Inspection on 04/07/07 for Dower House

This inspection was carried out on 4th July 2007.

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

The inspector 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

Dower House 14/08/09

Dower House 09/01/07

Dower House 26/09/05

Dower House 18/04/05

Dower House 14/09/04

Dower House 15/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Dower House Henley Ludlow Shropshire SY8 3HB Lead Inspector Pat Scott KEY Unannounced Inspection 4th July 2007 09:30 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 Dower House DS0000020753.V344935.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. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dower House Address Henley Ludlow Shropshire SY8 3HB 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) 01584 873456 Mrs Elizabeth Mary Owen Mrs Linda Ann Williams Care Home 5 Category(ies) of Old age, not falling within any other category registration, with number (5) of places Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: The Dower House is a privately owned Care Home registered with the Commission for Social Care Inspection to provide a service for 5 older people. Set in the village of Henley, within the grounds of Henley Hall, the Home benefits from being situated amidst beautiful surroundings, close to the town of Ludlow, making it is well placed for access to all local amenities. Originally built as the ‘Dower House’ to the country estate the property has been sympathetically converted to provide accommodation on one level, comprising 5 single bedrooms (3 with en-suite facilities), spacious communal living areas of lounge / dining room, with access through French windows to an attractive and well-maintained garden. The registered ‘Responsible Person’ is Mrs Elizabeth Owen, and her Daughter, Mrs Linda Williams, being the Registered Manager has day-to-day operational management responsibility for the Home, with on-site support from Mrs Owen. They are ably assisted by a small, but long established staff group. Current fees are £441.75-£500 per week. The inspection report is available in the foyer. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the owner, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: The service is currently performing to a high standard. The owner has given a clear commitment to improve fire safety in line with current legislation and best practice. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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 Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Key Standards 3 This judgement has been made using available evidence including a visit to this service. The home’s ethos and records demonstrate that the admission process is informative, personalised and that consideration has been given to all aspects of care. EVIDENCE: There have been no new service users admitted since the inspection in January 2007. The last inspection report stated that a review of care plans, and related documentation, provided evidence that appropriate and thorough care needs assessment is undertaken by the Registered Manager, prior to admission. Information gathered is utilised in enabling an informed decision regarding the home’s capability of meeting the individual care needs of each prospective service user. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Key Standards 7,8,9,10 This judgement has been made using available evidence including a visit to this service. Service users’ care needs and risk assessments are set out in their individual plans of care which ensures that all care needs have been addressed and will be fully met. The owner understands the need to comply with safe medication systems and staff practice ensures that the home’s procedures are complied with and that service users health matters are always safely addressed. The actions of staff and their approach to care ensures that service users are treated with respect and their right to privacy is upheld. EVIDENCE: Discussions held with service users, the owner and other staff identified no changes to the usual good practice of care planning and care provision. Care Plans are up to date and easy to follow; provide evidence of involvement of the service user, relative or advocate. Elements of risk are assessed and recorded. Service users all appeared well groomed with their hair, nails and Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 10 clothes looking clean. No issues were identified in discussions regarding approach of staff or being assisted with intimate tasks. The service accepts responsibility for administering medication to service users. The service has safe storage facilities and written records are up to date. A service user commented that The Dower House is a “Haven of tranquillity”, another said that she “Is treated like a Queen”. A service user, just getting out of bed around 11am stated that she had been in the home for five years and that “The care couldn’t be better”. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Key Standards 12,13,14,15 This judgement has been made using available evidence including a visit to this service. Service users are provided with social activity and can keep in contact with family and friends. Social, cultural and recreational activities meet service user’s expectations through assessment, consultation and choice. Service users receive a healthy diet according to their assessed requirement and preference. EVIDENCE: All service users reported they are in regular touch with family and friends, stating the home encourages and enables them to ‘entertain’ visitors as part of their daily routine. There is a strong feeling of the unusual social setting of the home, i.e. a very small and longstanding service user group and a stable staff group, which has generated a feeling of ‘close family’ amongst service users and staff. Service users are all very articulate and remain clear about the service they require from the home. All agreed their individual needs are being met and the care and support they receive is of a high standard. Service users Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 12 reported on how much they enjoy the quiet and tranquil atmosphere at the home, set within the peace and quiet of the countryside. One service user stated he enjoys the daily paper and