Inspection on 31/05/06 for Dover Cottage Rest Home

This inspection was carried out on 31st May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dover Cottage Rest Home 29/07/08

Dover Cottage Rest Home 07/06/07

Dover Cottage Rest Home 15/12/05

Dover Cottage Rest Home 07/06/05

Dover Cottage Rest Home 08/11/04

Dover Cottage Rest Home 24/08/04

Dover Cottage Rest Home 15/12/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Dover Cottage Rest Home Dover Farm Close Stoneydelph Tamworth Staffordshire B77 4AP Lead Inspector Mrs Wendy Grainger Unannounced Inspection 31 May 2006 09:30 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 Dover Cottage Rest Home DS0000004934.V291949.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. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dover Cottage Rest Home Address Dover Farm Close Stoneydelph Tamworth Staffordshire B77 4AP 01827 331116 01827 261569 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) Dr Rais Ahmed Rajput Mrs Glenda Margaret Pollard Care Home 15 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (15) of places Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Dover Cottage is located on the periphery of an estate outside the town of Tamworth. The home is near to the A5 and M42 but is not within walking distance of any major shops. Public transport is available at the end of the main road. The home is at the end of a cul-de-sac with a small parking area at the front of the home. At the rear of the home is a lawned area with a large weeping-willow tree. The main door is located at the rear of the home. Dover Cottage offers accommodation to fifteen older people whose primary diagnosis was dementia. There were two lounges for the service users. Bedrooms were for single and shared accommodation. Only one of the shared bedrooms has an en-suite facility. Bathing and toilet facilities were available on each floor. The shaft lift or the stairs can access the first floor. The current fees were provided from information contained in the PreInspection Questionnaire (received on 28 April 2006) and varied from £370 for a single room with no en-suite and £356 for a shared room. One of the bedrooms does have an en-suite facility. Any additional charges i.e. hairdressing and private chiropody would be the responsibility of the relatives. The home does not handle any finances. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was completed on the day of the 31 May 2006. Observations of the care practices provided by the staff to residents will be reflected in the report. Where able, residents contributed to the inspection. The care manager came on duty prior to her scheduled shift. The report will reflect information provided by the management, comments made on the day and from discussions with the staff. A tour of the home was made, which was found to be clean, well-maintained and hygienic. Records were made available to meet the requirements. Observations of the interactions between staff and the residents were part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Because of the diverse mental needs of the residents and the registration that identified that care for older people with dementia would be provided. There was a requirement for the staff to have current training for the care of this group. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 6 The pink non-leather chairs needed to be reviewed to ensure that they were safe. The manager was requested to remove one chair when it rocked when pushed at the back. The towels used for the personal needs of the residents were hard and not kind to delicate skins. It appeared that softeners were not used on a regular basis. Some of the towels were in a poor condition. The inspector also had concerns regarding the flannels used by the staff for residents. There was no differentiation in the colours used. It is required that this is reviewed to provided alternative colours; to distinguish and clarify which area of the persons body they will be used upon. There has been limited evidence, again, of the management obtaining feedback from the stakeholders that visit the home; this had been part of previous discussions on inspections. The records held on the staff were poor in content; the manager had not provided the required details to ensure that staff were identified, confirmation of their ability during the induction and provision of a job description. At the time of this inspection it was a requisite and discussed with the provider that the home was required to have a working facsimile machine. 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. Dover Cottage Rest Home DS0000004934.V291949.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 Dover Cottage Rest Home DS0000004934.V291949.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): 1,3,4 Quality in this outcome area is adequate. This judgement has been made using available evidence including discussions with the provider and manager. The Statement of Purpose information remained unchanged and provided the current details of the home and staff. Assessment of individuals needs would be completed prior to admission. There was a need to ensure that the facsimile machine was operative at all times. EVIDENCE: Thee had been no new admissions to the home for sometime; the number of residents was low. Despite this, the manager would continue to assess prospective residents. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 9 The Statement of Purpose was available to any person, located in the entrance hall under the signing-in book. This report made it a requirement that the home had a working facsimile machine to comply with the National Minimum Standards. This was part of the discussion with the provider. There was a need to maintain a copy of the confirmation letter following an assessment of individual’s need on file. