Inspection on 29/04/08 for Dothan House

This inspection was carried out on 29th April 2008.

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

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

Dothan House 09/08/07

Dothan House 02/03/07

Dothan House 24/02/06

Dothan House 19/10/05

Dothan House 06/12/04

Dothan House 23/06/04

Dothan House 10/05/04

Dothan House 27/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Dothan House 458 Upper Brentwood Road Gidea Park Romford Essex RM2 6JB Lead Inspector Jackie Date Unannounced Inspection 29th April 2008 09:25a 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 Dothan House DS0000027859.V362611.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. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dothan House Address 458 Upper Brentwood Road Gidea Park Romford Essex RM2 6JB 01708 761 647 01708 761 647 dothan@tiscali.co.uk 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) Genesis Residential Homes Limited vacant post Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2008 Brief Description of the Service: Dothan House is a registered care home for 19 people aged 65 and over. The home is situated in a residential area of Gidea Park and there is parking at the rear of the property. The home is a large two storey detached house with extensions. There is a passenger lift to the first floor. There is a combined lounge/dining area on the ground floor and another smaller lounge on the first floor. There are 17 single bedrooms and one double bedroom. Nine of the bedrooms have en-suite facilities. There is shower room and a bathroom. Personal care is provided on a 24- hour basis, with health care needs being provided by health professionals such as GPs and community nurses. The charge per week for each person is between £403-00 & £440-00. This information was provided by the proprietor at the time of the inspection. The fees charged were also in a copy of the contract in peoples’ files. Information about the service provided is contained in the service users guide Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced and started at 9:25 am. It took place over eight and a half hours. This was a key inspection and all of the key inspection standards were tested. Staff were asked about the care that people using the service receive, and were also observed carrying out their duties. Where possible people using the service were asked to give their views on the service and their experience of living in the home. All of the shared areas and some bedrooms were seen. Staff, care and other records were checked. The service is registered for 19 people but at the time of the visit only 9 people were living at Dothan House. The home has successfully been registered to provide a service for people with dementia but was not registered for people with dementia at the time of this inspection. Therefore the findings of this inspection are not in relation to a service for people with dementia. Relatives, social workers and healthcare professionals were contacted and asked for their opinions of the service. At the time of writing this report feedback had been received from 5 relatives and 3 healthcare professionals but no response had been received from social workers. In addition feedback surveys were also received from 7 staff and 5 people living at Dothan House. Any feedback subsequently received will be taken into account for future inspections. The last key inspection was in August 2007. In November 2007 a shorter random unannounced inspection was carried out. The purpose of this was to assess the progress made by the home since the last inspection on 9th August 2007 and to monitor the actions to address the requirements made at the time of that visit. Where appropriate references are made about this inspection in relevant sections of this report. Services are now required to complete an AQAA (Annual Quality Assurance Assessment) and the completed form was received in April 2008. Information provided in this document also formed part of the overall inspection. The inspector would like to thank the people living at Dothan House and the staff for their input during the inspection. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: A relative said, “we are often surprised with the new ideas they come up with and cannot at this time think of anything practical to improve”. Another said that he would like to see greater use of the garden when the weather is fine. As stated previously during the course of this inspection the service received confirmation that the application to be registered to cater for people with Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 7 dementia had been agreed. The service has not been running at full capacity for almost a year and has now started to accept new people, with dementia. It is important that the manager and staff team build on the knowledge that they have gained and develop good practice in the care of people with dementia and that staffing numbers and levels are increased as more people move into the home. This will be tested during the course of future inspections. 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. Dothan House DS0000027859.V362611.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 Dothan House DS0000027859.V362611.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): 1, 3, 4 & 5. Standard 6 does not apply to this home. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. People considering moving into the home and their relatives are provided with sufficient information to enable them to make a decision about living in the home. Information is obtained to enable the staff team to decide whether or not the home can meet a persons needs. People thinking of moving into the home and their relatives can spend time in the home to find out what it would be like to live there and to enable the person to make a choice about living in the home, within their capacity to do so, and to be confident that the home meets their needs. The home does not offer intermediate care. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 10 EVIDENCE: There is a Statement of Purpose & Service Users guide. These were updated recently as part of the application for the service to be registered to admit people with dementia. They both contain appropriate information to enable people considering moving to the home and their relatives to make a decision about living there. The results of a quality survey carried out by the manager are displayed in the reception area. Therefore appropriate information about the home is available. The service is in the process of developing a guide with photographs, a tour of the home and comments from people living there and their relatives. They also intend to make a taped version. The Service Users guide is quite lengthy and would not be user friendly especially for people with dementia. It is recommended that the Service user guide be simplified, shortened and that plain English is used. This can then be taped and made into a pictorial format to assist people with dementia. Referrals are usually received from the Social Services Department and they provide initial assessment information. This may be from information that they have gathered or from assessments made by hospital staff. The manager then carries out assessments before an individual moves into the home. There have not been any new permanent admissions since the last key inspection but there have been some people using the service for short respite breaks. The files of three people were looked at. These included someone who had moved in recently for emergency respite care. In addition during the random inspection in November 2007 the admission papers for two of the people staying for respite were examined. Both files contained assessment information from the placing authority. They also contained details of the assessments that had been carried out by the manager and the deputy. These individuals had been visited either in hospital or in their own homes. In one case further information had been obtained from a specialist organisation that provide support for this person. From this paperwork and discussions with the manager I was satisfied that appropriate assessments are carried out and that the necessary information is gathered before a decision is made as to whether the service can support an individual. Also that appropriate information is gathered to enable staff to meet peoples’ needs when they have been admitted to the home. The service has an admission procedure that says people are encouraged to visit and have lunch or dinner there, to have a look around and talk to other people using the service. Unfortunately a lot of people are admitted straight from hospital and do not have the opportunity to do this. Dothan House DS0000027859.V362611.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, 10 & 11. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. People’s needs are identified and staff have clear information about how to meet these. They receive personal and healthcare care that meets their individual needs and preferences. The principles of respect, dignity and privacy are put into practice. People using the service receive their prescribed medication as safely as possible. People using the service will be treated with care and respect and their wishes for their end of life care will be carried out as far as possible. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 12 EVIDENCE: Everyone using the service has a care plan. These cover the necessary areas and include, mobility, personal care, health, nutrition, religion and social needs. These give information about each person and how they need and prefer to be cared for. The care plans seen were up to date and had been reviewed on a monthly basis. Each person has a named keyworker and photographs of their keyworker were in each person’s bedroom. Care plans seen also include information about how people are encouraged to retain as much independence as possible. For example by washing their own face and hands but receiving support for other personal care or by letting a person, that no longer copes with using cutlery, to eat with their hands. People using the service have been asked about their preferences for support with personal care. One person’s file indicated that she wishes to be supported by female staff but that in an emergency would accept support from a male worker. One relative said, “despite the rich mixture of ethnic origins in Dothan House there is a commendable level of personal needs considered including discreet attention to private matters.” They are risk assessments in place. These identify risks for people and indicate ways in which the risks can be reduced to enable their needs to be met as safely as possible. These had been reviewed and were up to date. They had also been signed and agreed by people or their relatives. In addition staff are monitoring peoples’ wellbeing using appropriate assessments. Therefore there is current information available to enable staff to meet peoples’ needs. All of the people living at Dothan House are registered with a local doctor and specialist help is received when needed. Records are kept of medical appointments and these show that people have checks from the optician, dentist and when needed the chiropodist. The district nurse also visits when required. Nutritional and dietary needs are monitored and people are weighed regularly, as far as possible, to monitor weight gain or loss. Appropriate referrals are made if necessary. The blood sugar levels of a person with diabetes are monitored and there are guidelines in place for the action to be taken if she “ has a hypo”. This person said that the night before the inspection her blood sugar levels had not been good and that staff had given her glucose. She also said that they checked her during the night. People living at the home are supported to get the healthcare that they need and to be as healthy as possible. At the time of the last key inspection there were a number of requirements relating to the administration of medication and these have all been addressed. Medication is stored in an appropriate metal cabinet that is attached to the wall in the lounge/dining area. Medication is administered by staff that have received appropriate training and there is a list of staff that can administer Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 13 medication along with their initials. The medication file contained appropriate information and this included photographs of each person and details of any allergies. This is good practice. For accountability hand written entries on MAR (Medication Administration Record) charts are signed and dated by the person making the entry. The entry also includes the source of the