Inspection on 16/11/05 for Dorrington House

This inspection was carried out on 16th November 2005.

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 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

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 16/03/07

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 Mr Jerry Crehan Announced Inspection 16th November 2005 09:30 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.V257313.R01.S.doc Version 5.0 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.V257313.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dorrington House Address 73 Norwich Road Watton Thetford Norfolk IP25 6DH 01362 693070 01362 699464 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) www.dorrington-house.co.uk Mr Steven Dorrington Mrs Lorraine Dorrington Mrs Janice Kathleen Kendall Care Home 52 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (32) of places Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home may from time to time accommodate one service user who is under 65 years of age who has dementia. 23rd June 2005 Date of last inspection 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.V257313.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 8 hours. Opportunity was taken to tour the premises, look at care records and policies, and communicate with many of the fifty-one service users in addition to visiting relatives, staff and the newly appointed manager. One comment card was received from visiting G.P’s prior to the inspection. A further two comment cards were received from visiting relatives shortly after the inspection. These expressed satisfaction as to the care provided at the home, one relative indicating that they have been ‘impressed by the kindness, efficiency, professionalism and imagination of the staff at all levels’. As no other comment cards were received prior to the inspection, the new manager is advised to consider ways in which comment cards can be made more accessible to relatives and others. What the service does well: What has improved since the last inspection? Staffing levels and hand over periods are more carefully monitored to ensure the safety of service users following a requirement made at the last inspection. There is ongoing refurbishment of many areas, and replacement of fixtures and fittings in many areas. A recommendation made at the home’s last inspection that the home consider reviews for service users accommodated in the dementia care section of the home who’s principle needs may no longer be considered to be arising from dementia has been acted upon appropriately. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 6 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. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 7 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.V257313.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5, 6 The admission procedure is adequate, providing prospective service users with the opportunity to visit the home where possible. EVIDENCE: Evidence was seen that home has an admission procedure that adequately guides the manager or other senior staff responsible for assessment, as to actions to be taken to ensure service users needs are assessed prior to a move to the home. Service users spoken to confirmed this. Some service users indicated that they had been provided with the opportunity to visit the home prior to moving in. Some service users who had not had this opportunity indicated that their relatives had visited the home on their behalf. The home does not provide an intermediate care service. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 The care planning system is clear and provides staff with the information they need to meet the health and care needs of service users, though social histories require development with service users and their relatives. Service users are treated with respect. EVIDENCE: A sample of service user care plans was reviewed. These set out care requirements clearly and in detail and were evidently reviewed on a regular basis and are an informative tool for care staff in individual care delivery. Care plans also referred to the involvement of a variety of community health professionals. Comments by service users spoken with supported this confirming that they have access to the GP, District Nurse and other professionals as required. The general quality and clarity of care plans is commended. Though an area for further development (and a requirement in this report) that is acknowledged by the manager is undertaking social histories or ‘life story’ work for service users with dementia in particular. The manager described strategies recently employed to undertake this work, including ‘memory boxes’ that relatives have been asked to contribute to. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 10 There are currently no service users accommodated at the home who take responsibility for administering their own medication. Medication records and storage were reviewed and found to be satisfactory. The home has in place appropriate storage and a book used to record controlled drugs, which provides an additional level of security. The book meets the requirements of the Misuse of Drugs Regulations 2001. Observation during the inspection showed that staff had an understanding of how to promote service users privacy and dignity. Communication between staff and service users observed was appropriate to the individual needs of service users. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 14 Service users are able to maintain contact with relatives and others as they wish. Service users are able to exercise choice and control over their lives. EVIDENCE: Service users and visiting relatives indicated that they were made welcome at the home at any time of their choosing. Visitors are usually seen in the privacy of service users own rooms. However, it was also apparent that communal areas were available too. A number of visitors were present at the time of the inspection. It is evident that service users are entitled to bring and to keep personal possessions at the home. Several visitors to the home were present at the time of the inspection. The home has promoted the use of independent advocates in the past for service users, to promote their best interests. There is evidence of service users maintaining established links with the local community. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Arrangements for dealing with complaints, for protecting service users legal rights, and for protecting service users from abuse are satisfactory. EVIDENCE: Service users and relatives spoken to indicated that they would speak with the manager, office staff or with carers if they had a complaint or concern, and that they felt they would be listened to. A complaint was made to a staff member at the time of the inspection. This was dealt with appropriately and immediately by the staff member concerned. Information about complaints is readily available within the home. It was apparent that service users have access to relatives or friends, many of whom assist service user in managing their affairs, and that there are no independent advocates currently supporting service users. Service users are able to take part in the political process, voting by postal ballot or in person if preferred. The home has training (including external training) for staff and a procedure for responding to allegations of abuse, including ‘whistle blowing’. Staff spoken to are aware of these procedures and their function. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21, 22, 23, 24, 25, 26 A comfortable, well-maintained and equipped accommodation is provided by the home. The interior has a homely feel and benefits from an ongoing programme of redecoration and refurbishment. Though the lack of a reliable hot water supply compromises comfort. EVIDENCE: Service users are provided with a safe and accessible indoor and outdoor environment. The home and its grounds and gardens are very well maintained. There are a variety of communal areas available to service users including lounges, dining room and hairdressing facilities. The manager described plans to use the hairdressing room (when not in use) to extend the communal facilities available for service users with dementia. This is welcomed, as currently there is limited, though satisfactory space available to service users in this area. It is recommended that action be taken to address the noise made by the air conditioner between the lounge and conservatory in the section of the home designated for dementia care. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 14 The home has suitable bath, shower and toilet facilities on each floor. There is sufficient equipment available within the home to meet the assessed needs of service users, including stand-aids and hoists. Service users spoken to stated that their bedrooms were comfortable and that they had all that they required, including their own possessions, around them. However, it was noted that in some bedrooms there were missing chairs for service users or their visitors to use. The manager indicated that some chairs had recently been removed and were being replaced. It is recommended that adequate arrangements be made for seating for service users and their visitors in the interim. It is also recommended that alternative storage arrangements be made for the bulk of service users incontinence pads, as large numbers are stored in some en-suite facilities. There is clearly an ongoing programme of redecoration and refurbishment at the home with new furniture and new bedding in evidence. All areas of the home seen were cleaned to a high standard. Hot water temperatures were tested and found to be only tepid on both floors of the home, and certainly not warm enough for bathing. This was acknowledged as a problem by both staff and the manager, though is apparently an intermittent problem and is being addressed with the engineer. It is, however, of significant inconvenience in the meantime. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The staff induction and training programme is good and satisfactorily addresses service user needs. Service users are largely, though not fully supported or protected by the home’s recruitment practices. EVIDENCE: The home provides a stable and experienced staff group with relatively little staff turnover. Staffing levels are above the minimum standard required. Service users indicated that there was sufficient staff available to meet their needs (and this was apparent at the time of the inspection) and felt that they were in safe hands. Staff hand over periods are more carefully monitored to ensure the safety of service users following a requirement made at the last inspection. The home currently has over 50 of care staff holding at least NVQ 2. This percentage will rise following the successful completion of the training by other staff already registered to undertake the training programme. All care staff have access to training in dementia care, and to a full range of mandatory training. Other more specialist training is available, including training in eye conditions was being provided during the week of the inspection. Induction training records seen were satisfactory. Competence as to this and other training undertaken is evidently tested in supervision with the manager. This, approach, and the approach of the home in general toward training is commended. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 16 Sample files reviewed included evidence the recruitment of a care staff member prior to obtaining two satisfactory written references. Other records reviewed were satisfactory. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 The home is well managed by a new, though competent manager who has the confidence of service users, relatives and staff alike. The home is run in the best interests of service users. EVIDENCE: The new manager has recently been confirmed in post following her successful application to the Commission to become the Registered Manager for the home. She has also recently successfully completed the ‘Registered Managers Award’. It is apparent through discussion that service users and staff have respect for, and confidence in the new manager. The manager described strategies employed at the home to ensure that it is run in the best interests of service users. These include regular management and staff meetings, monthly residents meetings, a three monthly newsletter for service users and their relatives, communication books for relatives, and periodic questionnaires for health professionals. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 18 Relatives or others manage the vast majority of service users financial affairs. The home does not look after any monies on behalf of service users. Staff are appropriately supervised and service users further supported by the home’s policies and record keeping. The home seeks to promote the health, safety and welfare of service users. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 19 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 3 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 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP7 Regulation 15(1) Requirement The registered person must ensure that written care plans are prepared with the involvement of service users or their representatives. The registered person must ensure that service users have access to a suitable hot water supply. The registered person must ensure that new staff are confirmed in post only following satisfactory checks set out in Schedule 2 of the Care Homes Regulations 2001. Timescale for action 16/10/05 2 OP25 23(2)(j) 16/10/05 3 OP29 19(1)(b) (1) 16/10/05 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 Refer to Standard OP25 Good Practice Recommendations It is recommended that action be taken to address the noise made by the air conditioner between the lounge and conservatory in the section of the home designated for DS0000027516.V257313.R01.S.doc Version 5.0 Page 21 Dorrington House 2 3 OP24 OP22 dementia care. It is recommended that adequate arrangements be made for seating for service users and their visitors in bedrooms. It is recommended that alternative storage arrangements be made for service users incontinence pads. Dorrington House DS0000027516.V257313.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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. 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