Inspection on 27/10/08 for Dorset House

This inspection was carried out on 27th October 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dorset House 17/10/06

Dorset House 14/11/05

Dorset House 01/07/05

Dorset House 17/01/05

Dorset House 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Dorset House Coles Avenue Hamworthy Poole Dorset BH15 4HL     The quality rating for this care home is:   one star adequate service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter Still     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Dorset House Coles Avenue Hamworthy Poole Dorset BH15 4HL 01202672427 01202673239 dorset@care-south.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care South Name of registered manager (if applicable) Mrs Joan Fay Nickson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 52 in the category OP (Old Age) including up to 8 in the categories DE(E) and/or MD(E). Date of last inspection Brief description of the care home Dorset House is a residential care home registered with the Commission for Social Care Inspection to accommodate a maximum of 52 people. The home is located in Hamworthy and is close to local shops, libraries and churches. Local bus services operate from outside the home into the centre of Poole. The home offers accommodation on the ground and first floors, a passenger lift is available for people with mobility problems. Three bedrooms on the first floor offer en suite toilets and Care Homes for Older People Page 4 of 30 care home 52 Over 65 8 8 52 0 0 0 Brief description of the care home there are two double bedrooms. Communal lounges and dining areas are provided on both floors, as are specialist baths. Dorset House is part of Care South, a not for profit organisation, providing independent care services across the South West. Weekly fees on the day of inspection ranged from four hundred and seventy five pounds to five hundred and seventy pounds. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out over 2 days, by one inspector but throughout the report the term we is used, to show that the report is the view of the commission for social care inspection. At the time of the inspection the home was providing care to 45 residents at the home and two people were in hospital. We viewed documentation in relation to the care provided, staffing, policies and procedures. We spoke with a number of residents, staff, relatives and a Doctor. The care of four people was used particularly to track examples of the care they receive. A tour of the building was made and Residents and staff were also observed to Care Homes for Older People Page 6 of 30 consider the quality of life for residents and the way staff met their needs. Prior to the inspection Dorset House completed an Annual Quality Assurance selfassessment and forward this to the Commission. Surveys were also sent to residents, staff and other professionals. Most survey responses were positive in tone, including comments about the home being fresh and clean and good staff team work. However points were also made about a lack of activity and also staffing, with a consequence of a need to use agency staff. The last key inspection was made on 17th October 2006 and an Annual Service Review was completed by the Commission on the 10th March 2008. At the time of this inspection, it was noted that staff showed kindly attention to residents and were alert to individual needs. The manager supported the inspection and it was clear she was aware of shortcomings and had taken steps to resolve issues to improve residents lives. She also demonstrated a strong resolve to deal with outstanding issues, which we identified. All staff spoken with during the inspection were open and helpful. Responses to surveys sent out by the commission contained many positive points, for example: a doctor said communication was excellent and client centred; Relatives said: Home was fresh and clean; most responses from relatives were very positive. Comments about improvements included: Lack of staff at weekends and mid afternoon; Too much use of agency staff not enough activity; the lift for the home always breaking down. What the care home does well: What has improved since the last inspection? Since the last inspection we needed to talk to the service about a concern where residents were refusing medication and this had been responded to. The matter had been discussed with doctors and the deputy manager has attended training concerning the Mental Health Act and how it relates to points staff need to be aware of concerning the Act. The last inspection raised points about nutritional monitoring and the lack of a chef for the service. This had been responded to. Nutrition is being monitored and the service has a chef and an assistant. Residents have choice at mealtime and individual likes and dislikes are responded to. New computer based systems have recently been put in place to improve documentation and information systems. This includes an overview of staff training, which provides immediate information about training staff have had and when they need to up date their training. The computerised system also contains risk assessments, which can be easily amended. Meals are prepared by a chef who provides individual daily menus, which enables choice. The outside area has been improved since the last inspection and provides attractive places for residents to walk, with shrubs and climbing plants providing shelter from the sun and weather. Recently a number of roller shades have been fixed to the outside of the building to give more places for people to sit and also to ensure rooms inside do not become too hot. Care Homes for Older People Page 8 of 30 Whilst the staffing recruitment situation has been difficult since the last inspection, at the time of the inspection there had been a reduction in the need for agency staff. 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. People who have chosen to move into the home have been assessed to ensure their needs can be met. Evidence: The care files of four residents were viewed. Files showed that residents wishing to move to the home are carefully assessed prior to admission to ensure their needs can be met. Residents are provided with a contract of residency, which is kept up to date. All files reviewed showed a full admission process. It was noted that one person had decided to change their room following admission and detail was seen to record that the advocate for the resident had agreed to the change. Records showed that visits prior to an admission are encouraged and there was also evidence of the manager Care Homes for Older People Page 11 of 30 Evidence: visiting a person in hospital to provide information about the home and to enable the home to ensure they had good information to check the home could meet the persons needs. Part of the process included risk assessment and all files seen