Inspection on 31/05/07 for Doveridge Care Home

This inspection was carried out on 31st May 2007.

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

Doveridge Care Home 19/09/06

Doveridge Care Home 16/09/05

Doveridge Care Home 26/04/05

Doveridge Care Home 26/10/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Doveridge Care Home Doveridge South Street Colyton Devon EX24 6PS Lead Inspector Teresa Anderson Unannounced Inspection 31st May 2007 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 Doveridge Care Home DS0000061662.V332621.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. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Doveridge Care Home Address Doveridge South Street Colyton Devon EX24 6PS 01297 552196 01297 552924 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) Doveleigh Care Limited Amy Jane Burt Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th September 2006 Brief Description of the Service: Doveridge is a detached 2 storey former farmhouse close to the heart of the village of Colyton. It has been extended and adapted for use as a care home. Accommodation and personal care is provided for up to 20 residents who have needs related to old age and/or dementia type illnesses. The home has 18 single and 1 double bedroom on the ground and first floors. There are 2 floors but these are spread over 3 levels with stair lifts linking some areas. The home has 2 lounge/dining areas, one on each floor and a quiet area on the first floor. In addition there is a conservatory forming the entrance to the home where many residents like to sit. In front of this there is a patio area with covered seating and a small parking area. Current charges range from £306.00 - £610.00. These fees do not include the cost of bringing in outside entertainers or such things as toiletries, hairdressers or newspapers. Additional information about this home is available direct from the home. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place as part of the normal programme of inspection. The site visit began at 09.30am and finished at about 4.00pm. During that time we met and spoke with the majority of the people who live here. Some have communication difficulties, but most were able to let us know how they felt about this service. We case tracked three people (this means speaking with and looking at the services and care offered to these people as a way of judging the experiences of people who live here more generally). We also spoke with the manager, owner, with care and domestic staff and with a visitor. During this site visit we saw all the communal areas and some bedrooms. In addition we inspected records relating to assessment of care needs, care planning, medication, staff recruitment, contracts and fire safety. The manager and owner provided additional information about training and policies and procedures in a preinspection questionnaire. Prior to the site visit surveys were sent to 18 residents and 13 were returned; to 9 members of staff and 6 were returned and to health and social care professionals and none were returned. Responses and comments have been included in this report. What the service does well: Everyone who considers coming to live here is assessed to ensure that the home can meet their needs. They are given information about the home and invited to visit. Each person has a contract and this identifies the room they are to occupy and the fee payable. Staff ensure that what is potentially a traumatic move is handled sensitively and with kindness. Each person living here has their health and welfare needs met in an individualised and planned way. Nutritional and other healthcare needs are well met. Staff ensure that resident’s privacy and dignity is promoted. Medication is managed safely and people who live here can manage their own medications to a degree that suits them, if they so wish and if this is safe. There are organised activities available at the home that include arts and crafts, visits from the donkey sanctuary and reminiscent therapies. In addition there are some trips out and more spontaneous activities. Staff understand that people with dementia are not always able to join in with some activities and ensure they are stimulated in other ways. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 6 Visitors are encouraged, are made to feel welcome and are given refreshments or invited to have a meal. Meals are enjoyed by the people who live here and they are nutritious and offer variety. People who live here have no complaints about the home and no complaints have been received by the commission. People with dementia cannot make complaints in the traditional way, so staff watch their behaviour closely looking for signs of dissatisfaction, which can be addressed. Staff receive training in ‘safeguarding adults’ and demonstrate a good understanding of this, which helps to keep the people who live here safe. Residents say staff are kind and thoughtful. The majority of staff hold a National Vocational Qualification in care and also receive additional mandatory and specialist training. Staff are recruited using robust methods, which include references and police checks. The home is clean and fresh. There are good infection prevention and control measures in place and the home is well maintained and decorated. There are a range of communal areas for people to use, but the majority (by choice) use the conservatory at the front of the house or the small television lounge on the ground floor. Doveridge is a well managed home with a strong and committed management team. The manager is well trained and experienced and has consistently showed her competence. Quality assurance processes are in place and changes are implemented accordingly. The monies of the people who live here are well managed and are easily auditable. People who live here say they have nothing to complain or worry about, that they are happy with the way the home is run and that residents and staff work together to make it the best they can. What has improved since the last inspection? A number of improvements have taken place since the last inspection. Care plans are now regularly and appropriately reviewed to ensure that interventions remain appropriate and are effective. Issues relating to the area near to the boiler have been addressed and this area is now safe. The programme of covering radiators continues and there are only 4 left that are uncovered. Staff do not take their breaks all at the same time ensuring there are enough staff available to meet the needs of the people who live here. Staff training has continued and all but 2 of the 19 care staff are now trained to NVQ level 2 or above. In addition the manager has arranged with local Speech and Language Therapists