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Inspection on 26/03/07 for Dorrington House Residential Home

Also see our care home review for Dorrington House Residential Home for more information

This inspection was carried out on 26th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Dorrington House Residential Home 28 Quebec Road Dereham Norfolk NR19 2DR Lead Inspector Jenny Rose Unannounced Inspection 26th March 2007 09:20 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 Residential Home DS0000015633.V334614.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 Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dorrington House Residential Home Address 28 Quebec Road Dereham Norfolk NR19 2DR 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) 01362 693070 01362 699464 dorringtonhouse@btopenworld.com www.dorrington-house.co.uk Mr. Steven M Dorrington Mrs Lorraine Dorrington Mrs Lorraine Dorrington Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Fourteen (14) Older People who are named in the Commission`s records 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 forty five (45). Date of last inspection 19th December 2005 Brief Description of the Service: Dorrington House is a care home providing residential care for up to 45 older people including care for up to 16 people with dementia. It is situated close to the centre of the market town of East Dereham. The home comprises purpose built ground floor accommodation in separate wings. Each wing has its own lounge, bathing and toileting facilities. All rooms have en-suite toilet and hand basins. There are two communal dining rooms accommodating most service users at meal times. There are enclosed garden and patio areas that are visible from service user bedrooms. Dorrington House Residential Home DS0000015633.V334614.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. Nine comment cards had been received from residents and five from healthcare professionals including visiting GPs. One healthcare professional was spoken to on the phone. Overall the comment cards were positive and stated that they were satisfied with the care in the home. The Proprietor/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. One visitor and four members of staff were spoken to in private. Several residents were spoken to in groups and two in private. The information from the comment cards and from the people spoken to has been incorporated into 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 (Dereham) is a good service offering good quality care and some examples of good practice. 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 pleasant, secure garden with a fountain feature, providing an accessible area for residents to enjoy. Relatives and friends are welcomed into the home at any time and are involved with aspects of residents’ care, if appropriate; a frequent visitor spoken to said she was very pleased with the care given to her relative. • • Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 6 • There is a stable staff team, enthusiastic with their role. Training opportunities are given high priority across management and the staff team. There are over 70 of staff trained to NVQ2 level and above and the training of senior staff continues to be commended. Residents are able to keep their pets, if appropriate, in their rooms. The residents’ comment cards were positive about the food offered, one said “There are very good meals”. A visitor commented that the Home had responded to her relative’s need for a special diet. The Home has received the Good Food Award for the 3rd Year running. The home, together with its sister home, has developed a good working relationship with the local Pharmacy, who liaise with the surgeries, review the home’s medication system and provide training. The proprietors/manager seek to maintain a good working relationship with the Commisssion, 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. There is a computerised labelling system for residents’ clothes, which is shared between the two Homes. • • • • • • What has improved since the last inspection? • The care plans contain life histories and interests of residents, making them person centred. They are prepared with the involvement of residents and relatives, if appropriate. Finger foods have been made available for those residents whose mental health needs are such that it is difficult to maintain an adequate diet at mealtimes alone. There are ‘touch and feel’ pictures for residents throughout the Home. The Proprietor/Manager, the Deputy Managers, the Secretary, together with staff from the sister home have all undertaken an advanced Dementia Training Course. The two Managers have also completed a staff Recruitment and Legislation course, also a course in Nutrition, all of which information will be cascaded to staff. Carpets have been replaced in various areas of the Home as well as equipment such as over bed tables, ‘new enterprise’ toilet seats, vanity DS0000015633.V334614.R01.S.doc Version 5.2 Page 7 • • • Dorrington House Residential Home basin units replaced with pedestals, a new hoist and a new PAT tester machine. The laundry facilities have been upgraded, a new plasma TV has been installed in the lounge and a new gazebo built in the garden. • There is a new computer in the office; Broadband has been installed for better communication with healthcare professionals, relatives and staff, who have received IT training. There have been English lessons for those members of staff whose second language is English, although there has not been such a broad take-up of these as had been hoped. The procedure for ‘whistle blowing’ is readily available in all areas of the home. There is regular maintenance on wheelchairs. • • • What they could do better: • Although the storage heaters in the Dementia Care Unit have been risk assessed, they are hot to the touch on top. Some safe covering would help ensure the safety of residents. Although the take-up for support with English language training has been disappointing, training needs in this area should continue to be monitored in order to maintain good communication with residents. • 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 Residential Home DS0000015633.V334614.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 Residential Home DS0000015633.V334614.