Inspection on 16/03/07 for Dorrington House

This inspection was carried out on 16th March 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dorrington House 07/08/09

Dorrington House 11/05/09

Dorrington House 16/10/08

Dorrington House 23/05/08

Dorrington House 02/08/07

Dorrington House 16/11/05

Dorrington House 23/06/05

Dorrington House 06/01/05

Dorrington House 10/08/04

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

CARE HOMES FOR OLDER PEOPLE Dorrington House 73 Norwich Road Watton Thetford Norfolk IP25 6DH Lead Inspector Jenny Rose Unannounced Inspection 16th March 2007 10:10 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 Dorrington House DS0000027516.V333494.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. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dorrington House Address 73 Norwich Road Watton Thetford Norfolk IP25 6DH 01362 693070 01362 699464 dhwatton@btinternet.com www.dorrington-house.co.uk Mr Steven Dorrington Mrs Lorraine Dorrington Mrs Janice Kathleen Kendall Care Home 52 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) Category(ies) of Dementia - over 65 years of age (52) registration, with number of places Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Eight (8) Older People who are named in the Commission`s records may be accommodated. One service user under the age of 65 years, with a diagnosis of dementia, may be accommodated. Any new admissions to the home must be in the category of Dementia (over 65 years of age). Maximum number accommodated not to exceed fifty two (52). Date of last inspection 16th November 2005 Brief Description of the Service: Dorrington House is a purpose built care home providing residential care for up to 52 older people including care for up to 20 older people with dementia. It is situated close to the centre of the town of Watton and within easy reach of its amenities. The home comprises accommodation on two floors serviced by a shaft lift, stair lift and stairs, with 20 bedrooms on the ground and 32 on the first floor. All rooms have en-suite toilet and hand basins in addition to the home’s communal shower and bathrooms. There are other communal areas including lounges and dining rooms that accommodate most service users at meal times. The home is one of two homes in Norfolk owned by the proprietors. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. Six comment cards had been received from residents, two from Healthcare Professionals and five from relatives. The majority of comment cards were positive and stated that they were satisfied with the overall care in the home. The manager was available throughout the day and was helpful in facilitating the process. A tour of the building was undertaken and records relating to residents and staff were examined. A healthcare professional, three visitors and three members of staff were spoken to in private. Several residents were spoken to in passing, and three in private. The information from the comment cards and from the people spoken to has been incorporated in the report. Overall the information received prior to the inspection and the information and evidence observed and inspected on the day suggested that Dorrington House (Watton) is a good service offering good quality care. However, certain procedures could be made more robust. What the service does well: • There is an ongoing programme of redecoration and refurbishment and the home offers a comfortable, clean and homely environment for the residents. There is a stable staff team, enthusiastic with their role. Training opportunities are given high priority, but there are’ specialist’ areas of training, which could be improved. Relatives spoken to commented positively on the helpfulness of the staff. Relatives and friends are welcomed into the home at any time and are involved with aspects of residents’ care, if they choose and it is appropriate. • • Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 6 • One comment from a relative was “Overall we are very pleased with the home. My father’s health improved very much and this is due to the care he has received.” The residents’ comment cards were positive about the food offered, as were relatives and residents spoken to. The Home has developed a good working relationship with the local Pharmacy, who liaise with the surgery, review the Home’s medication system and provide training. The proprietors and manager seek to maintain a good working relationship with the Commission, particularly in the area of new developments. There is a communications book in each resident’s room for messages to and from the home to relatives and visitors, which are passed via the keyworker and Deputy Managers, but this is not always sufficiently robust. There is a computerised labelling system for residents’ clothes, which is shared between the Proprietors’ two homes, which has caused delays in marking residents’ clothes • • • • • What has improved since the last inspection? • • • • • • A new gazebo has been built in the garden. There is a new computer in the office, and Broadband has been installed and is being used by both residents and relatives. A new boiler has been fitted to ensure that there is a consistent supply of hot water. New staff are only confirmed in post following satisfactory checks. The air conditioner in the dementia care unit has been repaired, so that it less noisy, which was a Recommendation from the previous inspection. Chairs are available in residents’ rooms for visitors, which was a Recommendation from the previous Inspection, and foldaway chairs have been made available in other areas. Lockable cupboards have been made available for residents’ incontinence pads, which