaven group. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 11 Care plans, in this new system, were seen to be comprehensive and written with reference to the National Minimum Standards relating to Health and Personal care. The new plans incorporate risk assessments and provision to include advice and instruction from relevant professionals. There is also a page which is to be signed by the resident or his/her representative to show both their involvement and agreement to the contents of the care plan. This system will ensure that staff are provided with the information they require to meet residents’ needs consistently and safely. Healthcare professionals spoken to confirmed that any information and/or instructions supplied by them could be incorporated into the new care planning system. They also confirmed that the home ensured that residents were respected by receiving treatment in the privacy of their own rooms. The registered manager has reviewed and amended the home’s medication policy making it relevant to Donnington House unlike the previous policy. Residents are protected by the homely remedies it uses being listed and sanctioned by the general practitioner. The home was seen to have appropriate storage facilities for controlled drugs and their administration was seen to be recorded properly. Medication was observed to be administered in a manner which deferred to the right of residents to accept medication. The recording of the administration of medication was seen to be carried out correctly and there is appropriate recording of all medicines which are returned to the pharmacy. Medicines were seen to be kept securely in a wooden trolley, and also in a locked room specifically for the storage of medicines. The manager said that there would be improved storage facilities when a steel trolley which was ordered arrived. Donnington House DS0000053386.V293348.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home meets service users’ social needs but improvements are needed to ensure they are fully met. Contact with friends and relatives is encouraged by the home’s policy towards visitors. EVIDENCE: In discussion residents confirmed that they were free to go to bed and get up at whatever time they chose. They had the right to see visitors when they wished and in the privacy of their own rooms. During the inspection visitors were seen to come and go freely. When spoken to they said that there were no restrictions on visiting and that staff made them welcome. This was confirmed when staff were seen to prepare refreshments for visitors. Care plans listed the interests of residents and the home’s Statement of Purpose refers to the home offering activities. Four responses by residents to the pre inspection questionnaire said that the home ‘usually’ offered activities Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 13 they could get involved in, another said ‘sometimes’ and one said ‘always’. Whilst there are some organised in-house activities, such as bingo, quizzes and arts and crafts, the level of staffing combined with the layout and the needs of residents means that the staff cannot always ensure that such activities are available. The home also arranges for entertainers to visit the home. These have included Old Time Music Hall, a flautist, a Tea dance and a guitarist, although the home, despite its Statement of Purposes’s referral to activities, expects these to be funded by the residents or from fundraising by the home. Observation of residents’ rooms showed them to be personalised and confirmed that residents had the right to bring with them items of furniture and other items of sentimental value. Residents were seen to enjoy their food. They can dine in either the upstairs dining room or in the lounge downstairs. Those who ate in the downstairs lounge were seen to remain in their armchairs and have their food placed on small tables in front of them. When asked these residents confirmed that this was their choice and that if they wished they could sit at the table in the centre of the room. Discussion with the cook showed that he was aware of the individual food preferences of individual residents. There is a specific section on care plans, which refers to diet and whether there are religious or cultural needs which need to be addressed regarding this. Donnington House DS0000053386.V293348.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaints, whistle blowing and protection from abuse policies. EVIDENCE: The home has a brief but informative Complaints Procedure. This contains time scales for completion of investigations and details of who to contact. It also contains contact details for the Commission for Social Care Inspection together with the right of the complainant to contact the CSCI at any time during the complaint process. Copies of the Complaints Procedure were seen to be on display in key places around the home, allowing both staff and residents to be aware of it. Further protection is offered by the home’s Whistle-blowing policy, which serves to protect, staff who raise concerns about poor care practices. The registered manager is aware of the need to protect vulnerable adults and to refer staff who are unsuitable to work with them for possible inclusion on the register for the Protection of Vulnerable Adults The home has appropriate financial procedures to ensure that residents are protected from financial abuse. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 15 Staff spoken to had had training, or were scheduled to receive training relating to the protection of vulnerable adults and were aware of what to do if they suspected poor care practices. Residents, visitors and staff were confident that they could approach the registered manager if they had any concerns or complaints. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the overall quality judgement in this outcome group is adequate, some areas in the home are below standard. Some upgrading has taken place, but further redecoration and refurbishment is required to enhance the residents’ quality of life. EVIDENCE: Donnington House is a detached property on three levels. The ground floor and lower level are linked by a staircase with a chair lift; the ground and first floor are accessible only by use of stairs. As was stated in the previous inspection in May 2005. The owners have informed the CSCI of their intention to both enlarge the home and improve its physical standards. This would include the installation of a passenger lift, which would make access between floors easier for residents. The upgrading has not yet commenced. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 17 Since the last inspection there has been some improvement in the home’s physical environment. All bedrooms are now carpeted, a window in a lower floor bedroom has been enlarged to provide more natural light and the kitchen has been improved by the installation of stainless steel units. The laundry has been upgraded by the addition of new dryers and an increase in storage space for clothing. Overall however the home has a ‘tired’ feel, which was commented on by several of the people interviewed or who responded to questionnaires. Furniture in communal areas is old and worn as is some bedroom furnishings. Although radiators have safety covers these remain unpainted and marked and carpets in areas such as those on the lower floor are stained and perhaps result in the malodour referred to by different people. The home remains without a sluice with staff continuing to use the upstairs bathrooms, which are out of use to residents, for the purpose of cleaning commodes. The procedure appears to be safe but good practice would suggest that sluice facilities should be made available. The staff do their utmost to maintain a good standard of hygiene and records show that bedroom carpets are regularly shampooed in an effort to reduce malodours. Bathrooms and toilets were seen to be clean and the siting of the laundry ensures that soiled clothes do not need to be carried through areas where food is either prepared or eaten. Although two bathrooms are no longer in use, staff and residents confirmed that this has not had a negative effect on residents’ ability to have a bath or shower when they wish to. Residents spoken to were satisfied with their bedroom accommodation. Many had rooms which had been personalised, one commented favourably on the view from her room. In instances where rooms were shared privacy was ensured by the installation of screens and since the last inspection a second sink had been installed in a shared room, which allows more privacy for those occupying the room. Externally the home has a large rear garden, which is well maintained and can be accessed by residents. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has levels of care staffing to meet basic care needs. To provide a more stimulating environment staffing levels should be increased. The home demonstrates a commitment to staff training. EVIDENCE: Care staff and the registered manager were spoken to, together with information obtained from pre inspection questionnaires. This showed that the home has 67 of its care staff with NVQ 2 or equivalent qualifications, which is above the minimum 50 referred to in the National Minimum Standards and therefore shows that this home has a good level of staff training relating to NVQs. Within the last twelve months staff have received training regarding mouth care, continence care, fall and fracture awareness, dementia, confidentiality, diabetes, moving and handling, protection of vulnerable adults and fire safety which should improve the knowledge of staff regarding issues relevant to those to whom they have a duty of care. Rotas supplied by the registered manager showed there to be three care staff on at all times with the registered manager working from 8am till 5pm during week days. During the inspection the staffing level appeared adequate to meet Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 19 the basic care needs of residents, but, as stated previously in the report, not to guarantee meeting other needs such as 1:1 interaction or stimulating leisure and recreational activities. Responses from residents to the pre inspection questionnaire showed that in their opinion staff were always or usually available and that they either always or usually had their needs met. In meeting the needs of residents none of the nine staff who responded considered that they had ever been asked to carry out work outside their area of expertise and all thought that they were well supported in the work they did. Inspection of staff files showed that this home operates an effective recruitment procedure, which by use of references and police checks ensures that residents are protected from potential abuse. The home is scheduled to the New Skills for Care Induction Programme by September 2006. These are standards of training expected for newly appointed staff to ensure they have the knowledge to meet residents’ needs safely. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a competent manager. The home has effective auditing systems. Residents are protected by appropriate financial record keeping. Staff are appropriately supervised. There are appropriate practices and procedures to protect residents and carers. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager has run this home for approximately three years. She has instituted change and has demonstrated leadership skills in working with and developing her staff team. Donnington House is run by the Stonehaven Healthcare group. Since the last inspection they have employed a freelance consultant to audit the performance of this home using the National Minimum Standards as his baseline. A report from this consultant has been compiled and at the time of the inspection some of the issues raised in it were being addressed and others had suggested timetables for their implementation. The home continues to operate its weekly, monthly, six monthly and annual Quality Auditing system and has regular surveys to obtain information regarding how residents regard the service. The home operates a good system of recording finances, which protects residents. In responses received from the staff, all said that they felt well supported in their work and records showed that the manager oversees an appropriate system of staff supervision within the home. Responses received from the registered manager regarding Health and Safety issues state that appropriate procedures are in place and equipment is serviced and maintained appropriately. The fire safety log showed that appropriate fire safety precautions are in place. Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 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 X 3 3 X 3 Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard OP12 Good Practice Recommendations The home needs to review and develop its programme of activities if it is to achieve the stimulating environment referred to in its Statement of Purpose. A programme of routine maintenance and renewal of the fabric and decoration of the home is produced and implemented with records kept. The home requires refurbishment and replacement of old carpets and furnishings if it is to be clean, pleasant and hygienic. 2. 3. OP19 OP26 Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Donnington House DS0000053386.V293348.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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