Random inspection report
Care homes for older people
Name: Address: Dorrington House 73 Norwich Road Watton Thetford Norfolk IP25 6DH zero star poor service 11/05/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Dragan Cvejic Date: 0 7 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Dorrington House 73 Norwich Road Watton Thetford Norfolk IP25 6DH 01953883882 01953889035 dhwatton@btinternet.com www.dorrington-house.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Steven Dorrington,Mrs Lorraine Dorrington care home 52 Number of places (if applicable): Under 65 Over 65 52 dementia Conditions of registration: 0 Any new admissions to the home must be in the category of Dementia (over 65 years of age). Eight (8) Older People who are named in the Commission`s records may be accommodated. Maximum number accommodated not to exceed fifty two (52). One service user under the age of 65 years, with a diagnosis of dementia, may be accommodated. Date of last inspection Brief description of the care home Dorrington House is a purpose built care home providing residential care for up to 52 older people including care for 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
Care Homes for Older People Page 2 of 8 1 1 0 5 2 0 0 9 Brief description of the care 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 homes communal showers and bathrooms. There are other communal areas including hairdressing saloon, lounges and dining rooms that accommodate most service users at meal times. The home is one of three homes in Norfolk owned by the proprietors. The range of weekly fees is provided in homes documents. Care Homes for Older People Page 3 of 8 What we found:
After the last key inspection on 11/05/09, at which there were issues addressed in the report that caused concerns about residents safety, different actions were taken to ensure improvement. Social services created their plan of action, the home prepared their own improvement plan and introduced measures to improve provisions and care and we, the regulators, conducted management reviews where we decided to carry out this random inspection. The purpose of the inspection was to check compliance with the requirements set on the previous inspection that would ensure safety and respect for residents. Two inspectors conducted this random inspection. We focused on the requirements related to safety and respect for residents. We spoke to the new manager and his deputy about the actions and changes the home introduced since the last in section. We quickly spoke to the provider on the phone during the site visit. We checked the staff rota, accidents/incidents records, we spoke to 6 residents, to staff on the floor including kitchen staff, observed lunch time in one dining room and checked care in other communal areas during lunch. Our findings included significant improvements and confirmed that safety of residents was achieved with all the actions undertaken since the last inspection. What the care home does well:
The manager explained that the rota was arranged with a view to ensuring that there was a sufficient number of staff in each communal area during meal times. This target was achieved by reorganizing lunch times. Now, lunch was first served in one dining room and the staff number was increased to 4 in that area. After completing lunch in one, lunch was served in another dining room where 2 extra staff moved to ensure good cover in that area. The same principle applied to the third dining room on the first floor. The home planned and already conducted interviews of extra carers who would be employed during peak times: breakfast, lunch and dinner time. The manager stated that 2 bank staff had already been engaged in this new role; that 2 more had been interviewed and the home was awaiting their checks, CRB and references, before employing them. This plan would ensure that sufficient staff were present in all key areas during meal times and ensure not only safety but also full respect for residents dignity. This new practice was observed and demonstrated that residents were protected. Serving meals to one table at the time also indicated better respect for dignity of residents, as they were now eating together. At one point two residents were eating their lunch with two carers, each supporting one resident. Three other, more independent people were supported by another carer. An unhurried and well organized serving process also improved the respect for dignity and choice. A carer brought two different dishes to the table allowing the three residents sitting there to choose the dish they preferred. Choice was seen also when carers offered apple or cranberry juice to each table at a time. The rota was checked and showed that only a few shifts, approximately 5 , did not have full staffing cover as the home planned. The manager explained that these shortages would be covered by himself or his deputy who were supernumery to the planned care staff. He also explained that in an emergency situation, he would use the staff from another home belonging to the same provider. He stated that this would be his decision and that he would call the consultant for support and inform the provider of the action undertaken. This way, the risk was reduced by the authority of the manager to deal with the situation when it occurs. We
Care Homes for Older People Page 4 of 8 checked the other lounges during lunch time and found two carers in each, looking after 9 and 8 residents. They were engaging all residents present by walking from one to another, showing not only a respectful approach, but making sure that all residents felt cared for and supported. Residents spoken to confirmed that they were happy with the care and attention they received and with respect for their dignity. Staff spoken to stated that things were much better now. The kitchen staff also confirmed that choices were more meaningful now, that meal times were unhurried and much better managed. Apart from the visible improvements described above, the manager explained about other changes introduced to increase residents safety. He used the accidents/incidents records to explain how the protection had been improved. Now, all accidents/incidents were reported to the management office before being filed, thus ensuring that the management would be aware of all events affecting residents. The manager also reviewed the records on a weekly basis to establish if there were any significant triggers, times, situations, or even particular staff or resident presence in any of the reported events. Changes in care plans resulting from incidents would indicate the need for involvement of external health professionals. There were currently difficulties in bookings and referrals to the CPN (Community Psychiatric Nurses) team due to their smaller number and their being very stretched, but an example of a resident being referred and assessed demonstrated that the home reacted appropriately. After this reassessment when the residents needs assessed showed the need for nursing care, the home introduced interim measures to observe him and prevent any potential incident/accident insofar as possible. The entire atmosphere in the home was much better. The safety of residents was achieved by: - new manager and deputy manager - change of routine for meal times - extended choices for residents - better organized staff work - increased number of staff in particular areas at peak times - new approach to dealing with accidents/incidents - ensured respect for residents protection and respect for their dignity What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
