Inspection on 18/09/08 for Donwell House

This inspection was carried out on 18th September 2008.

CSCI found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Donwell House 20/11/08

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Donwell House Wellgarth Road District 2 Washington Tyne & Wear NE37 1EE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Irene Bowater     Date: 1 8 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Donwell House Wellgarth Road District 2 Washington Tyne & Wear NE37 1EE 01914167663 01914171952 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Tracey Jane Garland Type of registration: Number of places registered: Southern Cross OPCO Ltd care home 63 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 61 The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 48 Dementia Code DE, maximum number of places 20 Physical Disability, Code PD, maximum number of places 8 Date of last inspection Brief description of the care home Donwell House is a purpose built care home situated in the village of Washington Tyne and Wear.It is registered to accomodate up to sixty three people who need Care Homes for Older People Page 4 of 27 Over 65 0 48 0 20 0 8 Brief description of the care home nursing,social and personal care and it also cares for people who have a Dementia type illness. There is easy access to the home and there is planty of car parking to the front of the building.There is a pleasant conservatory to the back of the home which leads to a landscaped garden and patio area. There are lounges and dining rooms throughout the home and bathrooms and toilets are easily accessible. All bedrooms have an ensuite facility and access between floors is by stairs and passenger lift.Corridors and doorways are wide enough to accommodate wheelchairs and there are plenty aids and equipment for those who need assistance. The home is close to all public amenities and there is a regular bus service which runs to the local shopping area. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. Before the visit. We looked at. Information we have received since the home was re registered. How the service has dealt with any complaints and concerns. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service,their relatives,staff and other professionals. Care Homes for Older People Page 6 of 27 We have reviewed our practice when making requirements,to improve national consistency.Some requirements from previous inspection reports may have been deleted or carried forward as recommendations but only when it is considered that people that use the services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. The Visit. An unannounced visit was made on the 19 September 2008.This visit was carried out by one inspector and took seven hours to complete. During the visit we: Talked with people who use the service,staff,relatives and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records,which must be kept. Checked that staff have the knowledge,skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean,safe and comfortable. Checked the current fee rates for the people living in the home. These are: Social and personal care 402 Pounds, Dementia care 417 Pounds, Nursing care 402 Pounds with the free nursing care element set nationally, and continuing nursing care 503 Pounds. Items not included in the fee rate include, personal items,clothing,newspapers,some outings and clothing. What the care home does well: What has improved since the last inspection? What they could do better: Fluid and food charts need to be completed in detail to evidence practice and show what alternatives are offered and taken. Personal hygiene charts must be completed on a daily basis. Care plans must specify the type of moving and handling equipment that is needed for each person. Care Homes for Older People Page 8 of 27 Menus should be available in large print and picture style so people can understand what choices there are for each meal. Further refurbishment is needed and lighting levels increased. Prompts and signage needs to be introduced on the Dementia care unit so that people can find their way around and maintain a degree of Independence. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive clear information about the service and a comprehensive assessment of need before admission.This helps them make the right decision about using the service. Evidence: The home sets out the aims and objectives of the service in a Statement of Purpose and Service User Guide,both are readily available in the home. The Service User Guide is easy to understand and is also available in audio style if necessary. There is reference to supporting the diversity of needs,cultures and beliefs of all those involved in the home. Care Homes for Older People Page 11 of 27 Evidence: Before anyone is admitted a full needs assessment is undertaken by a Care Manager,the Home Manager and where necessary the nurse assessor.From this information the staff complete a care plan based on individual needs. Also the home confirms in writing to each individual that they can meet their needs and everyone has a contract that sets out the terms and conditions while living in the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Access to health care is good and detailed care planning demonstrates that peoples needs are being fully met. Evidence: Each person has a plan of care based on the admission assessment which has been carried out by care managers,the home manager and when necessary nurse assessors. Staff have completed pressure ulcer risk,dependency,moving and handling,nutritional assessments using the Malnutrition Universal Screening Tool(MUST),continence and fall risk assessments. These tools help the staff understand the level of risk for each person and helps them complete a plan of care. Care plans and risk assessments are reviewed and generally updated on a monthly basis. Staff have contacted Speech and Language Therapists (SALT) when there have been concerns about people having difficulty swallowing and being at risk of choking. Care Homes for Older