Inspection on 21/09/05 for Dovercourt House

This inspection was carried out on 21st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Dovercourt House 13/07/07

Dovercourt House 23/08/06

Dovercourt House 13/02/06

Dovercourt House 10/02/05

Dovercourt House 21/07/04

Dovercourt House 05/03/04

Similar services:

Claremont House

Chesham House

Argyll House

Firstlings

Dorset Lodge

Fen Road

Acacia House

Falcon House

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

CARE HOMES FOR OLDER PEOPLE Dovercourt House 23 Fronks Road Dovercourt Harwich Essex CO12 3RJ Lead Inspector Sara Naylor-Wild Unannounced Inspection 21st September 2005 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 Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dovercourt House Address 23 Fronks Road Dovercourt Harwich Essex CO12 3RJ 01255 506010 01255 553099 miketibbles@fsmail.net 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) Mr Michael Frederick Tibbles Ms Amanda Jane Dale Ms Amanda Jane Dale Care Home 27 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Dementia - over 65 years of of places age (27), Mental disorder, excluding learning disability or dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (4) Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, aged 65 years and over, who only fall within the category of dementia (not to exceed 27 persons) One named person, whose name was made known to the National Care Standards Commission in January 2003, under the age of 65 years, who only falls within the category of mental disorder (not to exceed 1 person) Person of either sex, aged 65 years and over, who only fall within the category of mental disorder (not to exceed 4 persons) Three named persons, whose names were made known to the National Care Standards Commission in January 2003, over the age of 65 years, who only fall within the category of alcohol dependence (not to exceed 3 persons) 10th February 2005 3. 4. Date of last inspection Brief Description of the Service: Dovercourt House is a large property refurbished from two substantial buildings. The home provides accommodation for older people with varying needs, including some people with behaviours that challenge. The home is located close to local amenities and the sea front, and has good bus routes to other areas. Nearly 70 of the accommodation is available in single rooms, some of which have en-suite facilities. A range of communal space is available which includes gardens to the rear of the property. Dovercourt House has a homely feel, and steady progress had been made in addressing the refurbishment of the premises. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 21st September 2005 and in total took 5 hours to complete. During the inspection discussions with service users, observations of staff interaction with service users, administration of medication and sampling of care plans was used to gain evidence of the home’s performance against the assessed standard outcomes. The registered manager was not at the home for the inspection but the inspector was pleased to be assisted by the Deputy manager as person in charge of the home. What the service does well: What has improved since the last inspection? What they could do better: There needs to be a change in the culture of the home to present a greater person centred approach in both the manner in which staff communicate with service users and the documentation used to identify the support required. This would also provide an additional dimension to the levels of independence offered to service users, for instance at meal times. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 6 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. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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 Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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): 3 & 6. Each service user had a their needs assessed and documented. The home does not provide intermediate care. EVIDENCE: The sample of service users’ care plans seen during the inspection demonstrated that assessment of their needs are carried out prior to admission. This provides sufficient information for the home to commence care planning documentation and informs their decision regarding the suitability of admissions. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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 and 10. Care plans are present, but are not individual in their instructions to staff. Records do not sufficiently support how staff respond to service users’ health care needs. Medication is administered according to the home’s policies and procedures. Care practices are not fully supporting service users’ rights to treatment with respect. EVIDENCE: The care plans of three service users were sampled during the inspection. These demonstrated that whilst some information is held regarding service users’ needs and abilities, these are not person centred in their approach and have omissions from the original assessment details and records relating to daily life. Examples include the care plan of a service user who according to daily records was known to “wander”, did not contain reference to this, nor did they provide instructions to staff as to how to support the service user in dealing with this. Another service user’s plan did not address the increased Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 10 difficulties they were encountering with continence management recorded in daily records. This does not support that care plans are a living document that accurately reflects the need or the care and support provided by staff in the home. The records relating to health visits were not updated and the changes brought about by health needs or health professionals’ advice was not included as a matter of course in care planning. The administration of medication was observed during the lunchtime period to a satisfactory standard, and the member of staff carrying out the task was able to correctly answer questions posed by the inspector. The home operates a very social and intimate atmosphere, where service users and staff joke and are tactile with each other. Whilst this is generally a positive approach there needs to be a strong element of professionalism and respect which supports this, and the inspector was not sure that all staff understood this principle. For example, a service user was repeatedly addressed by staff by a nickname, which could be construed as lacking respect. In another example during meal times service users were encouraged to feed themselves with staff offering intervention periodically. This support of independence is to be encouraged, there were however some additional steps which could be taken to ensure service users’ dignity was maintained, in the form of equipment which assists eating, such as plate guards, specialist cutlery, etc. The staff spoken with during the inspection were not aware of such equipment and had not identified the need for such assessments. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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, 14 and 15. The home does not provide a specialist activities programme to meet the needs of service users with dementia. The home ensures service users’ visitors are welcomed and assists service users to maintain relationships. The service users have opportunity to make some limited choices. The service users were provided with a good diet. EVIDENCE: The activities provided in the home were commented on at the last inspection as in need of further development, predominantly in staff skills in providing suitable stimulation and opportunity. The observations at this inspection continue to support this view, with staff making genuine attempts to engage service users in some forms of wholesale activity such as singing, etc. During the inspection visitors attended the home and arrangements were made for a service user to go out with family and friends, in support of the home’s visiting policy. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 12 The home is not operated in a regimental manner and service users are free to move around the home as they choose. Examples were seen of the staff offering food choices to some service users at meal times. However further consideration should be given to setting out in care plans how staff should support service users in making choices throughout their day. Meals were set out in the weekly menu and detailed a good range of nutritional choices on offer. The inspector observed a lunchtime meal during the inspection that service users obviously enjoyed. Whilst one service user commented that mince was present too much on the menu, the weekly menu seen by the inspector appeared to contain a variety of meals that included optional choices. During the meal a service user who did not wish to partake of the choice of meals on offer was supplied with an entirely individual choice at their request. The manner in which staff assist service users in eating their meals has been highlighted in the Health and Personal Care section of this report. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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. The complaints systems are generally appropriate; further exploration is required into how service users with dementia complaints are heard. EVIDENCE: The home has operated a complaints system that meets the general requirements of the Care Homes Regulations 2001 and National Minimum Standards (NMS). However, the provision of care to service users with dementia, who may have impaired abilities in both communication or the capacity to understand systems, mean that further efforts will continue to be required to explore this area. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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 and 26. The environment is maintained to a good standard and meets the service users’ needs. The personal and communal space meets the requirements of the standards for existing premises. The home is clean and hygienic. EVIDENCE: The proprietors have continued to improve the décor and appearance of the environment of the home. The majority of the home has now been refurbished and presents a bright and clean environment. The home has two lounges, one of which had been totally redecorated and refurbished following a major repair of the ceiling. The space provided by these two rooms and the dining room was sufficient to meet the standard for existing homes. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 15 The proprietors have an ongoing plan of refurbishment to the bathrooms and en suites. All these facilities are adequate for the purpose at present but are outdated. The provision of service users’ rooms meets the standards for existing homes. The furnishings and equipment provided for service users’ rooms was appropriate and was also part of the refurbishment plans for the home. In some cases service users brought their own furniture. Radiators have covers to reduce risk of scalding, and hot water temperatures were thermostatically maintained. The condition of the laundry area has been raised at previous inspections and had been given a basic makeover in décor that was sufficient as a temporary measure to provide a more hygienic environment. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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): These standards were not inspected at this visit. EVIDENCE: Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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): 32 and 38. The direction and leadership from the manager needs to include greater professional practice guidance. The home is operated in a way that supports service users’ needs and ensures their overall safety. EVIDENCE: The hands-on style of the manager provides staff with a strong sense of support in carrying out their daily duties. The manager has also influenced a strong maternal approach to care in the home. The positive outcomes of this ethos are the tactile and informal way in which staff relate to service users. However there needs to be professional boundaries in which care is provided to ensure there is not a detrimental derogatory outcome. Examples such as the use of nicknames for service users, the lack of assessment and provision of equipment in relation to eating and the person centred approach to complex Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 18 needs, all highlight the need for the service to move forward in a professional manner. The policies and procedures in the home meet with the NMS and health and safety guidance and legislation. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 2 X X X X X X Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 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 OP2 Regulation 5,17 & Schedule 4 Requirement The registered person must ensure that all service users have a contract or terms and conditions signed by both parties. Timescale for action 31/12/05 2 OP4 12,14,18 This standard was not assessed at this visit and is therefore carried over to the next inspection. 31/12/05 The registered person must ensure that the home is able to meet the assessed needs (including specialist needs) of individuals admitted to the home. In particular they are directed to NMS 4.2 in relation to good practice guidance. This standard was not assessed at this visit and is therefore carried over to the next inspection. The registered person must ensure that service users’ care plans contain adequate directions to inform staff of how identified needs should be met. 3 OP7 15 31/12/05 Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 21 4 OP8 15 5 OP10 12(4)(a) 6 OP12 13,14,15, 16 The registered person must ensure that service users’ health needs are recorded including any action taken in respect of these needs, such as health professionals visits and advice is included in care planning. The registered person must consider how the home and staff group support service users’ rights to dignity and respect. The registered person must ensure that the wishes and preferences of service users in relation to activities of daily living are recorded and promoted. The registered person must ensure thorough recruitment, induction and supervision procedures, to ensure protection of service users and to comply with the relevant regulations. This standard was not assessed at this inspection and is therefore carried forward to the next visit. 31/12/05 31/12/05 31/12/05 7 OP36OP29 19, Schedule 2 31/12/05 8 OP30 18 The registered person must ensure that staff training meets with National Training Organisation workforce training targets. This standard was not assessed at this inspection and is therefore carried forward to the next visit. 31/12/05 9 OP33 24 The registered person must ensure further development of the home’s quality assurance process. This standard was not assessed at this inspection and is therefore carried forward to the next visit. 31/12/05 Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 22 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 2 3 4 Refer to Standard OP14 OP17 OP36 OP36 Good Practice Recommendations The registered person should ensure that service users are provided with maximum opportunity to exercise choices in their daily lives. The registered person should ensure that service users’ care plans contain adequate directions to inform staff of how identified needs should be met. The registered person should ensure that all staff receive supervision in line with the requirements of NMS 36. The registered person should ensure that the staff training programme includes subjects linked to the identified needs of service users. Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Dovercourt House DS0000033764.V252099.R01.S.doc Version 5.0 Page 24 - 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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