Inspection on 02/03/06 for Dovecote Nursing Home

This inspection was carried out on 2nd March 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dovecote Nursing Home 29/05/07

Dovecote Nursing Home 15/06/06

Dovecote Nursing Home 27/09/05

Dovecote Nursing Home 11/03/05

Dovecote Nursing Home 14/10/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Dovecote Nursing Home Hugar Road High Spen Rowlands Gill Tyne & Wear NE39 2BQ Lead Inspector Mr Tom Moody Unannounced Inspection 10:00 2 March 2006 nd 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 Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 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. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dovecote Nursing Home Address Hugar Road High Spen Rowlands Gill Tyne & Wear NE39 2BQ 01207 544 441 01207 544 171 dc1eurodeancare@aol.com 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) European Care (UK) Limited Care Home 61 Category(ies) of Dementia - over 65 years of age (34), Old age, registration, with number not falling within any other category (61) of places Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: Dovecote Care Home has 61 places for older persons. The home is split into two separate units; the first floor providing care for persons suffering from dementia and the ground floor for older persons only. Both units provide nursing and personal care. The home is purpose built and the internal space is generous. The bathrooms and communal WC’s have handrails and appropriate lifting equipment for disabled service users. The home is constructed in a traditional style of brick and tile and has a variety of lounge / dining areas. There is passenger lift access to the first floor. The access is level from the ground floor entrance. It stands in it’s own grounds, which are well kept. There is a generous amount of parking space. The home is located in a village, in a rural area. It is a quiet setting with local facilities close to the home including shops and a pub. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day on 2 March 2006 and was carried out by one inspector. Records were examined and a tour of the premises took place. Discussion took place with the manager. The midday meal was observed and the inspector spoke to service users, staff, and visitors throughout the inspection period. The feedback from service users and relatives was positive. The home is reasonably well equipped with aids and adaptations suited to the client group’s age and lifestyle preferences. The home has plenty of space in all areas. It is popular with service users and their families. What the service does well: Staff are committed to providing a caring environment for people living at the home and try to support them sensitively. The relationship with families is good and they confirmed that they are kept informed about anything to do with their relative: ‘They ring me at home if (service user) has had a fall,’ The home maintains good contact with the local community. The home provides a wide range of social activities for service users. Most maintenance is carried out promptly. The home is clean and comfortable. There is a commitment to provide training and development for staff. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4, 5 Service users and their families are able to visit the home and are given enough information to judge if it can meet their needs. EVIDENCE: Visitors confirmed they were able to visit the home before their were placed there. One relative said that, “This home is better than most that we’ve seen.” Staff confirm this and spoke of relatives continued involvement in the home especially in fundraising and social events. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 A new care planning system has been introduced and is working well. The care plans demonstrate that the home is meeting all of service user’s healthcare needs. The homes medication systems are being largely adhered to and, with only a few exceptions, service users are protected by as safe system of medication that is properly operated by staff. Although staff generally respect service user’s privacy some aspects of the environment may not always support this on every occasion. EVIDENCE: The care planning and documentation has improved in most areas although some fluid balance charts were in use with three days recorded on the same sheet. Assessment information covers widespread areas of need. The care plans contain good risk assessments and this aspect of care planning was discussed with the manager. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 10 Life histories help to give a full picture of who the person was before they developed dementia and families are aware of and contribute to this process. Staff have a good awareness of service users needs and life story. Likes and dislikes are recorded, as well as individual preferences. Drug storage is secure and clinical areas are well organised and tidy. Unfortunately some valuables were improperly stored in the CD cabinet upstairs. Medication Administration and Recording (MAR) charts are well kept and there are few gaps in recording. Controlled drugs are appropriately stored and stock balances are generally kept correctly, although some of the practice surrounding the storage and recording of Temazepam raised doubts about staff following the home’s policies. This was brought to the attention of the manager. Service users were addressed respectfully by staff and staff were observed to knock at bedroom doors. However, some toilets were without proper locks and could not be secured by service users. Other toilets were locked and service users were unable to access them. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 Staff are sensitive to service users needs and an activities officer is in post but this service is not yet fully developed to ensure it meets the needs of people with dementia. There is evidence of family involvement in social events run by the home and with individual service users. Service users use community facilities and are able to feel part of the local community. Service users are given appropriate and sensitive support at mealtimes by staff. The dining experience has improved on the upper floor. EVIDENCE: There was further improvement in the mealtime experience for service users on the first floor. Tables were set with tablecloths, condiments, sugar bowls and milk jugs which gave a more homely feel to mealtimes and gave some degree of control back to service users. Staff were helpful and attentive and service users but unfortunately had to kneel beside them due to the absence of appropriate chairs. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 12 The menu for each mealtime was displayed on a large menu board and staff reminded service users about what was available. The cook asks service users about their menu choice on the evening before. The kitchen is well ordered and cleaned. Fresh vegetables were available in the kitchen and the cook confirmed that fresh vegetables were used for meals whenever possible. Service users commented positively on the meal at lunchtime which was appetising and well presented. Service user’s confirmed that, “the food is good” and “the meals are lovely.” Some service users on the ground floor were engaged in individual activities within their room. Several were observed to be reading and one confirmed that they enjoyed doing the jigsaw puzzles that were in their room. The music being played in the downstairs lounge was rock music and, although this was not loud, it seemed inappropriate to the service users age. There was some level of interaction between service users, but most sat quietly and there was little interaction with staff until some “entertainment” was taking place. As noted in the last inspection report, it seems as though staff were so busy doing physical care tasks that they had little opportunity to talk and interact with service users. One service user spoke of being, “bored” because “there was no one to talk to.” The manager spoke of increasing staffing levels to cover busy times, especially in the morning. There is an activities co-ordinator in post who is very enthusiastic about her role. She is exploiting community contacts to support social events in the home. There is also an “exercise therapist” who visits the home on a weekly basis. Relatives observed that, “there is always something going on.” They also spoke of their relatives being, “taken out for a little walk” in the surrounding area. Service users also spoke of visiting, and being visited by, “the ladies from the village.” There was an entertainer visiting the home on the day of inspection and there was also a minister of religion conducting a service. The home should consider the use of signs to indicate toilet and bathroom locations to service user’s who may have difficulty in recognising written signs. Toilets should not be locked to prevent service users accessing them. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Complaints information is accessible to service user’s and their families, and both are confident about using the process if needed. The home manager and staff have a good awareness of adult protection issues and work to preserve service user’s rights. EVIDENCE: Information about how to make a complaint is visible in the entrance of the building and service user’s and their relatives were confident of the process. Comments included: “I’d be happy to raise issues with the manager, but I’ve got none.” “The manager was sympathetic and dealt with it quickly.” “The staff were brilliant.” Relatives and staff were at ease with one another and showed signs of a relaxed and confident relationship. Relatives visiting on the day were able to speak to either the key worker or nurse in charge to discuss any concerns or ask for information about their relative’s progress. Service users are registered on the electoral role. The manager has spoken of the home promoting advocacy and there are leaflets and information about this on the notice board. Past complaints and adult protection issues were dealt with appropriately by the manager who has a good awareness of issues. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The home is well maintained and any problems are dealt with promptly. This ensures the environment is kept safe and pleasant for service users and others in the home. There are sufficient bathrooms and toilets and these have handrails and other mobility aids fitted. Unfortunately some of these are locked and others have defective locks, neither of which makes them properly useable for service users. The home has a range of aids and adaptations and meets most service user’s needs. It would be beneficial to have additional equipment for sensory loss, such as a “loop” system for hearing aid users. Service user’s rooms are pleasantly decorated and contain many personal touches. They reflect personal taste of the occupants and meet the needs of service users. Standards of cleanliness and décor are good but do not fully take account of people’s orientation or sensory needs. The standard of cleanliness is good and the home is pleasant and comfortable. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 15 EVIDENCE: The layout and décor of the building does not fully take into account the needs of people with dementia or sensory impairments. While the décor is regularly refreshed in bedrooms before new service users are admitted there are few cues to help orientate people around the home. Some simple measures could be taken such as the provision of large-faced clocks or signs on toilets and bathrooms. The new manager is working with the sensory impairment team in Gateshead and the Dementia Care Collaborative for advice. He is also investigating the possibility of introducing individual loop systems for people who have hearing loss. The home has mobility aids that can be used throughout the home and fixed in key areas such as bathrooms and toilets. Unfortunately some of the locks on toilets are damaged. Other toilets are permanently locked and this would pose problems for service users. The equipment in service areas, such as laundry and kitchen, are all working and staff can confirm that maintenance takes place rapidly if there is a problem. Service users bedrooms are pleasantly decorated. Many contain personal items and family photographs. The rooms reflect the personality of the occupants and several service users prefer to spend the majority of their time in their own rooms. Staff have worked hard to improve the standard of cleanliness and remove odours. The manager is currently addressing the problem of residual odours cause by substances penetrating below the carpet and into material below the surface. The grounds of the home are substantial and well kept. There is a sheltered and secure garden area at the back of the home. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 30 Although number staffing numbers meet the current NMS, shifts are being changed to ensure sufficient staff are available to fully meet the needs of people during busy periods. To ensure that service users receive skilled care the staff receive a range of in service training as well as updated mandatory training. EVIDENCE: The manager spoke of introducing extra staff to cover the morning shift. This would include busy periods such as lunchtime. The rescheduling of medication administration to before or after mealtimes may allow qualified staff to assist at this time. The manager spoke of some qualified staff being unavailable and indicated that the home may increase the use of agency nurses to cover for this time. It was noted that at some times during the morning it took several minutes before staff could respond to call buzzers and as noted in an earlier section staff are very busy during the morning period. The manager indicate that staff receive all of their mandatory training and staff could confirm this. Staff spoke enthusiastically of in service training programmes. One said that the training material was so interesting they, “couldn’t put it down once they started reading.” Some staff were engaged with NVQ assessors at the time of this inspection. One member of care staff told of her personal development and plans to study for a nursing qualification. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 38 The home is well managed and staff morale has improved under the latest managers. This ensures that the service users are cared for in a safe environment by staff who act in their best interests. EVIDENCE: The current manager is not yet registered with the regulatory authority. He is sensitive to staff’s feelings and staff and relatives expressed confidence in his abilities. It is evident that the weaknesses highlighted in the last report had been, or were being, dealt with by the manager. The manager spoke of increasing staffing levels and supporting staff through training and development. Staff confirm this is taking place. Other quality measures are being introduced such as a regular audit of care plans. The leadership in the home is encouraging a positive approach to care. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 18 One nurse said that, “Our people deserve better care and I intend to see that they get it.” Staff remarked on maintenance being carried out promptly and the improvements in the physical environment. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 2 2 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 x 3 Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? yes 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 OP9 Regulation 13(2) Requirement Staff must adhere to the homes policies and professional guidelines on medications Toilets must be fitted with working locks to preserve service user’s privacy and dignity. The home must provide suitable equipment for service users with sensory deficits and those who are prone to confusion. Timescale for action 21/04/06 2 OP21OP10 12(4)(a) 23(2)(j) 21/04/06 6. OP23 16(2)(c) 23(2)(a)(n) 21/04/06 7. OP12OP18 18 The home must employ 21/04/06 suitable numbers of staff to meet service users needs at all times. Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dovecote Nursing Home DS0000018172.V276694.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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