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 and residents living in the home are having their assessed needs met. The home does not offer intermediate care. EVIDENCE: All the comment cards confirmed that residents had received enough information about the home before they moved. Four care plans were examined in detail. There was evidence of detailed information from placing professionals, as well as assessments completed by the manager. The Deputy Managers visit prospective residents before admission and relatives and/or residents are able to visit the home before admission. All new residents and their relatives are given a Welcome Pack containing detailed information on the home on admission. Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 10 The Manager said that residents often come for short term respite care before moving in permanently. The Manager also said that the home re-assess residents in hospital before discharge in order to ensure that they can still meet any changed needs. The home does not provide intermediate care. Dorrington House Residential Home DS0000015633.V334614.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 are set out in an individual person centred care plan. It was observed that residents were treated with respect and that their privacy is upheld. The care and administration of medication appeared to be sound. EVIDENCE: All the healthcare professionals comment cards stated that staff demonstrated a clear understanding of the care needs of the residents, except one. However, this healthcare professional said on the phone that steps had since been taken by the home to request training from the District Nurse team in the care of pressure areas and there is good liaison between the home and the team for the benefit of the residents. All, except one of the residents’ comment cards, said that they received the care and support they needed. “I enjoy living here and feel that everyone helps me when I need them to,” was a comment in one. One was uncertain, Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 12 but on speaking to her, she stated she was happy living in the home. One visitor spoken to felt that her relative received the individual attention she needed, particularly in view of her multiple needs She said that the Manager has ensured she receives a special diet. She also felt she could make suggestions concerning her relative’s care and that she was able to contact the home whenever she wished. She visited frequently and still felt involved with her relative’s care and that the home is fulfilling her relative’s needs. There was good evidence from two particular care plans that, if appropriate, relatives are involved and informed of residents’ changing needs. The care plans contain photographs of the resident, the Keyworker and the Deputy Manager responsible for reviewing the care plans. There are Body Charts, which are used to indicate any bruises, skin tears or pressure areas. The care plans were person centred with details of family history and the resident’s previous interests and likes and dislikes which might affect the resident’s behaviour, for example for one person who was known to enjoy smoking occasionally. There was good information on strategies for supporting residents in difficult situations. There was evidence of regular reviews, involvement of GPs, Community Psychiatric Nurses, District Nurses and attempts to obtain reviews with Social Workers. There were also two other care plans which showed the involvement of relatives and risk assessments, for example, regarding the placement of cot sides on beds being discussed with the family. Communication books are in each resident’s room and it is the Keyworkers and Deputy Manager’s role to see that information in these books is passed to relatives, if they are not able to attend reviews or do not live locally. There is also communication with families by mobile phones and emails, if appropriate. The medication round was observed at lunch time with the help of the Deputy Manager responsible for ordering and auditing the medication. Practice observed was good and the records seen appeared correct. All staff who administer medication have had training recently with the Pharmacist who has been actively involved in reviewing the medication administration. The member of staff said that the new system is much better than the previous one. The MAR sheets have been redesigned and are safer in that they are more securely bound in the medication file. There are easier codes for indicating that medication was not required or was refused. In the case of the latter, two signatures are required and a procedure for returns followed. Two residents administer some of their own medication and the assessment for this was seen in the care plans. The visitor spoken to and interaction between staff and residents, particularly at meal time, demonstrated that staff had an understanding of how to promote residents’ privacy and dignity. Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 13 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. There is a training manual for activities available and the Manager encourages creativity in this area by staff. Relatives/friends maintain contact with residents as they wish and residents are supported to make their own choices. The food provided is wholesome and nutritious, finger foods are available as snacks during the day and special diets planned. EVIDENCE: Of the nine residents’ comment cards received, six residents confirmed that activities took place; they were asked if they wished to join in, but they chose to spend time in their own rooms. Of the two residents’ comment cards who found there were activities in which they joined, one said, “I like the music and the singing”. There is a daily activities calendar seven days a week, which is displayed in clear, large type, on a monthly basis throughout the home. There is a designated activities organiser, but staff have also been creative in a project to discover the meanings of English sayings and proverbs, which was enjoyed by residents. Gentle exercise was observed on the day, enjoyed by some Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 14 residents. DVD’s are recorded of activities such as parties, dancing and seasonal cooking, which can be shown on the large plasma TV in the lounge, as well as ‘old’ films. There is a photo on the information board of the person bringing Communion to the home, and also a reminiscence hairdresser. Some