Inspection on 17/11/08 for Dorothy House

This inspection was carried out on 17th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dorothy House 16/01/08

Dorothy House 11/07/07

Dorothy House 15/01/07

Dorothy House 21/08/06

Dorothy House 19/10/05

Dorothy House 23/06/05

Dorothy House 22/02/05

Dorothy House 18/05/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth 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: Dorothy House 186 Dodworth Road Barnsley South Yorkshire S70 6PD     The quality rating for this care home is:   one star adequate 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: Mike ONeil     Date: 1 7 1 1 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 28 Information about the care home Name of care home: Address: Dorothy House 186 Dodworth Road Barnsley South Yorkshire S70 6PD 01226249535 F/P01226249535 azaryounis@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Azar Younis Type of registration: Number of places registered: care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 16 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, Code OP - maximum number of places 61 Date of last inspection Brief description of the care home Dorothy House is situated on the main road from the M1 motorway to Barnsley town centre. The home is an extended bungalow that stands well back from the main road at the top of a driveway. The home shares the grounds with its sister home, The Firs. The gardens are landscaped and there is adequate car parking space. There are no stairs or steps either approaching or within the home therefore it is accessible to persons using walking frames or wheelchairs. The home has small bedrooms to the front of the property and larger bedrooms to the rear of the property. There is a Care Homes for Older People Page 4 of 28 Over 65 16 0 Brief description of the care home communal dining room and a small quiet lounge.There is a small patio area leading from the lounge. Care Homes for Older People Page 5 of 28 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: one star adequate 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: This is what was used to write this report. Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment. Information from surveys that were returned to us by 3 relatives and 1 staff. An unannounced visit to the home. This was carried out by Mike ONeil, regulation inspector on 17th November 2008 and included talking to 3 staff and Evelyn Phillips, Care Homes for Older People Page 6 of 28 home manager about their work and the training they have completed. And checking some of the records, policies and procedures the home has to keep. Evelyn is the new manager of Dorothy House and on the day of our visit it was only Evelyns second day as manager. She is not registered with the CSCI as manager but is aware that she needs to undertake the process to register promptly. Some time was spent observing staff supporting people and talking with 6 people and 2 visiting relatives. We wish to thank the people living in the home, staff, and relatives for their time, friendliness and co-operation throughout the inspection process. 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 into this report as recommendations but only when it is considered that people who use 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. What the care home does well: What has improved since the last inspection? What they could do better: Increased procedures must be put in place to ensure that peoples financial interests are safeguarded. People need to be assisted to move around the home in their wheelchairs in a safe way. The fire risk assessment must be up to date so that staff are clear of all fire procedures within the service. We would recommend that another person be employed at busy times during the weekend. Care Homes for Older People Page 8 of 28 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 28 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 28 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 were individually assessed prior to admission to ensure their needs could and would be met. Evidence: Three care plans checked showed that people within the service had been assessed before moving into the home. Risk assessments and a plan of care reflected any specialist interventions. The assessment forms checked were detailed and fully completed. The manager and senior staff liaised with professionals, the person and their families to find out about peoples needs. Records show that a home manager visited people and undertook assessments, prior to admission. Care Homes for Older People Page 11 of 28 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. Peoples health is monitored and arrangements for dealing with health issues were met with support from health professionals. People were treated with respect and said they were very happy with the care they received. Medication policies and procedures were well managed ensuring the safe administration of medication. Evidence: Three peoples care plans were checked. The peoples care plans contained details about the persons biography, personality and their preferences and choices. Staff had continued to improve the plans since our last key inspection. Overall the standard had improved significantly. The plans were being regularly reviewed and the changes in peoples health were being observed and recorded. Care Homes for Older People Page 12 of 28 Evidence: There was evidence recorded to show that people and/or their relatives were involved in drawing up and reviewing the care plans. Risk assessments were included within the documentation and included moving and handling, skin integrity, and other risk factors. The care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. People said they had regular contact with their GP and other health professionals such as district nurses and opticians. The care plans however still needed more attention because: Staff