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 10 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 Quality in this outcome area is good. This judgement was made using available evidence including speaking with residents, staff and a visiting district nurse and from information in the care plans. The care plans had been reviewed since the previous inspection. While simplistic in their layout, they provided the appropriate details of the care required. There was evidence of further medication training to ensure the safety of the residents. Staff were responsive and addressed a problem in a calm and sensitive manner. EVIDENCE: The care manager had considered the layout of the care plans and the need to have the appropriate details to enable the staff to offer personal and health care. The new care plans were simplistic in their format. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 11 Three care plans were evidenced, regular reviews were seen and changes identified and recorded. Discussed with the manager the need to contact one family to ensure that one residents self esteem was promoted by having her hair cut and set, and that a pedicure was completed more regularly. There was evidence that the community psychiatric nurse was involved fortnightly for one resident. The comment of that “the staff follow instructions and that they were responsive to residents needs” was provided by the visiting district nurse. The staff were observed to assist the district nurse during a difficult procedure when a resident was reticent to co-operate. They were calm and knew how to coax the lady. One resident told the inspector that she “liked coming here, the girls were good”. Another resident during the day also told the inspector that the “food was good and that she had plenty” and that “the girls were always there and good”. There was evidence of more staff training for the medication awareness. The provider and manager have never taken the advice from the Commission to have a more comprehensive training programme. Staff on duty were responsive to the needs of the residents. Later in the day one resident became obsessive about going home. The staff took time to take her outside as were her wishes, talk to her and explain that she was at her home. Eventually the staff made her comfortable and she became calm; finally sitting in the lounge. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 12 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): 12,13,14,15 Quality in this outcome is poor. This judgement has been made using available evidence including reviewing the activity program and menus. The activity programme had not been extended to include any external outings or entertainment from an outside person. The menus remained unchanged, with limited scope of food offered for the alternatives available. Menus were based on a winter style content. Relatives had the option to visit at any time. EVIDENCE: The activity programme had changed little; during the inspection as advertised the residents that were interested took part in a game of cards. There was a lot of enjoyment in this pastime. The home does keep a record but there were no diverse activities, no outings and no external entertainment arranged. This was discussed with the provider who did not provide the manager with any petty cash to purchase activities. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 13 The alternatives available to the main menu remained unchanged, two types of fish is not an alternative, and the menus displayed a softer diet including stews and mince, with the exception of the Sunday roast. Discussed with the manager and cook that the home should have by now considered, based on the likes and dislikes of the residents, a summer menu. Observed was one resident being provided with macaroni cheese, fish fingers, potatoes and mixed vegetables; because the catering staff recognised that she did not like the food of the day. During the tour of the cellar where the fridge freezers are located it was evidenced that there was limited options with the exception of fish fingers and beef burgers to offer residents. The freezer had one chicken, which was to be used the following day. Thick sliced bread is not conducive to providing a tasty sandwich. The cooks order what they need for the week; an outside person then delivers this. The potatoes in the kitchen were growing within the bag and one was particularly offensive as it was rotting. The inspector was told that the potatoes were delivered two days ago. This was pointed out to the provider, as he is responsible for payments. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 14 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including viewing the records and documents. The complaints process was displayed within the front hall entrance. The details were accurate, enabling any person to raise a concern with the appropriate person. The home offered accommodation to a section of the public that had a particular problem. There needs to be current training provided to meet their diverse needs. EVIDENCE: The complaints process was clearly displayed in the applicable documents and hung in the hall. The home’s manager had received no internal complaints. The Commission had not had reason to address any concerns in respect of the home or care provided. While the staff on duty dealt in a proactive manner with a problem involving one resident, the home offered accommodation to 15 older people with a dementia. There was a requirement to develop the staff training in this field by current dementia awareness training. This type of awareness should not be planned as a day course. To achieve the best results, staff should have the opportunity of a longer course including stimulation of people with a dementia. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 15 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 23 24 25 26 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a tour of the home. The home was maintained to a high standard hygienically. There were areas of furnishings, which were a concern in respect of the Health & Safety of the residents. The internal audit should have identified these areas. EVIDENCE: Residents were provided with a high standard of hygiene throughout the communal and personal bedrooms. The staff work hard and provide a hazardfree environment where residents can walk freely. On the tour of the home it was suggested that the small bedside light on the top of a wardrobe should be secured. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 16 The light was placed on the wardrobe because the resident takes it into her bed when light. It was suggested that a teddy bear may give her some more suitable comfort. The last inspection report recommended an audit of the pink non-leather type chairs to ensure that they were satisfactory and user friendly. One armchair was identified to be unsafe and the manager was asked to take it out of use. The recommended audit should have identified this problem. It is a requirement to review and replace the damaged chairs after consulting with the manager as to the suitable height of chairs required. There had been no changes to the environment since the previous inspection in December 2005. Personal items were observed in residents bedrooms. Only one of the bedrooms had an en-suite facility; the remaining bedrooms were located near to bathing and toilet facilities. The bathroom on the first floor, the inspector was told, was rarely used despite having a bathing aid. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 17 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 29 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a review of the staff records and training programme. The manager had failed to comply with the required checks; she had not ensured that all staff employed were suitable and that the residents were safe. The staff had not received current training for the care and stimulation of resident with a dementia, this left residents with limited stimulation. EVIDENCE: From the evidence seen on three members of staff records it was evidenced that there were some items that identified the person was missing. One application form was further discussed with the care manager who had not investigated the form when completed. One reference had been accepted which was unsolicited. One person’s records could not identify any written induction; no member of staff had a job description, photograph or copy of a birth certificate on file. Only one person had been fully cleared with a criminal record bureau check, the remaining two had been POVA cleared and supervised by staff. The standard and information required for the staff records had remained unchanged since the National Minimum Standards were introduced. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 18 These concerns were fully discussed with the care manager at the time of feedback. There needs to be more robust dementia training. While the home has a video, staff need further guidelines. Staff levels were adequate in numbers to meet the needs of the present residents. There were no staff vacancies. The Commission was expecting a letter from the provider to discuss proposed staffing levels. The care manager continues with the registered managers award. Recently the staff were involved with other training sessions to promote their skills: this had included Fall Awareness, and Diabetes. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 19 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): 31,33,36,38 Quality in this outcome area was adequate. This judgement has been made using available evidence including observations, discussions with the staff and manager. There remains limited evidence by the management to obtain a quality assurance feedback from the stakeholders of the service. Capable competent carers including management who were committed to the daily needs of the residents operate the home. There was a need to provide current obligatory training in respect of Infection control. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 20 EVIDENCE: The home operates with a staff team who demonstrated their skills in caring for residents with a dementia. Two residents told the inspector that they were “happy and liked living here”. There had been no resident comment cards completed for this inspection. There was no reason that staff who knew the residents could not have obtained their views. There remains limited evidence of the manager obtaining feedback from stakeholders to add to the quality assurance system. The required tests, protection and prevention in the event of a fire were current and satisfactory. Staff spoken with confirmed their training and that they had received and continue to receive supervision with the manager. The staffs training in respect of infection control was out of date, it is required that this was addressed. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 21 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 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X N/A 3 2 2 Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 16 (2) (ii) Requirement The registered person shall provide appropriate facilities for communication by facsimile transmission. The registered person shall consult with residents or their representative about their social interests and make arrangements for them to engage in local, social, community activities. The registered person shall provide in adequate quantities, suitable and nutritious food which is varied to suit residents’ needs. The registered person shall provide in rooms occupied by residents adequate furniture. The registered person shall ensure that the required details are in place prior to employing staff. The registered person shall establish and maintain a system for reviewing at appropriate intervals the quality of care provided at the home. Timescale for action 20/06/06 2 OP12 16 (m) 20/06/06 3 OP15 16 (i) 20/06/06 4 5 OP24 OP29 16 (c) Schedule 2 24 20/06/06 20/06/06 6 OP33 20/06/06 Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 23 7 OP38 18 The registered person shall ensure that the persons employed receive training appropriate to the work they are to perform. 10/07/06 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 OP4 Good Practice Recommendations To maintain on file a copy of the letter forwarded to the resident or representative to confirm that their needs can be met. Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Dover Cottage Rest Home DS0000004934.V291949.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!