residents are able to take advantage of the nearby facilities in the town and opportunities for chatting about local news. Residents are able to maintain contact with family and friends. Two residents were enabled to have friends, with whom they used to lunch regularly, come to the home for lunch, so continuing their usual routine. A visitor spoken to confirmed that she was able to visit at any time and did so frequently. Individual family histories are used to individualise activities and maintain choice for residents. Residents were observed being offered choice with their PRN medication and whether they wished to rest in their room. One resident spoken to was pleased to have her cat in her room. Five residents’ comment cards said they always enjoyed the meals; two said there were sometimes things which they were not so keen on and two said they usually enjoyed the meals. “There are some things I am not so keen on, but I do very well here”, said one comment card. There are regular residents’ meetings when residents are asked for suggestions for favourite foods. There is choice, which was confirmed by staff spoken to and the meal seen on the day looked appetising and was being eaten in comfortable, homely surroundings. Residents who needed assistance with their meals had them in a quieter area and finger food was offered if residents did not eat their served meal. Finger foods such as sandwiches, crisps and cakes are offered at 10.30 each day, which many residents enjoy, as well as their lunch. There is a tuck trolley from which residents can choose snacks at other times of the day. The Proprietor/Manager has recently attended a course in nutrition from which she had gained ideas in the presentation and suitable ingredients for use, especially in soft and special diets, which she is intending to cascade to staff. Weight charts are included in care plans and information passed on to staff on this issue was included in the February Staff Newsletter. The Proprietor/Manager was also hoping to carry forward producing pictures of meals, together with the menu, when seeking residents’ choices for meals. Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 15 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. Comment cards and a visitor spoken to on the day of 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. Seven of the residents’ comment cards said that they always knew how to make a complaint. One of these stated “Yes, I do and have done so in the past.” Two of the cards said that the residents usually knew how to make a complaint, one of which said “To the ladies in the blue dresses”. One visitor said she was aware of how to make a complaint and all the healthcare professionals said they had not received any complaints about the home. There had been five complaints received in the home and these are recorded, together with action taken to resolve issues. These were seen to be dealt with appropriately within the proper time scale. Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 16 The home has a policy and adopts procedures with regard to the safeguarding of vulnerable adults. The Manager and Deputy Managers are aware of the local adult protection procedures. All staff spoken to were aware of the whistle blowing policy, which was also displayed in various areas of the home, as recommended from the previous inspection. There was an ongoing issue which is dealt with elsewhere in this Report (See Health and Personal Care), but the Manager/Proprietor was seen to be taking appropriate action in this respect. Dorrington House Residential Home DS0000015633.V334614.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): 19,22,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although risk assessed, further research and action regarding the safe covering over the top of the storage heaters, particularly in corridors, would further protect residents. 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. Residents have access to indoor and outdoor communal facilities, including an enclosed garden with a pleasant enclosed secure garden with a fountain and seating. Within the dementia care unit, there are two communal areas, one of which is used as a quieter lounge/dining area. Part of the building was purpose built and there is a rolling programme of maintenance and refurbishment and the maintenance record book was seen Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 18 and there is a full time maintenance person who travels between the two homes. Several areas of the home have been refurbished since the last inspection and new items of equipment purchased and residents’ personal wheelchairs are maintained in-house to ensure there are fitted footplates, unless an appropriate assessment suggests otherwise. Two more electronic keypads had been installed for the safety of residents. All the bedrooms seen were personalised and comfortably furnished and the home works hard to introduce items to assist those residents with Dementia, such as ‘touch and feel’ pictures in the corridors. The Proprietor/Manager was measuring for net curtains to obscure reflections in glass and doors, especially at night, which were often confusing to residents. There is a Bar in one lounge with a newly purchased plasma 50” TV. Although storage heaters in the corridors in the Dementia Care Unit have been risk assessed and unsatisfactory covers tried in the past, and are not hot to the touch on the sides, the tops were found to be hot to the fingers. The Proprietor/Manager said that she had already noticed this and was intending to install safety shelves above these heaters. There is therefore a requirement that this work should be carried out in order to further protect residents. The laundry area has been refurbished as well as work completed in the kitchen. All areas of the home seen were clean and tidy. There is ongoing carpet cleaning and one of the Deputy Managers said that if necessary, any member of staff would do emergency cleaning. Seven of the residents’ comment cards stated that the home was always fresh and clean, three comments were “Very clean”; “The girls are good and always cleaning up”; “They are always cleaning, it is lovely”. Dorrington House Residential Home DS0000015633.V334614.