People Page 13 of 27 Evidence: People who have been identified at having lost weight have risk assessments in place to show how they are being supported with eating and drinking.However the food charts are not clear about what alternatives are offered and accepted which means staff cannot be sure that individuals have had nutritionally sound diet.Those who are at risk have their weights regularly recorded and advice sought if necessary. Although care plans state when hoists and slings are to be used staff do not specify which hoist and sling and do not always detail the moving technique that everyone should follow. Appropriate pressure relieving devices are available.Several people have air cell mattresses and cushions to prevent pressure damage. Advice is sought from the tissue viability nurse and clear records are available to show whet action is being taken.All of the records for wound care are currently being held in one file for easy access.The manager said that there are plans to move these records into individual care plans. Information about peoples lifestyles and preferences are recorded.And plans are beginning to show that a person centered approach to care is being given. Everyone has access to all NHS facilities to ensure their health care needs can be met.There are regular visits from GPs and other health care professionals including occupational therapists,physiotherapists,dentists,opticians and chiropody services. Medication policies and procedures are readily available for staff to use. Records are in place for all medicines received,administered and disposed of. An audit of Controlled Drugs and the Medicine Administration Records (MAR) showed no discrepancies. Many of the staff have worked at the home for some times and know the people they care for well. All of the staff worked very hard to make sure everyone was treated with respect and their rights to privacy and dignity maintained. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities to take part in meaningful activities and keep control of everyday decisions are good, and mealtimes are well organized. This makes sure people can lead full and active lives. Evidence: The home benefits from an enthusiastic activities person who organizes events both inside and out of the home. Some events take place in groups other people have some individual time allocated to them. The home has recently been re registered and is now managed as one home. Although on the day of the visit staff were still referring to three separate units.There were activities taking place throughout the home and many people enjoyed playing musical bingo in the morning. Some enjoy going to the local pub to play bingo and others go out on a regular basis for coffee.There is also a bus which takes people out on day trips. There are photographs of individuals previous live styles,their wedding photographs Care Homes for Older People Page 15 of 27 Evidence: and enjoying dancing at a dance hall in Newcastle. The two week activity plan includes,newspaper groups to discuss current affairs, arts and crafts, pamper days and memory games. Everyone has an activity record which shows what they have been involved in. Visitors are welcome at any time and are able to use the lounges or their relatives bedrooms for visits. Information about advocacy is available in the home. Many people have brought small items with them making their rooms homely and reflective of their previous lifestyle,religious beliefs and cultural backgrounds. There are three dining rooms in the home.Should anyone prefer to eat their meals in their own rooms this service is provided. Tables in all dining rooms were set appropriately for the lunchtime meal. Choices for the meal were quiche,chips and beans or chicken casserole, cabbage, sweetcorn , new potatoes and gravy.Alternatives for dessert included chocolate sponge and custard,yogurts,fresh fruit and ice cream. There is some self service in one dining room where vegetables are served in tureens so people can help themselves and retain a degree of independence. Jugs of juice were freely available through out the meal. Staff offered choices at the point of service and gave assistance where needed in a sensitive unhurried manner. Although menus were displayed they were difficult to see and people with some memory loss could not understand what was being offered and would benefit from a picture style menu. Everyone spoken to said: The meals are good. Nice food and always good. We get good food I am putting on weight I enjoy all of the food, no complaints. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good complaints and protection procedures are in place.People can be sure that their views are always listened to and that they are protected from harm. Evidence: The Company have detailed complaints and safeguarding procedures which are easy to understand and they are readily available in the home. The home keeps a full record of all complaints including detail of any investigation and action taken within timescales. The complaints register records seven complaints which have been dealt with at home level.One of these was referred to the Safeguarding Adults team but no further action was necessary. There have been no complaints or safeguarding referrals made to the the Commission. Staff have completed Safeguarding training and further training is planned with Sunderland Safeguarding Adults partnerships.There are also plans to complete the Responsible Person training which is a two day training course. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the home is clean and comfortable further investment is needed to make sure that it remains a pleasant place to live. Evidence: This is a purpose built home with accommodation over two floors. There is easy access to all areas of the home including a pleasant garden and conservatory. There are lounges,dining rooms,bathrooms,toilets and bedrooms have an en suite facility. The lighting in the corridors is very dim and there are some areas which do not have any natural light which means people with any sensory loss will have difficulty finding their way around.Also there is some damage to walls and doors from wheelchairs and trolleys. All of the communal areas are nicely decorated but the carpet in the upstairs nursing unit is badly marked and cannot be cleaned properly.Some of the lounge chairs are showing signs of wear with the backs and arms marked from constant use. There are tea and coffee making facilities in each lounge so that drinks can be made at any time. There is a Dementia Care Unit and although it is nicely decorated it has not been designed to help people with memory loss find their way around. Care Homes for Older People Page 18 of 27 Evidence: For example there are no aids or prompts such as images of bathrooms or toilets,names or photographs on doors or well picked out grab rails and bedroom doors. Bedrooms for single use and have an en-suite facility.People living in the home have been encouraged to bring small items with them making their rooms individualized and reflective of previous lifestyles. There is some scuffing to walls from wheelchairs. There are plenty of bathrooms and shower facilities throughout the home and these have appropriate aids so that people can use these facilities easily and safely. Again there is some damage to walls and doors from wheelchairs.The shower room upstairs has some damage to the flooring an would benefit from re grouting. The laundry has been re sited and is very busy. On the day of the visit one dryer was not working and there was a vast amount of laundry to be done. Staff confirmed that they had infection control training and although very busy the area was clean with no odours. All of the staff work very hard to make sure the home is kept clean,comfortable and free from any odours. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels and systems around recruitment,selection and training of staff are excellent and meet the range of needs of the people using the service and protect them from harm. Evidence: On the day of the visit there were two nurses two senior care staff and seven carers on duty. There were also sufficient ancillary staff including activities, administration, laundry ,domestics ,housekeeper,cook, kitchen assistants and maintenance person.The manager is supernumerary. Although the home has now re registered as one home it is still being staffed separately as a nursing,social care and dementia care unit. The records for recruitment are good.There was evidence of Criminal Record Bureau checks,two written references,proof of identity and professional identity numbers for registered nurses. The files show that all staff complete an induction and mandatory training including fire,first aid,moving and handling, infection control and food hygiene. Care Homes for Older People Page 20 of 27 Evidence: There is also a training programme in place for all staff and training has included Mental Capacity Act,Challenging Behaviours,Dementia Care,Palliative Care,Safeguarding Adults and Safe handling of Medicines. Over 50 percent of staff have completed NVQ (National Vocational Training) two and some have completed NVQ three. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by a competent manager who makes sure that good quality assurance systems are in place.This means that people receive an excellent quality care. Evidence: The manager is a first level registered nurse.She has been registered with the Commission continues to update her knowledge to continually improve the quality of the service. Audits of care and other services are carried out with actions and outcomes recorded.The regional manager visits on a monthly basis to make sure the quality of the home continually improves. The AQQA was completed and the information gave a good picture of what was happening in the home and also gave clear information about how it plans to develop over the next year. Care Homes for Older People Page 22 of 27 Evidence: Staff,relative and resident meetings take place with minutes kept.The manager holds regular surgeries so that everyone has a change to discuss anything that concerns them. The personal allowance records demonstrate that receipts and double signatures are maintained for all transactions.These can be cross referenced and regular checks are carried out to make sure there are no discrepancies. Mandatory training is up to date and further training is already planned.Health and safety risk assessments are clear and up to date. Accidents are recorded and best practice is used to examine and track trends which prevents as fare as possible the same accidents or incidents happening. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 15 The registered persons must 28/11/2008 ensure that all food charts are completed in detail. This will make sure that staff monitor those people who are nutritionally at risk and ensure they receive a good diet at all times. 2 19 23 The registered persons must 30/12/2011 introduce a programme for the renewal of the fabric and decoration of the premises. This will make sure that the home remains a pleasant and safe place for people to live. 3 20 23 The registered persons must 16/02/2009 replace the stained carpet and lounge chairs. This will make sure that the home remains a clean and pleasant place to live. Care Homes for Older People Page 25 of 27 4 25 23 The registered persons must 30/01/2009 ensure that the lighting in corridors meets recognized lux levels of 150 This will ensure that people are able to find their way around the home safely Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 It is highly recommended that the care plan records the exact hoist,sling and moving and assisting techninque for staff to follow. It is highly recommended that the menus are predominately displayed and are made available in picture format. The registered persons should change the colour schemes and provide pictures and signage to help people with memory loss find their own way around the dementia care unit. The registered person should ensure that all staff are given amended contracts. 2 15 3 20 4 29 Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!