were failing to record times they made entries in the plans. Staff, when writing peoples daily notes, were not being reflective of the information actually recorded in the persons care plan. Therefore, there were no records to evidence that staff had met certain care needs of people over several days. Documenting has been fine today is not sufficient when recorded, in isolation, in a persons daily record. We discussed with the manager further improvements that may need to be made with regard to documentation but also wished to acknowledge the improvements made over the last year. People looked clean, well dressed and had received a good level of personal care. People said The staff are really nice Its lovely here. Relatives said The care is excellent Staff are great . Medication was securely stored. Medication records were up to date with no gaps. Peoples allergies were also recorded which is good practice. Medication that required refrigeration was kept in a separate locked drugs fridge. Staff said they had received comprehensive medication training. Records were seen of this training having taken Care Homes for Older People Page 13 of 28 Evidence: place. Staff were aware of the need to treat people with dignity and respect. During our visit we saw good interactions between people and staff. Staff spent time sitting with people and their families. People and relatives said staff are friendly, kind and helpful. Care Homes for Older People Page 14 of 28 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. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a satisfactory quality and offered choice to ensure people receive a balanced diet. Evidence: People said they were able to get up and go to bed when they chose and generally how they spent their day and evenings. They said they often went out with their families. Relatives said they were able to visit at any time and were made to feel very welcome. We saw that everyone coming to the home was offered hospitality and staff took time to make sure friends and family were made to feel comfortable whilst visiting. People and relatives said that there were some activities planned. A pea and pie supper had just been held at the home and a jewellery party was being held at Dorothy House on the evening of our visit. There was a friendly atmosphere in the home and staff spent time talking to people and their families. Relatives and people Care Homes for Older People Page 15 of 28 Evidence: commented on the friendliness of Dorothy House and said, We are just like one big family. There was not enough information displayed in the home that may help people with orientation. Two blackboards in the dining area were left blank. The menu for the day was not written on them. Also displaying information such as the date, the weather and a news item, may help the people further with orientation to time and place. Food preferences were listed on peoples files. We observed the lunchtime period at the home. The tables were set nicely with cloths, condiments and matching crockery and when the meal was served people said The food is generally good Im enjoying my food. People said they were always offered a choice and asked what they wanted for their breakfast, lunch and teatime meals. People said they were offered drinks on a regular basis throughout the day. Care Homes for Older People Page 16 of 28 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. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. Evidence: People and their representatives had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People said that they felt very comfortable in going to the provider knowing that any concerns they may have would be addressed without delay. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff and clearly displayed in the office of the home. Some staff had undertaken adult safeguarding training. Staff also said that over the next 3 weeks they are all attending 3 full days training which will include adult safeguarding training. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment within the home was well maintained, furnished to a good standard and clean, providing a comfortable, safe environment for people. Evidence: The home was clean and tidy and no unpleasant odours were noticeable. Touches have been added to make Dorothy House feel more homely. When we spoke to people they said that they felt the home was very clean and a comfortable place to live. Lounge and dining areas were domestically furnished to a good standard. Bedrooms checked were comfortable, homely and reflected peoples personal tastes. People said their beds were comfortable and bed linen checked was clean and in a good condition. Care Homes for Older People Page 19 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were generally employed in sufficient numbers and recruitment procedures promoted the protection of people. People receive care from a well-trained staff team. Evidence: People and relatives said staffing levels were adequate. Relatives said that staff were usually very visible around the home when they visited. Some staff did raise some concerns over staffing levels at certain times during the day. There are two members of care staff on each shift. Another member of care staff is employed at particularly busy times in the day usually around breakfast time. This extra member of staff is an increase in staffing numbers since the last CSCI visit. Staff and people have said that this has improved the availability of staff. However staff said that this increase in staff numbers is only Monday to Friday and that weekends are still very busy and staff find it difficult to meet peoples needs at busy periods on Saturday and Sunday. We would recommend that another person be employed at busy times during the weekend. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This Care Homes for Older People Page 20 of 28 Evidence: confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. Staff said they had received appropriate training and had regular updates. They said they were looking forward to the forthcoming training planned for three full days over the next three weeks. Staff were able to talk about other various training courses that they had attended. Adverts were displayed for staff to attend training from visiting health professionals. This training included minimising the risk of falls and on the topics of Osteoporosis and tissue viability. Care Homes for Older People Page 21 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. The services policies and procedures and some actions by staff mean that the health, safety and welfare of people are not fully protected. Evidence: As highlighted earlier the manager, Evelyn, is new to the post of manager at Dorothy House which meant that she was not fully aware of all the homes policies and procedures and the whereabouts of some documentation. The affect of this could,however, have been minimised if she was able to receive supernumerary hours to ensure that all management issues can be met. This has been a previous recommendation by the CSCI inspectors and we would wish to repeat this recommendation particularly in view of the management outcome being one of the weaker outcome areas of the service. Evelyn has many years experience within the Care Homes for Older People Page 22 of 28 Evidence: caring profession and has obtained the Registered Managers Award in the past year. She said that was committed to further improve the service as much as she could. The manager is not yet registered with us. She is aware of the need to register promptly. The home had improved the internal quality assurance system since our last visit. There was evidence of internal auditing of the homes environment, services and records. Staff meetings were held and minutes of these meetings were seen. The registered provider visited the home several times a week. People said they saw the provider and spoke to him on a regular basis. Monthly reports were being produced by the provider. People who use the service and their families met with the management of the home. These quality assurance systems will help to ensure that the service is operating in the best interest of the people who live there. Since a requirement was issued at the last inspection, staff and management of Dorothy House, have told us about things that have happened in the service, these are called notifications and are a legal requirement. The manager was fully aware of her responsibilities in dealing with notifications. The home handles money on behalf of some people. Account sheets were kept and receipts were seen for all transactions. However some peoples financial interests were not fully safeguarded because: We found that the cash held for one person did not tally with their statement sheet. There was no evidence to show that regular auditing of the financial systems occurred. Jewellery was found in the safe with no identification as to the owner. A thorough review of the services financial systems are needed with additional auditing systems put in place to safeguard people and the staff who handle monies. The health and welfare of people could not be fully protected, as: Several people were being moved in an unsafe way. Staff were escorting people around the home in wheelchairs, which were not fitted with footplates. To minimise the risk of injury footplates must be used (unless risk assessment does not warrant this) when assisting people to mobilise in their wheelchairs. The service had developed a fire risk assessment however this had not been recently reviewed. The risk assessment identified that it should have been reviewed in November 2007.Also the risk assessment could not be found for some time. Staff must Care Homes for Older People Page 23 of 28 Evidence: know the whereabouts of risk assessments and what is contained in them. Since the last inspection staff said they had received fire safety and other health and safety training .A sample of records showed that some staff were receiving this statutory training. Staff also said that over the next 3 weeks they are all attending 3 full days health and safety training. South Yorkshire Fire and Rescue Service had visited the home in April 2008. No issues requiring attention were highlighted in the report. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of the people. Care Homes for Older People Page 24 of 28 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 25 of 28 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 35 16 Increased procedures must be put in place to ensure that peoples financial interests are safeguarded. To protect people. 06/01/2009 2 38 13 To minimise the risk of injury footplates must be used (unless risk assessment does not warrant this) when assisting people to mobilise in their wheelchairs. To minimise the risk of injury. 01/01/2009 3 38 23 The fire risk assessment must be up to date so that staff are clear of all fire procedures /precautions within the service. To protect people. 06/01/2009 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. Care Homes for Older People Page 26 of 28 No. Refer to Standard Good Practice Recommendations 1 2 3 4 5 7 7 12 27 31 The persons daily notes should reflect the information actually recorded in the persons care plan. Staff should ensure that all written entries they make in peoples care plans are dated, timed and signed. Arrangements should be improved so that people can be orientated to date, time and place. We would recommend that another person be employed at busy times during the weekend. Consider increasing the managers supernumerary hours to ensure that all management issues can be met. Care Homes for Older People Page 27 of 28 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 © (2009) 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 28 of 28 - 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!