was a Recommendation from the previous inspection. • Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 7 • • • Family history questionnaires have been received from many relatives in order for the Home to plan a more individualised activities programme. Finger foods are available in addition to meals, especially in the dementia care unit. Electronic keypads were being fitted on all outside doors on the day of the inspection for the safety of residents. What they could do better: • All staff need to continue to be aware that care plans should be prepared with the involvement of residents and/or their relatives or representatives and relatives kept informed of residents’ changing needs and action taken, if appropriate. The analysis of the life history questionnaires should continue to be incorporated into the activities programme, particularly for those people with dementia care needs. Not all care plans contained a check list to ensure that all tasks on admission had been undertaken, i.e. clothes marked. The home should continue to develop further training in the following: 1. 2. 3. • With the District Nurse team on the prevention of pressure sores and skin care, in particular in relation to moving and handling. Continuing support of staff for whom English is a second language, in order for there to be better communication with residents. All staff should receive an update in training in the area of ‘quality of life issues, particularly in relationship to residents’ choice. • • • There should be a review of the Keyworkers’ role, particularly in the admission of new residents, implementing the changed care needs of residents highlighted in reviews and in communicating these to residents’ relatives, if appropriate. The hot trolley should be used when delivering several meals to residents in their rooms upstairs, to avoid them getting cold. • 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. Dorrington House DS0000027516.V333494.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 Dorrington House DS0000027516.V333494.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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are made prior to admission, the home has its own assessment procedure and the prospective resident visited before admission. Residents and their relatives are normally given a Welcome Pack on admission. The home does not offer intermediate care. EVIDENCE: All residents’ comment cards confirmed that they had received enough information about the Home before they moved. One relative spoken to said that he visited the Home beforehand on his relative’s behalf and was impressed, having visited others. “They answered all my questions and I was given all the information I needed”. The home has its own detailed admission form, including medical and social histories, likes and dislikes and information from other healthcare professionals if appropriate. The manager visits a prospective resident, if possible, before admission. She had visited the most recent resident at home before Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 10 admission. Also, if possible, a potential resident is able to visit the Home before making the decision to move. The Manager said that she assesses whether prospective residents require special equipment and all new admissions are discussed with the Proprietors and equipment obtained before admission, if necessary. On admission, relatives and residents are given a Welcome Pack, for which they sign. On one occasion recently, the new resident and her relatives had not been given this Pack, which has clear information on procedures and facilities within the home, including procedures for laundry and marking of clothes, which had caused some difficulties. There is a computerised procedure for labelling clothes, which on this occasion was also being used in the Proprietors’ other home. The manager reported that valuable lessons had been learned from this and procedures would be made more robust and there is a recommendation that all care plans should contain an audit, including checking that all clothes are marked. Dorrington House DS0000027516.V333494.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs were set out in individual care plans. The home has good medication management systems in place. Residents felt they were treated with respect and that their privacy was upheld EVIDENCE: Six residents’ comment cards said that they always received the support and care they needed. One comment card from a healthcare professional and those from five relatives stated they were satisfied with the care in the home. Three relatives visiting on the day confirmed that they were very satisfied with the standard of care. One relative visited at least twice a week and asked to speak to the Inspector, said that he was “happy with the level of care and so happy (his relative) is here”. He felt he was kept informed of any changes and when he was visiting he was pleased to help his relative with her meal. One recently admitted resident said, “They look after me well here. The food is very good…they are very kind. I like to watch football in my room. I’m comfortable.” Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 12 One healthcare professional, who was visiting routinely on the day, said that she felt that the “staff could not work any harder”. She added that there were plans for District Nurses to be involved in training in the home, particularly in the area of skin care, especially in moving and handling, and the prevention of pressure sores and there is a recommendation for this. However, a comment card stating that staff did not always demonstrate a clear understanding of the care needs of residents (see Staffing) and also that there appeared to be a high incidence of accidental lacerations, which would be improved by further training (as above). Furthermore, there was a comment that the management were sometimes slow to act in taking appropriate decisions when they could no longer manage the care needs of the residents. (see below) All care plans had a photograph, were labelled with the Keyworker’s name and the Deputy Manager responsible, and relevant details in case of emergency. All care plans contained details of Medical needs, as well as Mobility, Nutritional, Emotional, Continence and Social needs. The involvement of of District Nurses, Psychiatric Nurses, Physiotherapists and other healthcare professionals, where necessary, were recorded. The GP visits weekly and whenever necessary, these visits are recorded separately within the care plan. Problems and Goals are set from the admission assessment which is developed into the care plan. The care plans are reviewed monthly, weekly or more frequently if needed. Problems and Goals are reviewed three monthly, or when necessary from the care plan. The care plans include Body Charts used to indicate any bruises, skin tears or pressure sores. Relatives are informed of reviews, if appropriate and information is also passed via a communications book in each resident’s room. It is the keyworker’s and the Deputy Managers’ role to see that information in the communications book is passed to relatives. if they are not able to attend reviews, or visit from some distance. This had not taken place in one instance recently and the requirement for residents and their relatives to be involved with the care planning process, if appropriate, is therefore repeated. One of the Deputy Managers, was observed administering medication at lunch time. Practice observed was good and the records seen were correct. New MAR sheets being introduced by the pharmacist, are stronger and do not tear out so easily. There are facilities for storing controlled drugs and the records were seen. At the present time two Deputy Managers deal with checking, ordering medication and auditing. between them. All staff who administer medication have had appropriate training and there had recently been a training update for all those staff from the local Pharmacist. He was visiting that day in preparation for reviewing all the residents’ medication with the GP Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 13 and the manager. One resident’s relative had also attended on that day in order to have an active role in these discussions. Residents spoken to and interaction observed between staff and residents demonstrated that staff had an understanding of how to promote residents’ privacy and dignity. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities take place on a regular basis. This area could continue to be developed further as more information is collated with regard to specific hobbies and interests of individual residents. The food provided is wholesome and nutritious and finger foods are available, however, using a heated trolley to deliver meals to residents who choose to eat their meals on the first floor would ensure that meals are more appetising. Relatives and friends are made welcome in the home. EVIDENCE: All the comment cards expressed satisfaction with the activities available. There is a monthly activities programme with something available every day which was not only available on the noticeboard, but also forthcoming events were advertised on a ‘black’ luminous board. The Home makes efforts to include residents in the activities and at the weekend, following the inspection, there was to be a special Mothers’ Day lunch, to which relatives were invited. One relative spoken to said how impressed he had been by the arrangements made for Christmas. There is a designated activities person for the two homes and activities have been recorded on DVD, such activities as making a fruit salad, Hallowe’en Party, Gentle Dancing, a BBQ in the summer and trips out. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 15 One resident spoken to is very keen on jigsaws and enjoys staff and visitors offering help. When completed, these are framed and there are many on the walls of the sitting area. Another resident still maintains his links with the community by attending various clubs in the town and also using the computer in his room. The manager has received a good response from relatives regarding individual life histories and it is hoped to use these to individualise activities and for residents to continue particular interests. In order to extend the Reminiscence session, the manager has asked relatives to make up a small box with memorabilia for residents. Two members of staff remarked that activities within the dementia care unit were a little more difficult to organise. There were several visitors to the home on the day and three were spoken to. The home is open to relatives continuing to be involved in their relatives’ care, if they wish and it is appropriate. One visitor did remark, however, that, “it would be nice if staff could spend more time individually with residents”. However, he felt residents being encouraged to sit in smaller groups and in different areas of the home was beneficial to everyone. Residents feel they have choice and this was confirmed by a member of staff spoken to. One resident chooses to smoke, and she is able to do this in a sheltered area just outside the door. She also chooses to go to bed early after the evening meal, in order to watch TV in bed. There is choice at meal times and the comment cards, residents and visitors spoken to confirmed that the ‘food is good’. There was choice for the main meal and choice at tea time…”something hot, or sandwiches and salads”, said one resident. Menus were seen and they offered variety. The nutritional needs of residents are noted and dietary supplements given if necessary. Finger foods are available for residents who have difficulties with meals. If residents choose to have their meals in their rooms, these are delivered by a trolley. On the day a ‘hot’ trolley was not being used, which meant that when staff were detained whilst delivering meals, other meals were getting cold. There is therefore a recommendation that a hot trolley should be used when there are several meals being taken upstairs. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 16 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives spoken to on the day of the inspection were aware of what to do if they wished to make a complaint. The home has a policy to safeguard residents and those staff spoken to were aware of this policy and had received training in the protection of vulnerable adults. EVIDENCE: The home has a policy and procedure to deal with complaints and this is also included in the Welcome Pack, given to new residents and their relatives as well as being available elsewhere in the home. All the comment cards said that residents would know how to make a complaint, together with the relatives’ comment cards and residents spoken to. Also, the three visitors said they would know to whom to complain, should they need to do so. There had been three complaints received in the Home, which had been recorded and dealt with appropriately. There is one ongoing, direct, complaint, which is being dealt with by the Home, which had been brought to the attention of the Commission, and some of the issues are dealt with in this report. The Home has a policy and adopts procedures with regard to the safeguarding of vulnerable adults. The manager is aware of the local adult protection procedures. All of those staff spoken to were aware of the whistle blowing policy; staff spoken to had received training in the protection of vulnerable adults. Dorrington House DS0000027516.V333494.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): 19,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an ongoing programme of redecoration and maintenance and residents live in a comfortable, clean and safe environment. EVIDENCE: Overall the quality of the environment is good. This was a purpose built building and there is a rolling programme of maintenance and refurbishment. There is a ‘walk’ round every week and records kept of maintenance issues and when completed. There were new lampshades waiting to be fitted in various areas and on the day electronic keypads were being fitted on all outside doors for residents’ safety. All the bedrooms seen were personalised and comfortably furnished. There was a recommendation at the previous inspection that there should be chairs available in bedrooms for residents’ visitors; this has been carried through. In Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 18 addition there are foldaway chairs available for visitors in various areas of the Home. A noisy airconditioner in the conservatory in the dementia care unit had been repaired and lockable cupboards provided for incontinence pads, which were also Recommendations from the previous inspection A new boiler had been installed in the Home. There had been a Requirement in the previous inspection that all residents should have access to consistent hot water. All areas seen during a tour of the home were clean and tidy and there is ongoing carpet cleaning, which was taking place on the day. All comment cards stated that the Home was always “fresh and clean”. Dorrington House DS0000027516.V333494.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management ensure that good staffing levels are maintained. The safety and welfare of residents is ensured by the training programme, for both the manager and the staff team. Recruitment practice now further ensures the safety of residents EVIDENCE: All the residents and relatives spoken to on the day spoke positively about the staff and one healthcare professional remarked, “the staff couldn’t work any harder” and a relative said, “I can’t praise the workers enough, if it weren’t for the workers, my wife wouldn’t be here”. All six comment cards from residents confirmed that the staff always gave the care and support residents needed and listened to what residents said. However, there was one comment card stating that staff did not always demonstrate a clear understanding of the care needs of residents. The Commission was unable to act directly on this comment, as it was unnamed, but there is a recommendation that Deputy Managers and Keyworkers receive an update of their role in implementing care plans, advice from healthcare professionals, reviews and communicating with relatives; as well as ensuring that this information is cascaded to other staff. This would be particularly important in changes in healthcare needs, and informing relatives, if appropriate. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 20 The Manager said the Home has assisted staff by providing opportunities to improve their English, especially if this were their second language. This had been done in conjunction with a local college, but there had been poor take up. However, there is a recommendation that there is continuing review of staff needs in this area and that there is continued assistance in access to training. The home has a stable staff team and little staff turnover. Staffing levels from the current rota are good, and the home has over 50 of care staff holding at least NVQ2. All staff have access to training in dementia care, and the Manager, the Deputy Managers and one of the Proprietors have recently undertaken a Dementia care course, which they will be cascading to staff. Mandatory training is carried out and recorded. Other more specialist training is available in Nutrition and Challenging Behaviour and the Manager showed evidence that staff competence is tested in supervision and necessary training planned One member of staff, who had considerable experience, said she gained good job satisfaction and she felt there was a good staff team. She had worked on nights previously. There are four members of waking staff, one of whom is an appointed keyholder, but all on shift are aware of procedures. Another staff member with considerable experience said that there were regular staff meetings and staff could bring their own issues to the agenda. She also confirmed there was supervision with the manager on a regular basis. Another member of staff spoken to said she would appreciate some clarification of ‘quality of life issues’, especially in the area of residents’ choice to refuse medication. There is therefore a recommendation that all staff should receive further training in the area of ‘quality of life issues’, particularly in choice and the refusal of medication. There was evidence from the four staff files examined that the necessary recruitment practices are now in place following a Requirement from the previous inspection. Dorrington House DS0000027516.V333494.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by the Manager, who has the backing of the Proprietors and the confidence of relatives, staff and residents. Quality assurance takes place but some improvements could be made. Residents’ finances are protected, and the health, safety and welfare of residents and staff promoted. EVIDENCE: The Manager has nearly 10 years’ experience working in the Home. She has been in her present post for 18 months, having achieved NVQ4 in Care and the Registered Manager’s Award. It was evident from observation, talking to staff and visitors that there was confidence in, and respect for, her. She also demonstrated that she is developing her own skills and has the backing of the Proprietor in this. She has recently completed a further Dementia Care Course with one of the Proprietors and is looking to increase the home’s training Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 22 resources in this area. She is liaising with the local Pharmacy to review the medication in the Home and with the Pharmacy have developed further medication training. She has also completed IT training and the home has installed Broadband and Skype in order to communicate efficiently between two homes and with the Proprietors. Some relatives also choose to communicate with the Home via email, which is used in conjunction with the communication book and one resident has his own computer and access to the Internet. Quality Assurance in the Home takes the form of regular management and staff meetings, monthly residents’ meetings, a three monthly newsletter for residents and their relatives, communications books for relatives and periodic questionnaires for healthcare professionals. Staff supervision is supplemented by written handouts given to staff on particular issues. For example, notes on Grievance Procedure was the current issue. Staff also receive a Newsletter. The Manager showed evidence of falls audits, also audits of the Accident Book. There are periodic questionnaires to healthcare professionals and relatives and a Letterbox in the hall, which is locked, and into which comments can be placed to ensure that the Home is run in the best interests of the residents. The Home does not look after any monies on behalf of residents, which are largely managed by relatives and residents’ representatives. Various records demonstrated that the health, safety and welfare of residents and staff were being promoted. Dorrington House DS0000027516.V333494.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 X X X X X 3 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 X X 3 Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES 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. 1. Standard OP7 Regulation 15(1) Requirement The registered person must ensure that written care plans continue to be prepared with the involvement of service users or their representatives. This requirement is repeated. Timescale for action 30/04/07 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 OP4 OP7 Good Practice Recommendations It is recommended that all care plans contain an audit, in order to check that issues such as all clothes are marked on admission It is recommended that there is an updating of the roles of the Deputy Managers and Keyworkers in implementing care plans, reviews and communicating with relatives if appropriate. It is recommended that the ‘hot’ trolley be used in DS0000027516.V333494.R01.S.doc Version 5.2 Page 25 3. OP15 Dorrington House 4. OP30 delivering meals to residents choosing to eat on the first floor. Further staff training is recommended in the following ‘specialist’ areas: 1. Skin care, particularly in moving and handling and the prevention of pressure sores. 2. Continuing to review staff training needs for those people for whom English is a second language. 3. Further training for all staff in ‘quality of life’ issues, particularly around choice and the refusal of medication. Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Dorrington House DS0000027516.V333494.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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