information. e.g. GP, registered nurse. Some people receive PRN (when required) medication and protocols/guidelines have been developed for these to ensure that all staff know when to give this medication and for what purpose. The MAR (Medication Administration Record) charts are appropriately completed using the correct codes and abbreviations. The manager said that they have been researching up to date information on the internet. For example medication and dementia. As a result of this they discovered that a particular medication can cause confusion and as a result of this the doctor was asked to review a persons medication and this was subsequently changed. The staff team have been developing advance end of life care plans for some of the people living at Dothan. They have started talking to people with more complex health needs and their relatives. One person’s care plan covering this area was seen and she was able to tell staff exactly what she wanted to happen and where her preferred place of care would be. The intention is for this to be developed further as staff complete further training on end of life care. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. Residents are able to make informed choices about what they do and how they spend their time. People living at the home have the opportunity to join in a range of activities suitable to their needs. Visiting times are flexible and visitors are welcomed in the home. People are supported to keep in contact with relatives and this exceeds minimum standards. People living in the home are given meals that they enjoy and that meet their needs. As far as possible, people are helped to exercise choice and control over their lives. EVIDENCE: Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 15 Staff were observed chatting to people in the lounge and there was a very relaxed and friendly atmosphere. A hairdresser visits each week and some people have aromatherapy massages from a visiting aromatherapist. The ‘house bound’ library visits and provides a selection of books many in large print. In addition people have been doing some indoor gardening and also baking cakes. A reminiscence corner has been developed in the main lounge. The staff team have had training on working with people with dementia and activities have been purchased. In addition activity products have been borrowed from Age Concern. These are designed for stimulating older people. Each person has had an assessment using a specific assessment tool for activities. This has helped staff to understand more about the type of activities for each person. One person living at the home said “ there are a lot of activities for us like quoits, snakes and ladders and bingo. I really enjoy playing all the games. Another said, “I go to the shop to buy flowers, went to the pub and had a look around in Romford and Gidea Park”. Feedback from a relative was “as a result of discussions with us as well there are constant efforts through many different criteria to explore residents interests. We are often surprised with the new ideas they come up with.” It was evident that activities continue to improve and that people are being offered more stimulation. The manager and staff team are aware that this is an area for ongoing development. Relatives can visit at any time, as there are no restrictions placed on visiting times. Relatives said that they are always made welcome and are offered refreshments. One family said, “we are often asked to eat with mother and have energetic conversations about recipes. We always have tea”. Members of the local church visit each month to hold a service. A representative said, “their welcome to us is very good”. In a note to the home a relative said “thank you for making us welcome.” Recently staff at the home have arranged for one of the people to meet with her son, who has a learning disability and does not live locally. Staff put a lot of effort into organising this meeting in an appropriate place and making arrangements with the other care home. The person concerned said, “I asked to meet my son and I went to the pub to meet him. I was very happy”. In each persons room there is now a communication book so that staff can put in information for relatives and relatives can do the same. People living at the home said that they celebrate birthdays and had birthday cakes. Outside entertainers visit periodically and people said that they enjoy this. On occasions clothes parties are held so that people have the chance to buy some new things if they wish to. This year people living at the home made Easter cards for their relatives and some went to church for Easter. A prayer corner has been introduced in the upstairs lounge and one person in particular likes to use this. Peoples’ nutritional needs form part of their care plan and staff keep records of what each person has had to eat and drink. This enables them to monitor that Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 16 people are eating and drinking. One person said, “they always ask me for advice. They take care of the menu, as I am diabetic. I have fruits like kiwi and banana.” The menu has been discussed at a ‘residents’ meeting. One person said, “The meals are really good. They always serve different meals. All the meals are tasty and it is enough for me”. At present none of the people using the service have any specific dietary requirements in relation to their cultural or religious needs. Records show that some people like to have a late snack and tend to have tea and toast. The inspector joined people at lunchtime. People were given plenty of time to eat their meal and were offered drinks. One person no longer manages cutlery but is happy to eat with her fingers. She is given time to do this and food that she can eat in this way. Staff were observed to clean the persons hands after each course. People living in Dothan House said that they could choose when to go to bed and what to do and that they can spend time in their room or in one of the lounges. One person said that she prefers to stay in her room and to have her meals there. Records seen contained information about when people go to bed and reflected the fact that they go to bed when they are ready. A member of staff said, “some people like to get up early, but others don’t want to so we leave them”. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 17 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 & 18. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. There is a complaints procedure that is followed in the event of any complaints being made. Staff have safeguarding adults protection training to ensure that they are clear about what constitutes abuse and what to do if abuse is seen or suspected. This gives people living at the home a greater protection from abuse. EVIDENCE: There is a complaints procedure and this is displayed in the home and people living at the home have copies of this in their rooms. The complaints procedure is also available on tape. Complaints are recorded and dealt with by the manager and the staff team. A relative said, “We certainly know how to make a complaint and have no problem doing so. The first option with anything we are unsure of is to ask the management, this has been enough.” A person living at the home said, “I always go to the manager if I have any problem. I know him, his name is Bis Oozageer. He is very good in helping me if I have any problem. He always listens to me and sorts out the problem as soon as possible.” Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 18 The home has policies and procedures for safeguarding people. Staff have received training in what constitutes abuse and how to report it. The safeguarding issues that were ongoing at the time of the last key inspection have been resolved and were not proven. The service has supported one person to access an independent advocate to assist her to express her wishes about what happens to her. Feedback from a healthcare professional was “they care for each individual person with respect.” A visitor to the home said “the staff talk to the residents in a calm, friendly way.” One of the people living at Dothan said, “all the care that they give is really nice and helpful”. From records seen it was also evident that the manager talks to people living at the home and their relatives about the care provided and actively seeks feedback from them. Staff have had a lot of training in various aspects of the work that they do and said that this has helped them to work in a more professional way. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, 25 & 26. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The environment has greatly improved and is comfortable and homely and suitable for the needs of the people living there. EVIDENCE: The home is situated in a residential area of Gidea Park and there is parking at the rear of the property. The home is a large two storey detached house with extensions. There is a passenger lift to the first floor. There is a combined lounge/dining area on the ground floor and another smaller lounge on the first floor. There are 17 single bedrooms and one double bedroom. Nine of the bedrooms have en-suite facilities. There is a shower room and a bathroom. In the past year the home has undergone a lot of refurbishment and redecoration. Last year the building was recarpeted throughout and all bedrooms and communal areas repainted. Some new beds and bedroom Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 20 furniture have been purchased and there is new bedding, new curtains and new soft furnishings. The overall effect was that the lounge is much brighter and homely. People living in Dothan House chose their curtains and bedding and advice and suggestions for the lounge were also taken from relatives. A small reminiscence corner has been set up in the corner of the lounge. There is also a small lounge upstairs and with advice from the visiting members of a local church a quiet/prayer area has been set up for people to use. One of the people living at Dothan said, “the staff are always hoovering, it smells nice. They have painted the lounge, which looks brighter and they have put nice curtains and a new carpet. My bedroom is always nice clean and tidy”. The garden has been cleared and the refuse area separated from the garden. There is a ramp to the garden so that people living there will be able to use this area. The manager and staff team have also worked to make the environment suitable for people with dementia in preparation for a change in registration. There are signs and pictures on doors and keypads have been fitted on exit doors and the laundry as a safety and security measure. A sample of bedrooms were inspected. All bedrooms were individually decorated and lots of personal possessions were on display making the rooms look homely. The wardrobes had been secured to the wall as an additional safety measure. There are sufficient bathrooms and W.C.’s and these are suitable for the needs of the people living there. The toilet in the upstairs bathroom is not easily accessible due to its close proximity to the door. Future plans include refurbishing the bathroom. Suitable laundry facilities are available so that peoples’ clothing, bedding and any soiled items can be washed appropriately. Staff have all had infection control training and the home appeared to be clean and hygienic and was free from odours. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 21 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 & 30. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. People using this service are supported by a staff team that have the necessary skills and training to provide a good quality service. People living at Dothan House are supported and protected by the services recruitment practice. Staffing levels are sufficient to allow staff time to fully use their skills and experience to meet peoples needs. EVIDENCE: At the time of this visit there were only 9 residents living at Dothan House and one of these was just staying for respite. Two staff are on duty for each day shift. At night there are two staff on the premises, one waking and the other sleeps between approximately midnight and 5 am. In addition there is a designated cook and some domestic support. One of the people living at Dothan said, “at night they come whenever I buzz and anyway they always come every half an hour to see if I am alright”. From checking the rota, talking to staff and observations during the visit the current staffing arrangements are sufficient to meet the needs of the people living there. It is recommended that this be kept under review as peoples’ needs change and Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 22 more people are admitted. Especially as the service has now been registered to