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 managers and the staff team; there is a 70 proportion of staff trained to NVQ2 level and above. Recruitment practice further ensures the safety of residents. EVIDENCE: Comments from residents were: “Everyone is very helpful”; They are very good girls”; one who answered positively also said “The girls are very busy”. One comment card answered the question of whether she was listened to, in a negative way, but added, “I do most things for myself”. Five residents’ comment cards stated that staff were always available when needed, three said that they usually were and one stated that staff sometimes were. All the healthcare professionals’ comment cards said that staff demonstrated a clear understanding of the care needs of residents, except for one comment that specialist advice is not always carried through by all members of staff. The home has a stable staff team and little staff turnover. The management work hard to ensure that good staffing levels are maintained and that there is a broad skill mix daily by maintaining control of the staff rota. The home also Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 20 has a commitment to training at all levels of staff. Over 70 of care staff hold at least NVQ2 and others have been supported to complete NVQ3, NVQ4 and Registered Manager’s training. All staff have access to training in Dementia Care and the Proprietor/Manager, the Deputy Managers from both homes have undertaken an advanced Dementia Care Course, information from which they will be cascading to staff. Mandatory training is carried out and recorded. Other more specialist training has taken place in Nutrition, Challenging Behaviour, Pressure Area Care, Continence and Aggression Management. Training in house by DVDs takes place and new training resources are being reviewed on an ongoing basis. The management have been disappointed by the poor take up of the training opportunities in English created with the local college for members of staff for whom this is not their first language This is partly due to shift patterns. However, there is at least one member of staff who is continuing with this and there is a recommendation that there is continuing review of staff needs in this area and continued assistance in access to this training to maintain good communication with residents. Four members of staff spoken to said they enjoyed their work and that there was a good staff team. There were regular staff meetings and supervision where staff could bring their own issues. One member of staff mentioned how helpful she found the staff newsletter. Three members of staff gave a good account of the keyworking system in communicating with residents’ families and all displayed knowledge of protection of vulnerable adults and confidentiality issues. There was evidence from the four staff files examined that the necessary recruitment practices are in place. The Proprietor/Manager has recently completed a course, together with the Manager of the sister home, in Recruitment and Employment Legislation. Dorrington House Residential Home DS0000015633.V334614.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 a competent manager who has the confidence of the residents, relatives and staff. The home is run in the best interests of the residents and the health, safety and welfare of residents and staff promoted. EVIDENCE: The registered manager has had several years’ management experience in the care of elderly people. She is committed to keeping abreast of current developments and updating policies and procedures at the home in line with these. Evidence of this, was her attendance on a recent course on nutrition and updating care plans in line with these, as well as an advanced Dementia Care Course. It is apparent from observation, discussion with staff and a visitor that there was confidence in and respect for her skills as a manager. Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 22 She was described by members of staff as being fair, open and willing to discuss and explain decisions. There is a clear management structure through the Deputy Managers and Keyworkers, with committed administrative staff, who also receive training in the care of elderly people, all of which supports her in the efficient running of the home. There are photos of all staff in the hall with details of their roles. Continuous monitoring of quality is through regular management meetings every other month, regular staff and residents’ meetings, a monthly newsletter for residents, relatives and friends of the home and communication books in every resident’s room. At least one suggestion from a relatives has resulted in action being taken as part of the infection control procedure. There are monthly staff newsletters and it was evident that staff supervision is supplemented by written handouts on particular issues, the most recent being the staff Grievance Procedure. There are periodic questionnaires to healthcare professionals and relatives and there is a locked Letterbox in the hall, into which comments or concerns can be placed. The home has recently installed a Broadband and Skype for ease of communication and all senior staff have received IT training. The home does not handle any monies on behalf of residents, which are largely managed by relatives or residents’ representatives. Bills for such expenditure as hairdressing, chiropody, the tuck trolley and other services are dealt with in retrospect. Various records were seen supporting the home’s promotion of the health, safety and welfare of residents and staff. Dorrington House Residential Home DS0000015633.V334614.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 3 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 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X X 3 Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 24 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 OP25 Regulation 13(4)(a) (c) Requirement The registered person must ensure that heaters are guarded Timescale for action 01/06/07 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. Refer to Standard OP30 Good Practice Recommendations It is recommended that English language needs continue to be monitored so that staff can better communicate with residents. Dorrington House Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 25 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 Residential Home DS0000015633.V334614.R01.S.doc Version 5.2 Page 26 - 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. 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