for staff to receive training in communicating with people who have communication difficulties following a stroke. The home has bought a fridge especially for the storage of medications and a thermometer to monitor Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 7 the temperature. Records in relation to handling people’s monies have improved. What they could do better: The following areas for improvement have been identified. These do not pose significant risks or significantly affect the outcomes for people living at the home. Apart from the first two issues, the remainder are recommendations relating to good practice. This ongoing programme of covering radiators should continue to prevent accidental scalding and the last 4 must be covered by December 2007. The home is not a purpose built establishment, and along with many other similar homes, does present some access and moving and handling issues. An assessment of these should be undertaken to ensure that the people who live here can be as independent as possible and to ensure that any risks involved in moving and handling are identified and dealt with. The moving and handling needs of each person are not assessed during the preadmission assessment. This means that staff do not have the information they need to carry out such tasks. More attention needs to be given in the care planning process to helping people to remain or become continent and to remain as independent as possible. In addition records in relation to the use of an intervention to prevent one person undressing should state when it should be used, should record when it has been used and how long it was used for. In addition its use should be reviewed. In this way it will always be the appropriate intervention Menus are presented in visual forms to help those with communication difficulties to make choices about what to eat. As these ‘menus’ do not contain photographs of all the meals served, there is potential for them confuse some people. As this is home for people with dementia consideration needs to be given to assessing and making changes to the environment which would help people with this disability to get around the home safely. Please contact the provider for advice of actions taken in response to this Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 8 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. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 9 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 Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 10 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): 2 and 3. (Standard 6 was not inspected, as this home does not provide intermediate care). Quality in this outcome area is good. Assessments of people prior to admission ensure that staff have the majority of information they need to help them to know and meet their needs. Residents generally have enough information about the home before they move in and each has a contract with the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the majority of the people who live here say they have a contract. Those that did not remember having one thought that their relative might have handled this. We asked to see three at random and these were in order and showed the room to be occupied and the fee charged. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 11 The majority of people said that they had enough information about the home before they moved in. Comments included ‘satisfied enough with the information’ and ‘I can’t think of any other information I might have wanted’. One person commented they would have liked to have information on, for example, the suppliers of food. All prospective residents are assessed prior to admission and the information obtained is relevant to helping to meet care needs. Although some information is gathered regarding moving and handling needs, there is not enough to ensure that people will be helped to move safely. In discussions staff demonstrate an understanding of the potential impact of moving into a care home and how people might be helped through this time with kindness and sensitivity. One person said ‘it took a while to settle in but I am very happy here now’. They said staff getting to know them and their ‘little ways’ and respecting these had helped them. The manager talked of organising the admission of a new resident at a quieter time when staff have time to be with and help them, and when there is time for them to be introduced to other residents. The majority of paperwork and bedroom personalisation is completed prior to admission so that the family can concentrate on helping their relative to settle in. The manager is currently working on further improving the guide to the home to be used by those people who cannot visit the home before they move in. This would include photographs of bedrooms, staff and communal areas. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 12 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 and 10. Quality in this outcome area is good. The arrangements in place for planning resident’s care ensure that residents get the care they need in a way that suits them, and which promotes privacy and dignity. The systems for the management and administration of medications have improved and ensure that residents’ medication needs are met safely. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home has a well-established system for assessing and planning care needs. These are well documented and are written in a way that is easy to read and understand. The level of detail is proportionate to the issue being addressed. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 13 Each person has a ‘key worker’ whom they choose and who organises for example their care, appointments and any shopping needs. This person usually writes the plan of care and reviews this at least monthly with the manager. Health care needs are identified and healthcare professionals referred to as needed. Each care plan contains good explanations of any illnesses that the person has to help staff understand these and their management. All the people who live here have their nutritional needs assessed and are helped to eat and drink a healthy diet. Weights are checked regularly and action taken if necessary. Staff ensure that people have the equipment they need to prevent pressure sores and no one living at this home has a pressure sore. Care plans show a high regard for helping people to make decisions and for individualised care. For example, one person has been assisted to write to a doctor regarding a specific health condition in order to gain a better understanding of this. Another was helped to negotiate a satisfactory alternative to weekly blood tests that they find