care for people with dementia who’s care needs may be higher or more complex than some of the people already living there. Since the last inspection the staff team have undertaken a lot of training and this includes, infection control, food hygiene, medication, moving and handling, first aid and safeguarding adults. Staff have also received dementia training and also activities for people with dementia and dealing with aggression. Feedback from staff was that they have had a lot of training. One member of staff said, “we do a lot of courses to update ourselves, which I find very useful and helpful”. Another said “before starting my job I was given 2 days induction where my manager explained everything about resident care, security, the fire system and what to do in an emergency. I have also had training sessions in house and outside. A great effort has been put in to give all staff training. I was well prepared to work after my two days induction. I have already done manual handling, dementia advanced, fire and safety, food hygiene, report and record keeping and infection control”. In addition staff have also been doing more formal training and 4 staff have NVQ level 2 and 3 are doing NVQ level 3. 4 of the staff team have nursing training. Staff said that the training had improved the way that they worked with people living in Dothan House. The service operates an appropriate recruitment procedure. Jobs are advertised, application forms completed and interviews held. Staff records are kept at the home. There have not been any new staff appointed since the random inspection in November. Three staff files were checked. The files contained copies of the application form, references, POVA (Protection of Vulnerable Adults) first checks and CRB (Criminal Records Bureau) checks. There was also evidence that the necessary identification details had been obtained. A member of staff said, “Our manager only let us start work after we got a CRB. He also asked for my references as well”. Therefore the recruitment procedure offers safeguards to people using the service. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 23 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, 32, 33, 35, 36 & 38. People using the service experience good quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The manager has implemented changes for the benefit of people using the service. The home is being well managed and a safe environment is being maintained. EVIDENCE: The proprietor now manages the home and has submitted an application to be registered with the Commission. He has previously been the registered manager and therefore was deemed to have the necessary experience and qualifications to manage the home. He is a registered nurse and has enrolled to do the RMA (Registered Managers Award). Since he has taken over the management of the home there has been a lot of improvement both in the Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 24 environment and the quality of the service provided. The requirements from the last key inspection have all been addressed. Feedback from staff was that the home is more professionally run now and that the manager keeps them up to date on new ways of working on a regular basis. One member of staff said, “whenever I have concerns my manager always makes an effort to spend time to talk to me. After every training session he asks me if it helped or if I needed more training. My manager always points out if I’m doing something wrong and shows me the right way to do it. He is always making sure that we are providing the best care to our residents”. There was evidence that the manager or deputy monitor the work practice of the staff team and also that they seek feedback from people using the service and their relatives. A relative said, “we are often involved in the transfer of information whether it be from the viewpoint of making improvements or changes in policies”. Staff spoken to said that they had been receiving supervision and that staff meetings were being held. This gives staff the opportunity both collectively and individually to discuss work practice, any concerns and the development of the service. Staff also said that they can talk to the proprietor or the senior carer and that they get advice and support from them. The home’s insurance policy is current. The proprietor does not deal with peoples’ overall finances, but for some has small cash amounts in safekeeping. This cash used on their behalf for purchases or services from the chiropodist, hairdresser and aromatherapist were found to be in order. The cash held for three people was checked and amounts recorded tallied with cash held. All entries were recorded and receipts were kept to evidence any expenditure. For other people the proprietor keeps a record of money spent and then sends invoices to relatives. Therefore peoples’ finances are appropriately dealt with. The staff team carries all of the necessary health and safety checks out regularly. For example fire call points are tested weekly, as are hot water temperatures. Fridge and freezer temperatures are tested daily Appropriate servicing is carried out on the fire system and fire equipment and a safe environment is maintained. To improve the safety and security of the service the shed doors are lept locked, the refuse area has been fenced off and additional security has been fitted on the laundry door and exit doors. Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 25 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 26 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. Standard Regulation Requirement Timescale for action 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 OP1 Good Practice Recommendations It is recommended that the Service User guide be simplified, shortened and that plain English is used. This will make it more user friendly especially for people with dementia. It is recommended that staffing levels are kept under review as more people move into the home and also as people with dementia are admitted. This will ensure that there are sufficient staff available to meet people’s needs. 2. OP27 Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Contact Team 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Dothan House DS0000027859.V362611.R01.S.doc Version 5.2 Page 28 - 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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