Inspection on 02/07/08 for Dormy House

This inspection was carried out on 2nd July 2008.

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

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

Dormy House 29/06/09

Dormy House 03/07/07

Dormy House 31/07/06

Dormy House 03/10/05

Dormy House 09/05/05

Dormy House 10/08/04

Dormy House 11/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Dormy House Ridgemount Road Sunningdale Berkshire SL5 9RL Lead Inspector Jill Chapman Unannounced Inspection 2nd July 2008 10:15 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 Dormy House DS0000010983.V367396.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. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dormy House Address Ridgemount Road Sunningdale Berkshire SL5 9RL 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) 01344 872211 01344 875111 dormy@caringhomes.org www.caringhomes.org Dormy House (Sunningdale) Limited Sian Belinda Davis Care Home 63 Category(ies) of Dementia - over 65 years of age (13), Old age, registration, with number not falling within any other category (63) of places Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the inner rooms numbered 4 and 22 are not used as service users bedrooms until advised by Fire Service 3rd July 2007 Date of last inspection Brief Description of the Service: Dormy House provides residential/nursing care and accommodation for 63 older people. The home is a large mansion that has been extended on three sides, providing single and double rooms with en-suite facilities. The main house provides care and accommodation to people who require residential/nursing care, and the Surrey Wing provides care and accommodation for 13 people who have dementia. The gardens overlook a golf course and have seating provided. Dormy House has a Statement of Purpose and Service Users Guide available on application to the home. Email dormy@caringhomes.org Information CSCI received on2/07/08 confirm that fees range from £650 to £1200 dependant on assessment, and dependant on whether the room is residential shared/single en-suite, or nursing shared/single en-suite. Additional charges for Hairdressing, Daily Newspapers, Chiropodist, Physiotherapist, Escort duties, Dry cleaning, Private dentistry and Toiletries. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10:15 am and was in the service for 6 ¼ hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector had detailed discussions with the Registered Manager, two nurses and one one carer and met a variety of other staff during the visit. The views of service users were sought in a group setting at lunchtime and some were seen in private in their bedrooms. Two relatives and the GP also gave their views on the service and care of the residents. A tour of the premises was carried out and records relating to staff, care and health and safety were sampled. The inepctor was introduced to the Regional Manager who visited the home during the inspection. What the service does well: Service users and their representatives have information to help them decide if the home can meet their needs. The home makes sure it can meet service users needs before offering them a place. The home is able to meet the diverse needs of the service users including any religious or cultural needs. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 6 Service users health and social care needs are met with dignity and respect as detailed in their plan of care and risk assessments. Activity plans support the diverse needs of the service users. Service users have choice at mealtimes and are involved in menu planning. They are supported to maintain contact with family and friends. The homes complaints procedure is readily available for service users and their representatives. Staff are trained to safeguard service users from abuse. Service users live in a safe environment that is in the process of being updated, refurbished and extended. The home has a diverse staff team who are competent, trained and sufficient in numbers to meet the care needs of the service users. Thorough recruitment procedures and practice protects service users. The manager follows corporate policies and procedures in the management of the home and to protect the health and safety of service users. The views of service users and others are sought to help develop the service. What has improved since the last inspection? What they could do better: Weekly checks to all bath hot water outlets will make sure all baths provide hot water at safe temperatures. The development of individual bathing risk assessments will make sure that the risks of drowning; scalding and falling in the bath have been assessed for each service user. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 7 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. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. The people who use the service experience good quality outcomes in this area. Service users and their representatives have information to help them decide if the home can meet their needs. The home makes sure it can meet service users needs before offering them a place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a Service Users Guide to inform potential residents and their representatives about the home. In discussion with a relative during the inspection they confirmed that they had received information about the home. The manager said that a recent assurance questionnaire had highlighted that not all service users were familiar with the Service Users Guide, although they Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 10 each have a copy in their rooms. She said she has reminded those individuals or their families where these are kept. Discussion with two service users and one relative confirmed that service users are fully assessed prior to being offered a place in the home. They said that the manager visited them at home or in hospital to carry out the assessment. The files of new service users showed that the assessment is well documented and a checklist makes sure all areas are covered. Assessments include specialist health assessments and manual handling. The assessment procedure covers a range of diverse needs including spirituality and any cultural needs. The home does not offer intermediate care and so standard 6 does not apply. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. The people who use the service experience good quality outcomes in this area. Service users health and social care needs are met with dignity and respect as detailed in their plan of care and risk assessments. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care files of six service users were sampled, including two who are resident on the unit that cares for service users with dementia. Files were well organised and had a care plan index. They evidence that service users are involved in care planning and review and that monthly evaluations are carried out. Daily records of care and a care checklist are kept to evidence that care plans are carried out. The manager said that the Caring Homes Group is currently reviewing the care plan format. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 12 Service users health care needs are well documented, screening tools or risk assessments are used to identify risks from pressure sores, falls and malnutrition. Records are kept of GP, District Nurse and other health professionals’ visits and the outcomes are recorded. The inspector was able to speak with the homes GP who was visiting during the inspection. He confirmed that there are good working relationships and good communication between the surgery and home and that the home makes appropriate referrals. The home has a policy and procedure for the control, storage, disposal, recording and administration of medication. Only trained staff administer medication and a registered nurse confirmed that they had been given training and passed a competency assessment before giving medication to the service users. The manager said that medication is audited once a month. One service user self medicates and the GP was consulted about this procedure. Service users spoken with confirmed that staff treat them respectfully and uphold their privacy and dignity. Care plans document the need to carry out tasks upholding these principles of good care practice. Observation of staff practice confirmed this. All service users seen were clean, nicely and appropriately dressed. Some had been to the visiting hairdresser that morning. A relative visiting a service user on the dementia care unit said that her relative and other service users are always kept clean and clothes well looked after. Service users spoken with made the point that staff deal well with any problems between service users, they said that they quietly intervene and diffuse the situation, protecting the dignity of all concerned. This was observed when staff were helping a distressed service user in the dementia care unit. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. The people who use the service experience good quality outcomes in this area. Activity plans support the diverse needs of the service users. Service users have choice at mealtimes and are involved in menu planning. They are supported to maintain contact with family and friends. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has three designated activity co-ordinators. Activity assessments care plans and activity records were seen on files sampled. There is a rolling programme of activities and copies are kept in each service users room. Some service users said that not all activities on the programme take place but said they enjoyed games and Bingo. Service users and a relative said that outings and musical entertainers are popular. There was good feedback from service users and relatives about the visiting arrangements. Some relatives visit every day to be with their husband or wife Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 14 and the home can accommodate them at mealtimes for a fee. Visitors are welcome in communal areas or can be entertained in private in service users rooms. A visiting minister comes once a month to give communion and service users are free to attend religious venues of their choice. The home manager said that the does not act appointee for any of the service users but they hold pocket money accounts for personal shopping and hairdressing. Service users said they give staff a list of items and then these are purchased and given to individual service users. Receipts and records are kept to verify the purchases. Service users confirmed they could bring their own small items of furniture and belongings into the home and inventories were seen on files sampled. The home has recently had a Food Safety inspection by the Environmental Health Officer, so the kitchen was not inspected on this occasion. The majority of service users spoken with said they are very satisfied with the meals on offer. Breakfast is served in their bedrooms and some service users choose to have all of their meals in their rooms. Service users confirmed that there are two choices for each course at the three-course lunchtime meal. The cook said that any special dietary requirements could be met and that menus take into account service users preferences. Some service users felt that certain aspects of the food provided could be improved and these points were raised with the manager. She said that these comments had not been raised in recent surveys carried out and that she would look into them. A lunchtime meal was observed and this was a sociable occasion, staff assisted where necessary. Some service users had their relatives joining them for a meal. Food was served at the residents pace and looked appetising. The meals for service users who need a soft diet were well presented. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 15 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 & 18 The people who use the service experience good quality outcomes in this area. The homes complaints procedure is readily available for service users and their representatives. Staff are trained to safeguard service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission has not received any information about complaints about the service. The home has a complaints procedure and service users spoken with knew who to talk to if they had a concern. The complaints record was seen and the outcomes were clearly documented. The Annual Quality Assurance Assessment shows that the home has a policy on safeguarding adults and the prevention of abuse. Staff spoken with confirmed that they had received training on this issue. The manager said the home use two local authorities to provide this training. The home has informed the Commission when it has needed to make any safeguarding referrals and of action taken to further protect service users. A recent strategy meeting has highlighted that the manager needs more information about the Berkshire Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 16 reporting procedures that differ from Surrey County Guidelines that she is more familiar with. The Local Authority has forwarded this to the manager. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 17 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): The people who use the service experience adequate quality outcomes in this area. Service users live in a safe environment that is in the process of being updated, refurbished and extended. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is in the process of a major rebuilding and refurbishment programme. The manager said that that the new build unit is expected to be handed over from the builders in the Autumn 2008, a second phase will be completed in the summer of 2009 and a five-year refurbishment plan for the rest of the building has commenced. She said that that a written update is to be sent to the Commission. Previous requirements about storage of equipment Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 18 and furniture in service users accommodation, keeping a comfortable temperature in service users bedrooms and to keep the home clean and odour free have been met. Although significant parts of the home are still in need of refurbishment or upgrading it was seen on a tour of the premises that there has been an improvement in the management, maintenance and cleanliness of these areas. A new housekeeper has been appointed and a maintenance man is employed. Seven bedrooms have been redecorated and bathrooms have been refurbished. A new worktop has been fitted in the dementia care unit. The home was found to be clean and hygienic. There is an infection control policy and staff spoken with confirmed they had received mandatory training in infection control. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 19 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 & 30. The people who use the service experience good quality outcomes in this area. The home has a diverse staff team who are competent, trained and sufficient in numbers to meet the care needs of the service users. Thorough recruitment procedures and practice protects service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff deployment was confirmed during the site visit. Daytime deployment in the main house is a nurse plus 8 carers in the morning and a nurse and 6 carers in the afternoon and evening. At night there is a nurse and 4 carers. In the dementia unit there is a nurse in the day plus 2 carers and at night there is a nurse and a carer. There is evidence that staff deployment is reviewed to meet increased needs, additional funding has been obtained to provide 1-1 care staff for one service user whose needs have changed. There is a Deputy Home Manager, Qualified Nurse in charge of the Dementia Unit, Administrative Assistant, Chef, Housekeeper, Domestics and a Maintenance man. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 20 There is a diverse staff team and staff turnover is very low. Staff spoken with were positive about the levels of staff deployment and the way that the teams work together. Service users were positive about the support they receive from the staff. The manager confirmed that there are 49 of care staff who either have or are working towards National Vocational Qualification training Level 2 or above. (Two staff with NVQ 2 have recently retired) Two staff have NVQ level 3 and three are taking this. The home has a recruitment policy and from records sampled and discussion with staff it was seen that this is carried out. Recruitment records were well organised and had a checklist to show that the different stages of the procedure had been carried out. These include Criminal Record Bureau and POVA list checks, two references and work permits, when relevant. The Annual Quality Assurance Assessment states that staff are given ‘Skills For Care’ induction training that meets the National Minimum Standards. Staff spoken to confirmed that they had received mandatory training that includes Manual Handling, Health and Safety, Infection Control, Fire Safety, First Aid, Food Hygiene and Protection Of Vulnerable Adults. Additional training includes Customer care, Diabetes and Computer Skills. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. The people who use the service experience good quality outcomes in this area. The manager follows corporate policies and procedures in the management of the home and to protect the health and safety of service users. The views of service users and others are sought to help develop the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 22 The Registered Manager is an experienced qualified nurse and has obtained the Registered Managers Award. The manager has made good progress in addressing the requirements from the last inspection. Service users views are sought via Customer Satisfaction Surveys, the manager advised that these had been carried out recently and were being analysed by Head Office. Views are also sought in staff, service users and relatives meetings. The system for managing the service users pocket money accounts was verified with the manager. She confirmed that monies are kept and recorded separately and individual receipts are kept. Service users files sampled showed that inventories are kept of service users personal possessions in their rooms. Staff spoken with confirmed that managers are approachable and supportive and that they receive regular, documented supervision. The home employs their own maintenance man to deal with routine repairs and the manager said that there has been an improved response for replacement and repairs that are accessed via head office. The Annual Quality Assurance Assessment shows that the home has a health and safety policy and that health and safety training for staff is mandatory. The AQAA also shows that routine servicing of equipment is carried out. Records sampled show that regular testing of heath and safety and fire safety equipment is carried out. Regular checks are carried out on hot water temperatures to outlets that are accessible to service users. Although checks are carried out weekly, because of the volume of outlets baths are only checked monthly on rotation. It is recommended that all bath hot water outlets be checked weekly. There are risk assessments in place to cover a variety of risks to individual service users. There is a communal bathing risk assessment in place but it is recommended that individual bathing risk assessments are developed to document that the risks of drowning, scalding and falling in the bath have been assessed for each service user. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 23 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 3 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 3 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 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 X 3 3 X 3 Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 24 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 2 Refer to Standard OP38 OP38 Good Practice Recommendations Weekly checks to all bath hot water outlets will make sure all baths provide hot water at safe temperatures The development of individual bathing risk assessments will make sure that the risks of drowning; scalding and falling in the bath have been assessed for each service user. Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Dormy House DS0000010983.V367396.R01.S.doc Version 5.2 Page 26 - 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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