painful. Some people who like to go out into the village have memory problems. These people carry cards supplied by the ‘Alzheimer’s Society’ explaining their condition and giving the contact details of the home. Staff spoken with are very familiar with the needs of the people who live here and with their plans of care. The home’s philosophy is geared towards maintaining the abilities that people have and to helping people remain independent. However, care plans do not always fully promote this. For example instructions for helping one person to dress state that the carer is to assist. They do not tell the carer what the person can do for themselves and what specifically they might need help with. This is needed if consistent support is to be given in a way that helps people keep their skills and their independence. There are few people living at this home who the manager/owner identified as being incontinent. However, whilst staff spoken with demonstrate an excellent understanding of how to keep one person dry, care plans in general do not help staff to achieve this to its full potential for all the people who live here. In addition the interventions staff have tried are not recorded and are not reviewed in a way that helps to see if these interventions are being applied consistently and if they are working. In surveys the majority of people say they always receive the care and support they need and staff say they are never asked to care for someone outside their area of expertise. Comments included ‘they call the doctor for me when needed’ and ‘I get the most attention I have ever had’. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 14 The system for managing medication has recently changed which further reduces the margin for error. Staff who handle medications have received training and the manager checks on competency and provides additional training if needed. Medication records were checked and found to be in order. Medications are stored safely and securely. The home has recently purchased a dedicated medication fridge and thermometer, although this is not currently needed. People who live here are encouraged to manage their own medication as far as possible and to a degree that suits their abilities. The manager ensures that a comprehensive risk assessment is carried out and recorded. Staff demonstrate a good understanding of how they can help residents to maintain their dignity and how they can ensure residents have privacy. For example all care is given in private and residents wear their own clothes at all times. One person who likes to undo their buttons is supported to do this in a way that prevents them undressing and thereby preventing them losing their dignity. Records relating to when this intervention should be used and for how long were not as detailed as they should be. This is important to prevent it becoming a standard, but inappropriate, response to this persons needs. Its use should also be reviewed to ensure it remains the most effective and appropriate intervention. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 15 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 and 15. Quality in this outcome area is excellent. The people who live here benefit from good links with the local community and are supported to have their social care needs met and to be stimulated. Support is offered in a way that promotes choice and flexibility, sometimes in quite creative ways. The meals offered provide choice, variety and meet nutritional needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the people who live here say there are always, usually or sometimes activities arranged by the home in which they can join in. When we explored this further with the people who live here the general feeling was that the staff do everything they can but that some people prefer not to join in group activities. Some people like to stay in their bedrooms, reading or watching television. Others join in when they please. A few said they wished there were more trips out and are looking forward to the time when the home Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 16 has its own minibus (fundraising is on-going). One person said they spend a lot of time on their own, but they are never bored and never feel lonely. The home has an activities co-ordinator who works half days in the home during the week. This service is very flexible to suit the needs of the people who live at the home. There are singalongs, trips out, skittles and visits from the local donkey sanctuary. In addition the activities co-ordinator, and care staff, spend additional time with those who cannot join in with these activities. Staff understand that because some people have dementia they are not always able to join in with organised activities. They demonstrate a good understanding of how to engage with people with communication difficulties on their terms. For example, during the inspection an ‘old time’ cassette tape was played, to which a number of people responded, talking about what it meant to them, their feelings and memories. Staff took the opportunity to listen and interact with the residents taking their cues from the resident. In this way the people who live here show signs of well-being. They also interacted with their environment and with other residents and staff, and engaged in tasks such as looking at newspapers, booklets and books. Some people who live here have attachments to soft toys and these are treated as important objects and are always available to the person they belong to. The home has applied for and been awarded a grant from the local authority. The owner intends to match this grant with his own monies to create a 1940’s/1950’s café/diner/bar area and an information room. The people who live here are really excited about this and are already planning how to furnish it. The manager is taking specialist advice on how to make this a success. This will be completed by April 2008. Visitors are encouraged to come and go and to have refreshments or lunch with the person they are visiting. They are involved in their care as staff keep them up to date with day to date events and with any developments or changes through the newsletter. People are assisted to continue with their established relationships and to develop new friendships in the home. In surveys the majority of residents say they always enjoy the meals and are largely complimentary about the food served. This has improved since the number of people cooking meals has reduced. Comments range from ‘meat can be tough’ to ‘meals are ‘always lovely’. One person living here said ‘food is really important to older people and you will never please everyone. It’s the main topic at meetings and Amy (the manager) always does her best to please everyone’. Hot and cold drinks are available throughout the day and these are served with biscuits. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 17 Staff help the people who live here who have communication problems to make meaningful choices about what they eat. They have laminated pictures of the meals being served and show these to people just before they are due to eat. However, the photographs of the meals served are not complete and do not show all the meals offered. A complete set will really help people to communicate their wishes and preferences. Assistance is given discreetly to those who need help with eating. This includes using specialist equipment so that the person can continue to eat independently. However, care plans do not provide staff with a baseline knowledge of the abilities each person has and cannot therefore be sure that they are providing sufficient support to help maintain this. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 18 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 and 18. Quality in this outcome area is excellent. People who live here are safe and are helped to express their concerns, which are taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys all those people who responded say that they know how to make a complaint and the majority say they know who to speak with if they are not happy. Some identified ‘the girls’ and others ‘the manager’. When we spoke with the people who live here they say they have no reason to make a complaint. One person said the food was usually a favourite topic to talk about at meetings and this was always dealt with. Staff understand that some of the people who live here may not be able to make complaints in the usual way. They therefore watch people’s behaviour to try and determine if the person is not happy, why this might be. In addition key workers have a close relationship with residents and quickly address any ‘niggles’ or requests. People who live here understand the ‘key worker’ system and tend to address any issues with this person before the issue becomes a complaint. No complaints about this service have been received by the commission or by the home. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 19 People who live here are relaxed and confident in the company of staff. They say feel safe and well cared for. Staff have received training in ‘Safeguarding adults’ and this is about to be updated. The manager intends to present this in a very creative way to aid understanding and to bring it to life. Staff demonstrate a good understanding of how to protect people and of what to do if they suspect abuse or if abuse is alleged. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 20 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, 25 and 26. Quality in this outcome area is good. People live in a safe, well-maintained and comfortable environment where independence is encouraged. Additional attention to the design and layout of the home would help to improve access for those people with disabilities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys people say that the home is always clean and fresh. It is well maintained and safe. Since the last inspection the issues relating to the area near to the boiler have been addressed and this area, and the rest of the home, are safe. The home is well maintained and furnished. However, there is no evidence that the environment has been arranged or decorated to help meet the needs of people with dementia. In addition there are some moving and handling Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 21 issues within the home that need addressing. Most obviously the front door has a raised step. When staff move people in wheelchairs through this area they have to lift the wheelchair and the person in it, which is not good practice. Not all rooms have liquid soap dispensers and paper towels. However, staff manage this in a way that helps prevent the spread of infection. The laundry is tidy and clean. People say their clothes are well cared for. Residents are protected from hot water scalds through the fitting of thermostatic valves to hot water outlets. The owner is continuing with a programme of covering radiators to prevent scalds based on risk assessments. Only four radiators remain to be covered and these have been assessed as posing a low risk to people living at the home. Doveridge has been adapted and converted to a care home and has a number of communal areas on both floors with the most popular area being the conservatory at the front of the home. Here people watch the comings and goings. There are steps leading from this area down to the TV lounge which some people do have difficulty using and the accident book does show that two residents have had minor falls in this area. However, staff are usually available to assist people and do not restrict peoples movement in and out of the area. Visitors say this area can become busy and noisy which prevents people settling or dropping off to sleep. However, although there are alternative places to sit people make a positive choose to sit here. There are plans in place to make one underused sitting room into a 1940’s café/diner/bar by April 2008. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 22 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 and 30. Quality in this outcome area is excellent. People who live here are supported by a well-trained and committed workforce who are employed in sufficient numbers and who are recruited using robust procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In surveys the majority of people who live here say that staff are always available when they need them and that staff always listen and act on what they say. The majority also say that they receive the care and support they need. Comments about staff include ‘they are lovely’, ‘ they are so good’, ‘staff may be busy but they come as soon as they can’, ‘the carers are very good and give me a lot of help’ and ‘I couldn’t fault them’. During the inspection it was noted that call bells seldom rang. When checked it was evident that this is because staff are exceptionally competent at making sure that they have attended to all the needs of residents before they leave them, ensuring that each person has everything they need. In addition they demonstrate excellent communication skills. For example, letting people know when they will be back, going back at that time and letting them what is happening and at what time. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 23 There are four care staff on duty in the morning and three in the afternoon. There are two waking staff at night. The care staff are supported by the manager and a cook and cleaner. Staff say they always know who to contact in an emergency, what to do if a resident becomes unwell or upset and what to do if a resident’s needs change. The majority say they are never asked to care for people outside their area of expertise and that there is enough time to care for each person living at the home. There is a stable workforce who are well trained. In conversation the manager reports that only 2 of the 19 care staff have not yet trained to National Vocational Qualification (NVQ) level 2 in care or above. Other training includes caring for people with dementia, communication and care of people with Parkinson’s disease. At the last inspection it was recommended that staff have specialist training in communicating with people who have communication problems following a stroke. The manager arranged this immediately. Observations of staff at work in communal areas show that they are respectful, treat each person as an individual with kindness and respect. The recruitment files of three members of staff were checked. These show that these people were not employed until for example satisfactory references had been returned and a police check had been received. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 24 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 and 38. Quality in this outcome area is excellent. The management and administration of this home is based on openness and respect. There are quality assurance and safety systems in place and the management team is qualified and competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager of this home (Amy Burt) is qualified and experienced. She holds the Registered Manager’s Award and has taken additional training in caring for people with a variety of disabilities and communication problems. She has a background in supporting people with disabilities and sensory problems, and demonstrates a high level of competence as well as commitment. She understands the aims and objectives of the home and over Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 25 the years has worked with the management team to meet the objectives set and to develop new ones based on the needs of the people who live here and best practice. She has an open and honest style and asks for advice when needed. The home is owned by a husband and wife team who are both involved in the running of this and the sister home. Mr Mills has overall management and decision-making responsibilities. Mrs Mills carries out monthly unannounced visits to assess the quality of the services being provided and to suggest and support the manager to make changes where needed. The management team have regular meetings that are focussed on bringing about improvements. In addition the manager meets with key workers and the deputy manager regularly to discuss the needs of individual residents. The team meet regularly with people who live at the home. These meetings are recorded and copies of these notes are sent out to all the people who live at the home. Suggestions made at these meetings by residents are acted upon where possible. Satisfaction surveys are sent to residents, visitors and relatives and to professionals. Appropriate responses are made to any issues raised. For example residents in the past had been unhappy with the inconsistent quality of the food served. In response the number of people who plan and prepare meals has been reduced and overall satisfaction has improved. In addition, many people who live here say they would like to go out on trips more. In response the home is fundraising for a minibus. Staff receive mandatory training including moving and handling, infection control, fire safety, food and hygiene and 14 staff hold a first aid qualification. The manager has a good system for ensuring that staff receive updates at appropriate times. The owner, in the pre-inspection questionnaire reports that appropriate maintenance contracts are in place. The fire log shows that appropriate checks and drills are undertaken. The home helps some people to manage their monies. These are kept safely and securely, and there is a good audit system in place. Three accounts were checked and these were in order. People who live here say ‘I have nothing to complain about’, ‘I never have anything to worry about’, ‘I am happy with the way this home is run’ and ‘we work together to make it the best it can be’. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 26 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 3 3 x 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 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 x 18 3 2 x x x x x 2 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 x 3 x x 3 Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 27 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 OP19 Regulation 23 (2) (a) Requirement An assessment of the home should be undertaken to identify any access and moving and handling issues. This will help to ensure that people who live here have maximum independence and that staff are protected from injury caused through moving or handling. The programme of covering radiators should continue to help protect people who live here from injury through accidental scalding. Timescale for action 31/07/07 2. OP25 13(4) 31/12/07 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 OP3 Good Practice Recommendations When carrying out preadmission assessments the moving and handling needs of people should be determined. This will help to ensure that staff have the information they DS0000061662.V332621.R01.S.doc Version 5.2 Page 28 Doveridge Care Home 2. OP7 3. 4. OP7 OP7 5. 6. OP15 OP19 need and that people are handled safely. Care plans should have more detail so that staff are aware of the abilities that the people who live here have. In this way staff will be able to support them to retain these skills. Each person living here should be helped, through individualised care planning, to remain continent for as long as possible. Records in relation to the use of an intervention to prevent one person undressing should state when it should be used, when it is used and for how long it was used. In addition its use should be reviewed. In this way its use will always be the appropriate intervention. You should continue creating a visual menu and ensure that this contains pictures of all the meals served so that it is useful in aiding people to communicate their choices. As this is home for people with dementia you should consider making changes to the environment, which would help people with this disability to get around the home safely. Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Doveridge Care Home DS0000061662.V332621.R01.S.doc Version 5.2 Page 30 - 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!