had these completed. The responses from sixteen surveys said that fourteen residents or people important to them have seen their contract of residency. Two said they had not, including one person who noted that their relatives placement had been undertaken at short notice by social services. One person responding to a question about sufficient information being given before a decision was made to move into the home, said: We had a grand tour and introduction to the staff, we were there for two hours or more - superb. A health care worker said: Sometimes the clients health-care needs are too much for a residential care setting and referral to nursing care is made. Otherwise I view this home as exemplary in bending over backwards to meet the needs of the clients. The number of people with a dementia has not changed significantly since the last inspection, three people were considered to be a challenge to the service. We had discussion with the manager about the number of people with dementia and the balance of staff and their skills. The manager is careful to consider people wishing to be admitted to the home to ensure suitability and that care needs can be met. We observed practice during the inspection and considered that people are suitably placed at the home. However it is important for staff to be supported with training in relation to dementia. Dorset House does not provide an intermediate care service. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This Judgement has been made using available evidence including a visit to this service. Dorset House has a new and comprehensive system for care planning, however it must be fully implement to ensure the needs of all residents are met. The daily record of information concerning each resident and points emerging during their night and day, sometimes gave excellent detail to help update staff. However many daily records were not adequate and some staff need help in the way they complete their records. Administration of medication follows a robust process to protect residents. Residents are treated with respect and as individuals with their right to privacy upheld. Care Homes for Older People Page 13 of 30 Evidence: Four care files were reviewed concerning residents health and care needs. The manager of the home was aware that a number of care files were inadequate in terms of the detail necessary to ensure staff have good information to support residents. The company had recently introduced a new and much improved system, which the home was in the process of transferring to. A review of files showed that where the new care planning system had been established fully, the records were comprehensive and easy for staff to understand. However some files had not been reviewed and one other file, which had been transfered, failed to have all of the information required by the form used. The manager fully accepted this and had taken the step of scheduling her Deputy Manager to dedicate two weeks to transfer all existing care plans onto the new corporate documentation. The manager was clear that this action would ensure a full review and exchange of information to the new system within two weeks of this inspection, with all care plans being fully up to date and accurate. Whilst much good work was seen, this failure and the length of time it has taken to improve the detail of care plans has caused this outcome group to be scored only as adequate. Of the four care files reviewed, recording under the new system for one resident was very good, however others were not. A number of gaps were found where no record had been made, one did not contain a full risk assessment; a review of the old file relating to this resident, found that the last review was in 2006. Comments from health care professionals included: Very good communication with health- care workers. Often address health care needs pre-emptively. Very prompt to seek medical attention. Very occasionally written handover between shifts surrounding medical issues needs to be more detailed but realistically this is hard to expect from a residential home - generally their written handover is better than some nursing homes I have visited. We reviewed health care needs in relation to care plans and they provided detailed information; it is important to be clear that not all information had failings, care plans cover a wide range of key aspects. We found that the daily recording by care staff was often inadequate, in the records reviewed, examples included: All care given, or all P/C given. From this type of record, we found it was not possible to establish, for example, that cream was applied thinly to itchy areas of skin. However some recording was seen to be excellent and provided key information for other staff working with the resident. One member of staff responding to our survey said: In terms of their induction training, More information about what to record in care plans and how would be helpful. Care Homes for Older People Page 14 of 30 Evidence: We noticed one resident to have a personal care need and brought this to the attention of the manager. Staff had tried to support the care for this person, who refused to allow staff to respond. On the second day of the inspection visit, it was noted that the person had been helped. We decided to look at the care plan for this resident and found it failed to contain information about the particular personal care needed. This gave further evidence of the importance of more detail needed within care plans. We observed one resident, who was a challenge to the service, slip to the floor. Three staff responded and used kind and confident attention to support the resident; equipment was used to lift this person. During the inspection the home had a meeting with a new pharmacy provider that Care South are transferring the supply of medication to. The meeting was to ensure good communication during the transition period and to provide details of the support system available when the new pharmacy takes responsibility. We met with the pharmacy representative and were shown the comprehensive system they will put in place. It is understood that the contract with this pharmacy will ensure tight control over ordering and recording of medication and that there will be easy support to change medication when needed. The company will also provide other support including training. It is not possible to comment on the new pharmacy or their system since it was in the process of changing over. The current medication process was reviewed and checked for accuracy. The administration of medication was correct for the records checked and staff were also observed to take great care in the handling and recording of medication as they gave it to residents. Comments from relatives included: They care about their residents who always look happy and contented. Staff are excellent at keeping me informed. I