completing the crossword, whilst another service user goes out in his car and still visits his own house during the day time and comes back to The Dower House at night. Observations clearly demonstrated the home has a ‘family style’ routine, which is based around each individual. This was reflected in comments, made such as: “The staff really understand what I like and are first class”; “I spend my time exactly as I wish, its just what I looked for in a home”. Meals, which include fresh vegetables grown in the home’s garden, are freshly prepared by care staff, all of whom have received appropriate ‘food-handling’ training. The evening meal is provided to a set menu following consultation with service users with the remaining meals arranged by individual choice on the day. Two of the service users choose to eat their meals in the dining room, which is formally laid out, whilst the remainder prefer to take their meals in their bedrooms. Special diets to meet individual health care requirements are provided and identified within the needs assessment and care planning process. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Key Standards 16,18 This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure which is accessible so that people who use the service have information of how to make complaints about the home. Training is provided so that service users are protected from abuse and have their legal rights protected. EVIDENCE: Service users stated they would definitely approach staff if they have a problem. All expressed confidence that issues would be dealt with. There is a high level of accessibility to the management at this home which ensures that concerns can be dealt with very quickly. Previous inspections have identified that staff receive full training on safeguarding adults. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Key Standards 19,26 This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The home is set in the grounds of Henley Hall, a factor service users reported as a key feature in their initial care home selection. There is a large, wellfurnished communal lounge where service users can choose to relax alone, or with each other, entertain visitors, or simply sit and enjoy the views of the garden and surrounding countryside. The attractive walled, and well-kept gardens, extend to three sides of the property and are easily accessible. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 15 All areas seen around the home are clean and rooms personalised and decorated according to the wishes of those service users occupying them. The Home was observed to be clean and well maintained with a high standard of furnishings and décor. General maintenance of the building, which is underpinned by a programme of regular assessment and action, is carried out by the Landlords from Henley Hall and ensures a good environment for service users, visitors, and staff. Plans are in place to comply with recent advice from Shropshire Fire and Rescue Service to make the premises much safer in the event of fire. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Key Standards 27,28,29 (no new staff),30 This judgement has been made using available evidence including a visit to this service. Staff in the home are being trained and are in sufficient numbers to fill the aims of the home and meet the changing needs of service users. EVIDENCE: Staffing numbers, though small, and skill-mix, enable a service provision, which meets the care needs of the service users. Specifically there is always a minimum of two staff members on duty, which, during the afternoons may include either the Owner or the Manager. Whilst the Home has no ‘waking’ night staff, the Owner lives on site (as well as her son) and responds to calls as required. Given the client group and their care needs there is no evidence to suggest this is not a satisfactory arrangement, and should the Owner not be available alternative arrangements for cover are put in place. Staff were observed to carry out their duties in an enthusiastic yet professional manner. Service users stated the staff are very kind and caring and that they felt well looked after and not patronised because of their age. Records demonstrate the proportion of staff having attained NVQ Level 2 is in excess of the 50 required level. In addition, one member of staff has Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 17 achieved Level 3 and one is currently undertaking Level 3. Staff are subject to a thorough and relevant orientation/induction programme with evidence of on-going training. Much of the training is conducted ‘in-house’, is well documented, and includes lifting and handling, and health and safety. Infection control training is provided through the auspices of the SPIC organisation (Shropshire Partners in Care). Six staff have done safe handling in medication and had recent updates in adult protection and first aid training is due in September. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is excellent. Key Standards 31,33,35,38 This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect and with effective quality assurance systems and audits in place, service users are assured that the overall conduct of the home is being well managed. EVIDENCE: The owner is competent to run the service and demonstrates a desire to continually improve the service to provide value for money. She is aware of the running costs of the home and provides for improvement to achieve safer outcomes for service users, e.g. the injection of cash to fund the fire safety improvements of the premises. The owner’s practice is very service user Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 19 focussed and customer satisfaction is high on the agenda. People who use the service stated that they trust the staff and feel safe in the home. The Home regularly receives complimentary letters from service users’ family and friends, which forms a further part of the home’s quality assurance system. All service users manage their own personal monies. Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 20 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dower House DS0000020753.V344935.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 - 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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