Inspection on 15/04/08 for Dorriemay House

This inspection was carried out on 15th April 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

Dorriemay House 30/04/07

Dorriemay House 27/04/06

Dorriemay House 07/11/05

Dorriemay House 04/05/05

Dorriemay House 11/01/05

Dorriemay House 20/07/04

Similar services:

Thorndene

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Southfields

Magenta

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Dorriemay House Dorriemay House 23/27 Eaton Road Margate Kent CT9 1XB Lead Inspector Wendy Gabriel Unannounced Inspection 15th April 2008 10:30 Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 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 Dorriemay House DS0000023391.V361102.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 Adults 18-65. 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. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dorriemay House Address Dorriemay House 23/27 Eaton Road Margate Kent CT9 1XB 01843 292616 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) marbleshcare@tiscali.co.uk Mr David Barrie Mirsky Mrs Jacqueline Ann Mirsky Manager not yet registered. Care Home 25 Category(ies) of Learning disability (25) registration, with number of places Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th April 2007 Brief Description of the Service: Dorriemay House is registered to provide residential care for up to 25 people with a learning disability. The home comprises three adjoining terraced properties, with a paved garden to the rear. The home provides 13 single bedrooms and 6 double bedrooms. Two bedrooms have en-suite bath/shower and w.c. All other bedrooms have wash hand basins. The premises are situated in a residential area of Margate. The town has amenities such as rail and bus services, shops and churches, a library and a concert hall. The sea front is a short distance away. There is no parking at the premises and limited pick up time in the road. There is no access for people with impaired mobility. The registered provider stated that plans for changes to the registration are currently being discussed with Kent county Council social services. The fees at the time of the inspection are in the range of £311.15 - £388.15. For up to date information please contact the provider. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The unannounced inspection took place on the 15th April 2008 at 10.30 am. The registered provider completed an Annual Quality Assurance Assessment (AQAA) when requested. The registered provider stated in the AQAA that he is currently in discussion with KCC social services about future changes to the service. This includes plans for redeveloping much of the premises to meet the changing needs of the people who live in the home. The two requirements made at the previous inspection had been met. There were 17 people living in the home at the time of the inspection. The registered provider was in the home and the manager was available later for a short time. Adult protection issues from last year have been concluded. During the inspection, some records were looked at and case tracked. Some people living in the home and 3 members of staff spoke with the inspector. An accompanied tour of most of the premises was undertaken. What the service does well: The home has met the 2 requirements made at the last inspection regarding staff training. Since then, all staff has completed NVQ2 and 2 members of staff are progressing with NVQ3. A training matrix indicated the training that has been undertaken since the requirements were made and there was clear planning for training and updating for the coming year. Staff were very enthusiastic and knowledgeable about their different roles and responsibilities. There was very comfortable, warm and appropriate communication noted, especially between the registered provider and people who live in the home. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Lack of full pre-admission assessments for emergency admissions could affect the homes ability to meet peoples needs. Prospective residents know they can visit the home before making a decision to live there. EVIDENCE: The files of three of the people who live in the home were looked at. There were assessments from the placing authority and from previous establishments and these are consulted by the home before they accept the application for admission. However, the home must add their own findings as part of the assessment to ensure they can meet the needs and aspirations of prospective residents and that the new admission will meet the criteria and ethos of the home. This is especially important for an emergency admission. The registered provider stated that there had not been an emergency admission since last year. The registered provider agreed to use the format already available to the home. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 9 Prospective residents are given the opportunity to spend some time in the home, from a few hours and a meal on one day to spending a night and then for a few days prior to making a decision to stay. The registered provider said they encouraged the individual to meet and chat to established residents at this time, as they were the people who really knew about life in the home. After an admission, the home undertakes a care assessment and includes a history of the individual. The service has developed a statement of purpose, which sets out the aims and objectives of the home. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People know their assessed needs are reflected in their individual plans but further guidance will support their changing needs and independent lifestyle. People know their decisions about their lives will be supported. Confidential information is handled appropriately. EVIDENCE: Care plans contain assessments of different needs, risks and preferences of individual people. But these must have more detailed guidelines for staff. The home tends to be reactive to behaviours and staff would benefit from a more proactive ethos to, for example, recognise signs and deal with issues before certain behaviours occur. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 11 One member of staff said that this had happened successfully with one person but it had not continued. Some people had signed their care plans where possible and a member of staff said that key workers encouraged people to understand what information the plans contained. Regular reviews in the home are undertaken as are reviews from care managers. Key workers have a lead role in ensuring people are enabled to make choices about their lives. Members of staff showed great understanding of the needs of residents and of one person in particular whose needs were being reviewed towards greater independence. The registered provider said that the home had very good support from care managers. A casual conversation observed between the registered provider and a resident indicated the importance the home puts on equality and maintaining choice. Confidential information is secured in a locked office with locked storage facilities. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to take part in appropriate activities at home and in the community. People are able to have appropriate relationships that will be improved by detailed guidelines for staff. Peoples’ rights are recognised and respected. People enjoy the varied menu and know that special diets are catered for. EVIDENCE: The homes own day centre across the road has been closed and there are plans to develop this into a drop in centre. There was good evidence of participation in college courses including skill net run by the local learning disability team. College courses include IT skills, office skills, drama and the theatre. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 13 Some people have part time jobs with a local charity shop and one person said he enjoyed being in the shop and the useful work he did there. Written evidence was seen of one persons attempt, encouraged by staff, to seek work in the locality. One person said he enjoyed playing his guitar. There were puzzles and games in the lounge that were obviously in use. One person was informed about a change in venue for an outing and the registered provider made sure the person understood the reason and checked with him that he was happy with the alternative choice. Many of the people who live in the home have a degree of independence including travelling out of the home alone. Families are welcomed in the home. There was evidence of staff undertaking work with some people towards independent living. One person said he was looking forward to being more independent and was undertaking different classes towards this end. One member of staff is undertaking NVQ 3 for independent living. Individual finances are mostly maintained by the home and a sample seen corresponded with records kept. A member of staff has lead responsibility for maintaining the records and has a very good and clear understanding of recording, security and confidentiality. The kitchen is very well stocked with fresh, frozen and dry store goods. The cook said that the menu offers daily choices and specialist diets are catered for. The menu was varied. This was confirmed at lunch time when two choices were seen being served. All people who were asked said they liked their meals. Some staff has undertaken a course on nutrition and this has been put into practice by recording and nutritional assessment charts. Weight charts are maintained and a member of staff said these were regularly checked. The kitchen will be altered during the proposed redevelopment and some worn tiles and kitchen furniture will be renewed. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal support in the way they prefer and their physical and emotional health needs are met. Medication administration is sound and supported by policies and procedures. EVIDENCE: There was written evidence in care plans of health care needs being attended to or being referred to health care professionals. Daily reports evidenced when a gp or emergency service was called in response to health matters. Staff respect privacy and dignity and some people hold their own bedroom door keys. People who use the service are supported to be independent and to take responsibility for their personal care needs where possible. Some individual support is being reviewed with a view to the future redevelopment of the service. People are aware of the changes and one expressed happy agreement and that he was looking forward to this. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 15 Information regarding one person’s ongoing health and safety needs was recorded in his person centred plan, daily log, incident report and accident forms. Medication administration is sound and well organised. Medication is securely stored in a dedicated room. A member of staff has lead responsibility for medication procedures and was very knowledgeable about policies and procedures. Staff undertake suitable training before being allowed to administer medication. There was attendance by staff at medication administration training updates during the month of the inspection. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident their complaints will be listened to and dealt with appropriately. Policies and procedures and staff training are designed to protect people from abuse. EVIDENCE: The registered provider stated that the home had not received any complaints since the last inspection. The home uses complaints forms that are in pictorial format. The home has a culture that allows people to express their views and concerns in a safe environment. Key workers spend 1-1 time with people to enable them to make their opinions known and to be able to voice any concerns. Key workers also carry out regular reviews. Conversations between staff and individuals were noted to be very caring and staff took time to listen to people and respond in a suitable manner. The home has adult abuse procedures and since the last inspection, training on adult abuse procedures and on managing aggression and violence has been increased to include all staff. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 17 The registered provider stated that adult protection issues from last year had been concluded in January 2008. He said that the home has always had very good support from care managers. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a homely, comfortable and safe environment. Bedrooms suit peoples’ lifestyles. The home is clean and hygienic. EVIDENCE: The service offers a homely, comfortable and safe place. Some redecoration would improve the environment but because there are advanced plans to redevelop the three adjoining buildings that make up Dorriemay House, there is no point in undertaking this until building work is completed. This does not compromise health and safety. Bedrooms seen were attractive, very personal and homely and generally in a better decorative state that the communal areas. One person showed his room Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 19 to the inspector and was very proud of his possessions and it was obvious by his communication and body language that he liked his room very much. There are some shared bedrooms but these will go once the redevelopment has taken place. The shared rooms have screening for privacy. The home is not suitable for wheelchairs. The stair carpet and some other areas have been cleaned since the last inspection report made this a recommendation. The laundry has commercial facilities. Staff have a good awareness of infection control. There are disposable hand drying towels, pump soap dispensers and hand wash facilities for infection control. Maintenance certificates are up to date and the gas safety check was due to be done at that time. The fire book was up to date and the registered provider confirmed that the people who live in the home were very aware of and responsive to evacuation procedures. The rear garden is well maintained. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent and appropriately trained staff supports peoples’ individual and joint needs. People are protected by the homes recruitment procedures. EVIDENCE: Staff training has increased considerably since the last inspection and has met the two requirements made at that time. A senior member of staff has lead responsibility for organising training and was aware of the need to ensure training was kept updated and at times, be specific to needs of people in the home. She said that the registered provider supported her requests to seek particular courses to meet the changing needs of people. There was a training plan already in use for the year with further courses being sought. A member of staff and the registered provider stated that all staff has completed NVQ2 and two were undertaking NVQ3, one in independent living. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 21 Staff were enthusiastic about their roles and had a very good understanding of the responsibilities they had been given. The home was fully staffed and the organisation of the rota reflects the needs of the people using the service. Some of the staff have worked at the home for many years. Recruitment procedures are sound and include CRB checks. Induction is undertaken and staff undertakes regular supervision that is recorded. This meets a recommendation made at the last inspection. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a well run home. People know their views are listened to and acted on. People know their health and safety is protected. EVIDENCE: The manager has many years experience in working with adults with learning disabilities. He is applying for registration. The registered provider has also worked with adults with a learning disability for many years. Both the manager and the registered provider believe that their redevelopment plans for Dorriemay House will enhance the lifestyles of the people living there. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 23 All sections of the AQAA received from the home were completed and the information gives a reasonable picture of the current situation within the service; although there are areas where more supporting evidence would have been useful to illustrate how the service has improved in the last year, or how it is planning to improve. Quality assurance is undertaken by regularly reviewing policies and procedures. Staff monitor peoples views through key worker sessions and by writing regular, individual reviews. The registered provider has the skills and ability to provide good value for money. Maintenance checks are undertaken and the home has up to date certificates for checks on services. The registered provider said that they were awaiting the annual gas service check. The fire record book was up to date. Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 2 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Dorriemay House DS0000023391.V361102.R01.S.doc Version 5.2 Page 25 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 YA2 YA9 Good Practice Recommendations Pre-admission assessments are to be undertaken including those admitted on an emergency basis. Risk assessments must include guidelines for managing behaviours and supporting relationships. 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