am very lucky to to have Dorset House with its caring staff to look after my partner who has dementia - they are also very kind to me. The care home meets my relatives needs and staff are always friendly and helpful. Could not wish for anything more. I believe some care staff are definitely in the wrong career but most seem to work well. The review of the home by the Commission raised concern about residents refusing medication, their rights and the Mental Capacity Act. The deputy manager had attended training relating to the Mental Capacity Act recently and was due to cascade this learning to staff. Care Homes for Older People Page 15 of 30 Care Homes for Older People Page 16 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This judgement has been made using available evidence including a visit to this service. The home provides social, cultural and leisure activities. However improvements to the range of activity, will ensure residents have access to choice and an interesting lifestyle to improve their lives. Residents are supported in maintaining contact with families and other people important to them. The appointment of a catering team led by a chef has improved residents diet and ensures individual choices can be made. Evidence: Activity was seen to be taking place during the afternoons of the inspection and on the morning of the first day, residents were seen enjoying having their hair done. Surveys sent to the Commission by relatives indicated that there may be a lack of Care Homes for Older People Page 17 of 30 Evidence: activity for residents. Examples of comments include: Not enough activity, Residents sit in same chair most of the day; residents are bored. Staff responses included: More activity and outings needed. We found no records were available about the range of activity generally in the home. We observed that whilst activity was provided, it could be improved with more variety to meet group and individual needs. One resident spoken with said that sometimes residents get on each others nerves in the lounge and became agitated, which is not good - it would be better if they could have more to do and not sit so long - this would help. We discussed these findings with the manager who accepted that this was a priority area to improve on. The manager had tried for about a year to appoint an activities coordinator, without success and it was now necessary to take proactive steps. New staff were about to start work at the home and the manager has a plan to give responsibility for coordination of activity and ideas to one of these new staff, to ensure a proper focus. In the managers Annual Quality Assurance Assessment, she had raised the issue of activity as being an issue and clearly wishes to make improvements for residents. Dorset House has a day centre service, which is contracted with the local authority, with separate staff. Residents of the care home do not have much contact with this service. It was observed that people who use the service were enjoying their time and it was unfortunate that the same type of experiences were not available to residents of the home. We met with the chef, who was experienced and focused on his work. a copy of menus were given to us, showing balanced, varied and wholesome meals being provided. The meal on one day had three options for the main meal and a number of deserts. A home made soup was being enjoyed as a starter and a team of staff were helping to give residents meals they had chosen from the daily menu discussion. People sat in small groups in the dining room and though a large room, was homely. We observed that one resident had decided to leave the dining room before they received their meal and that the chef gently and kindly supported this person back to the dining room showing that staff were flexible and alert to the needs of residents. The importance of monitoring nutrition had been raised at the last inspection and that the manager should introduce a new monitoring system. This was in place at this inspection, a monitoring tool being used, which triggers action if a person loses more than five pounds, in weight. This ensures there are no underlying issues affecting a Care Homes for Older People Page 18 of 30 Evidence: persons well being. Care Homes for Older People Page 19 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A system is in place to respond to complaints from residents. Residents are protected from abuse by staff who have received training and by the homes adult protection policy. Evidence: Dorset House has a robust complaints policy and procedure and details were also seen by the front door. The home ensures relatives and advocates have details so they know who to approach if they have a concern. One complaint had been dealt with in line with the homes stated policy. The homes adult protection policy demonstrates an understanding of abuse and how to protect residents. Staff training and induction showed that staff have training in adult protection and one member of staff spoken with was confident in the steps to take if they had a concern about abuse and the protection of vulnerable people, including whistle blowing. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents at Dorset House are provided with an attractive , homely and safe place to live. Evidence: The company has a programme of ongoing work to the environment, which the manager prioritises. One relative expressed concern that corridors can be smelly. This was not found during the inspection; the home was fresh and clean. The home has special equipment to clean any accidents and there is a continual programme of carpet replacement. The manager said that new furniture was being purchased and that the laundry service was to be revised and it would be redecorated. The secure outside area was being enjoyed, even during the inspection when the weather was poor. Much thought and work has gone into the outside area, which provides a valuable and enjoyable space for residents. New external roller blinds have been a recent development. One WC, upstairs, which is not used frequently had a stained floor, which is due to be replaced. There has been an ongoing problem with the lift providing access to the first floor and Care Homes for Older People Page 21 of 30 Evidence: whilst the lift was working properly during the inspection, the company had decided to change their contract to a new service provider. One relative mentioned the problem with the lift in their survey response. The home had reported the difficulties properly to the Commission, when it had effected residents. Residents were seen to enjoy their lounges, though at one point one was not being used. Residents also enjoyed the busy main corridor, where there are chairs for people to sit. On the first day of inspection, a number of people visited the home, which included maintenance staff. On the second day of inspection, an unannounced fire inspection took place with a full team of fire officers, with their appliance. Comments from residents in their survey responses include the following: My bedroom is always untidy before the staff attend to it - sorry everyone. Feel that the corridors are the worst for smells and that this could be improved. A number of comments related to the lift, which had failed to work properly for a long time. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Difficulties with staffing have had an impact on staff morale at times, which may have had an effect on the service provided to residents. New staff being appointed and steps the manager is taking will ensure residents are happy and that the home continues to feel positively about the future. Residents needs have been met safely. Robust recruitment practice protects residents from unsuitable staff. Evidence: There was much evidence of good teamwork amongst staff and praise for the managers ability to listen to staff and to work to resolve issues. During the inspection, staff morale was good and the staff team were happy and supportive of each other as they worked with residents. Staffing levels were considered to be sufficient to meet the needs of residents during the inspection and only one agency member of staff was working during a part of each day. The manager said she will use a Buddy system to welcome and support new staff. However by reading staff minutes, taking note of staff surveys and relatives being concerned about staffing and the use of agency staff it was clear that Dorset House has been going through a prolonged period of difficulty. Care Homes for Older People Page 23 of 30 Evidence: It has been vital for the home to appoint suitable staff to vacant jobs, which had been very difficult to achieve. The impact has been a difficulty in moving care practice forward and one particular area which suffered concerns good record keeping. Staff hold team meetings in their separate teams of: domestic day, catering, and night staff. Excellent minutes were reviewed, which were open and honest. These meetings are likely to have supported the positive changes being made. The imminent appointment of staff will be an important time of transition for Dorset House. Two staff were due to start during the week of the inspection and six staff were awaiting recruitment checks. The files of three staff were reviewed to track recruitment, training and supervision. Two files were complete in relation to a good recruitment process, however one person appointed some years ago only had one reference. There had been a phone call concerning the second reference but no detail recorded. The manager contacted the company office during the inspection and they found that a mistake had occurred and a follow up of the reference had not happened. This mistake occurred before the current manager was in post. The manager has a staff training matrix to provide an overview of staff training needs. Staff training is seen by the home as important and at the time the Annual Quality Assurance Assessment was completed, 55.9 percent of staff had achieved a National Vocational Qualification at level two or above. Training and support will be needed in record keeping and also since a number of residents have dementia, further training in this area will be needed too. One area of training, which staff need relates work with people who have dementia. This is especially important due to the number of residents that have specific needs in relation to dementia. Staff responding to the survey and those spoken with were positive about their supervision and ability to seek guidance when necessary. Records showed that staff had received induction training. Comments from staff in their survey responses include: I enjoy coming to work. Everyone works as part of a team so everyone knows what is going on Training is top form. I would like to see more staff so they can stop having agency staff. I find agency staff dont work so well and I think they cause more problems. Care Homes for Older People Page 24 of 30 Care Homes for Older People Page 25 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is committed to ensuring development of good practice at the home and she creates a positive and relaxed atmosphere for residents. Residents are assured their financial interests will be protected. The health and safety of the residents and staff are protected by the policies and procedures followed at Dorset House. Evidence: The manager is supported by staff who have shown good teamwork and know they can discuss issues with her that are important to them. The manger said she has valuable support from the Responsible Individual for Care South, who is aware of the difficulties that have been faced and is supporting the steps the manager is taking to make residents lives better. Care Homes for Older People Page 26 of 30 Evidence: Performance has been reviewed by an external and independent source and the analyses of their work has demonstrated that the home is viewed favourably by residents, their families and staff. Monitoring by the Responsible Individual at monthly visits and through reports of staff meetings and supervisions also enables an overview of the service. The Annual Quality Assurance Assessment was produced in a comprehensive and honest way and provides key areas where the manager is seeking to make improvements. The financial records of one resident, being case tracked was used to test that a proper record was being maintained and that the balance of cash was correct. A simple system was used and it was easy to confirm a correct balance of cash. Records concerned with health and safety were seen and found to have been reviewed concerning environmental tests, for example: Fire, electrical equipment and hoists. The Annual Quality Assurance self assessment also confirmed this. Care Homes for Older People Page 27 of 30 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 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, Care Homes 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 1 7 17 Maintain up to date records within the service users care plan. Ensure all care plan records have sufficient detail so that staff are aware and can meet residents needs. 02/04/2009 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 1 7 Support care staff to provide daily care records for individual residents that are meaningful to ensure staff have good information to continue to meet resident needs. The manager should be supported in her plan to delegate responsibility of coordination of daily life and social activity to a new member of staff to respond to an identified weakness in this Standard. 2 12 Care Homes for Older People Page 29 of 30 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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. 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