Inspection on 24/10/05 for Drakelow House

This inspection was carried out on 24th October 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

Drakelow House 26/06/06

Drakelow House 08/07/05

Drakelow House 01/12/04

Drakelow House 10/05/04

Drakelow House 20/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Drakelow House 64 Parsonage Road Heaton Moor Stockport Cheshire SK4 4JR Lead Inspector Kath Oldham Unannounced Inspection 24th October 2005 08:45 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 Drakelow House DS0000008553.V254580.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. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Drakelow House Address 64 Parsonage Road Heaton Moor Stockport Cheshire SK4 4JR 0161-432 4033 NO FAX 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) Miss Gloria Dawn Patten Miss Gloria Dawn Patten Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 18 OP. Date of last inspection 8th July 2005 Brief Description of the Service: Drakelow House provides residential care for up to 18 service users over the age of 65. The home is owned and managed by Gloria Patten. Drakelow House is situated in a residential area of Heaton Moor, approximately quarter of a mile away from shopping facilities and the local health centre. Stockport town centre is approximately a mile away. There is off-road parking for up to four cars with further parking on Parsonage Road. There are mature gardens to the front and side of the house where, in good weather, service users are able to sit out. Accommodation is provided on the ground and first floors. Access to the first floor is by stairs and passenger lift. The home has been extended to provide single bedroom accommodation to all service users and nine bedrooms have en-suite toilet facilities. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the day, commencing at 8:45am. The inspection centred on the requirements and recommendations of the last inspection, observation of staff practice and routines, and discussion with service users. A partial inspection of the building was also undertaken. The deputy manager was on duty during the inspection. Comment cards were left at the home to distribute to some of the service users and their friends and visitors. Comment cards were sent to service users’ GPs, four were returned. Comments received about the care and support provided by the home are included in this report. What the service does well: What has improved since the last inspection? New chairs and dining tables and chairs have been purchased and provide service users with additional comfort. Service users were complimentary about the quality and presentation of the meals. The statement of purpose has been developed which gives more detail to service users about the aims and objectives of the home. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 6 The home continues in its endeavours to recruit staff to its vacancies and is taking time to find the right calibre of staff. The deputy has been successful in obtaining NVQ 4 and is to continue her studies to become an assessor for NVQ training. The registered person continues to study NVQ 4 and hopes to obtain this qualification during 2005. The majority of staff have worked at the home for some time, service users spoke about knowing staff well and having continuity of care. Service users said the staff knew their likes and preferences and made sure that they had what they liked. Comment cards and questionnaires are sent by the home to visitors and service users’ representatives to find out what they think of the home and the care that is provided. This quality assurance is to be extended to include professionals that visit the home. What they could do better: Staff must receive updates in medication, adult protection, moving and handling and commence NVQ training to ensure that practice is safe and protects service users. The commencement of new staff without Criminal Record Bureau checks working without supervision needs to be addressed by the home, as this contravenes the regulations and has the potential to put service users at risk. Staff need to be familiar with what constitutes abuse and the process which must be followed if an allegation of abuse comes to light. A number of radiators need to be guarded to promote the safety of service users in the home. A lot have been done, however there is a need for the work to be finished. All staff need to receive regular fire drill training and practices so they are familiar with what must be done in an emergency. The care planning process needs to be developed to include the needs of service users and how these needs are met. There are requirements outstanding from previous inspections that must be addressed fully by the home. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 7 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. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 8 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 Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5 Information is provided to service users to allow them to make a judgement whether they wish to reside at the home and the home assesses prospective service users to ensure they can meet their needs. EVIDENCE: Service users wanting to live at Drakelow House are assessed to identify whether their needs can be met by the home. Examination of a sample of the care files identified an assessment in place. Service users are able to visit the home before making a decision whether they want to live at the home. One service user said she came to the home on a number of occasions before deciding she would like to try it. A review meeting is arranged to see if the service user is settling in and to make any changes to any aspect of the care provided. The service user said that their relative looked at the home and made a judgement about the home before the service user came for a trial. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 10 The statement and purpose and service user guide have been amended and now detail the correct legislation. The home needs to re-read the documents to ensure the documents are an accurate reflection of what the home provides. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 11 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 Care planning for service users’ needs was not sufficient to ensure that all needs would be met. The safeguards in place for medication administration did not meet regulations. EVIDENCE: Individual care plans are available; the home needs to develop the recording in the plan to ensure that all aspects of health, personal and social care needs are identified and planned for. Plans are basic, but were reviewed. Daily entries gave little indication of the actual care given. A number of service users need very little help or assistance and are able to undertake specific tasks for themselves. For these service users, the home provides the security of a care home, assistance with bathing, regular meals and medication administration. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 12 Examination of the medication administration records identified them to be completed as prescribed by service users’ GPs. A staff signature indicates the receipt of medication but does not detail the amount received, which would assist the home to account for all medication. A photograph was on the majority of service users’ medication records to assist in identification. Recently admitted service users did not have a photograph on file. Specimen signatures are in the records as a means of identifying the staff with responsibility of administering medication. Staff have not received training in medication administration. All staff who have the responsibility of administering medication must have this essential training to safeguard service users and be clear about their responsibilities. Requirements have been made on previous inspections to undertake risk assessments for service users who administer their own medication. Despite this, these have not been undertaken which has the potential to put these service users at risk. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 13 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 & 15 Service users have a flexible lifestyle in the home, maintain contact with their families or friends, and receive an appropriate diet. EVIDENCE: A daily record is maintained of all food provided to service users to identify the meals each service user has, this enables anyone looking at the record to judge whether the diet is satisfactory. Service users spoken to said they enjoyed the meals and liked traditional food. The main meal is served at lunch, which includes soup as a starter. A snack meal is served at tea. The cook is employed five days each week and prepares the main meal. In her absence, care staff prepare meals. The home continues to look for additional cooking staff to cover for the cook’s absence. To safeguard service users, basic food hygiene training should be attended by all staff who have the responsibility of preparing and serving meals. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 14 Service users were observed watching television, they said this is what they liked to do. A number of service users were in conversation, while others slept or rested. Some service users play dominoes or play I-spy and listen to music. Comment cards indicated that there could be more for service users to do. One service user said they spent time in the lounge and the remainder of the day in their bedroom. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Procedures for dealing with complaints were in place, however the recording was poor. There were inadequate systems, routines and training in the home to safeguard service users from abuse. EVIDENCE: A complaints procedure is in place and a record is kept to detail complaints. Examination of the record did not detail any recent comments and complaints. Service users said they were happy with the care they received and they or their family would speak to the manager or deputy if they had any comments or complaints. GP comment cards stated that they had never received any complaints about the home. Service user meetings were described as an opportunity to talk things over and put forward any ideas for change. Some staff have, in the past, undertaken abuse training by an external facilitator. This training was some time ago and the manager and staff are not familiar with the procedures that should be adopted and how to recognise and deal with allegations of abuse. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 16 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): 26 The home was clean and without offensive odours. Some redecoration is required and safety issues have not been fully addressed. EVIDENCE: New lounge chairs have been purchased, so all the chairs match in the larger of the two lounges; service users said the chairs were comfortable. The chairs and the new curtains in the lounge highlight the need for the lounge to be redecorated and new carpet purchased. The room looks tired and dull. It was reported that the lounge was to be redecorated. The home was clean and free from any odours. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 17 There was a record of the service to the passenger lift and the bath hoist, when it was recommended that remedial work was needed to be undertaken on the lift. The deputy stated that the contractors were waiting for parts and the lift would then receive attention. Most radiators within the home are guarded which reduces the risk to service users, the remaining radiators need to receive attention. The deputy stated the contractor plans to complete this work in forthcoming months. A partial inspection of the building identified that service users with the support of family or staff had personalised their bedrooms with ornaments and furnishings. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 The procedures for the recruitment, selection and training of staff do not offer protection to service users. The deployment and the number of staff available is not sufficient to meet the needs of service users at all times. EVIDENCE: Examination of recently appointed staff files identified that the home’s recruitment and selection procedures had not been followed which has the potential to put service users and staff at risk. One staff member was working under supervision whilst the necessary checks were undertaken, which is as required. A further staff member was not and worked at a time when direction, supervision and guidance could not be provided when service users are at their most vulnerable. Some evaluation of the quality of care and support provided to service users by the specific staff member was reported to have been undertaken. Drakelow House employs a small group of staff and, at such times as holidays, sickness or staff leaving their employ without notice, this puts pressure on staff to work long hours. The staff team support one another and undertake care, cleaning and cooking duties at various times during their shift. A domestic has been appointed to the home who was working on care to cover holidays. The home has difficulty recruiting the right calibre of staff. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 19 The deputy has recently completed NVQ 4 and plans to undertake the assessors training to enable her to motivate and encourage staff to take NVQ 2 training. Currently, one care assistant has NVQ 2. Staff have not received annual updates to their moving and handling training, as stipulated in health and safety legislation. New staff have not yet undertaken any moving and handling training which has the potential to put service users and themselves at risk. Training within the home has not been ongoing and this needs to be addressed by the home, the lack of training could compromise the safety of service users and, when provided, will provide some safeguards. A number of service users have some degree of confusion or forgetfulness. Staff would benefit from training in dementia to assist them to understand and support service users with deteriating mental health. A newly appointed care assistant was scheduled to commence induction training to Care Skills specification. Service users were complimentary about the skills and personalities of the staff at the home. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 20 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): 35 & 38 There is guidance and direction of staff to ensure service users receive care and support. Health and safety issues have not been fully addressed. EVIDENCE: Staff meetings are arranged at the home, the most recent being in June 2005. Notes are made of the meetings, which provide staff with an opportunity to discuss areas of development within the home and to influence practice and routines. Examination of the accident records identified their completion in line with Data Protection legislation. Ten accidents, incidents or occurrences had been recorded since July 2005. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 21 The home does not carry out an audit of accidents, which would identify any patterns to the accidents experienced by service users. Fire safety records identified the means of escape, fire alarm system and the emergency lighting to be recorded as having been checked regularly to safeguard service users and staff. Fire drill training and practice records did not detail all staff as having received training in the previous six months. A new member of staff said they had not had fire drill training and was not aware of the routine to adopt in the event of an emergency. The staff member was recorded as having received this training. The deputy said that she would go through the procedures with her again. Service user meetings are arranged and the majority of service users attend and contribute to the meeting sharing their views and opinions. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 22 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 2 X 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 X X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 2 X X X 2 Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 23 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 OP7 Regulation 15 Requirement The registered person must amend the current care plan to include the areas identified within the standards. Further develop the recording in the care plan to provide the specific, individualised and personal care needs of service users. (Previous timescale of 01/10/05 not met). The registered person must ensure that all staff who have the responsibility of administering medication are trained in the practice and procedures that must be undertaken when administering medication. The registered person must ensure that risk assessments are undertaken and reviewed at a frequency dictated by the risk assessment for all service users who self-administer medication. (Previous timescales of 31/01/05 & 01/09/05 not met). Timescale for action 30/11/05 2 OP9 13 30/11/05 3 OP9 13 31/12/05 Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 24 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. 4 Standard OP18 Regulation 13(6) Requirement The registered person must improve their knowledge on what constitutes abuse and how to deal with it and follow the adult protection procedures of the local authority, arrange for management and staff to attend adult protection training. The registered person must install radiator guards or have guaranteed low temperature surfaces on pipe work and radiators in the home. (Previous timescale of 01/10/05 not met). The registered person must arrange for all staff to receive moving and handling training at a minimum of annually. The registered person must ensure that all staff are subject to a thorough and robust recruitment and selection procedure and that all documents are obtained as identified within the regulations prior to staff commencement. The registered person must recruit adequate numbers of care, domestic and cooking staff. The registered person must ensure that receipts are obtained and are available for purchases made on behalf of service users or for services received. DS0000008553.V254580.R01.S.doc Timescale for action 31/12/05 5 OP25 23 30/11/05 6 OP28 13(5) 31/12/05 7 OP29 19 Schedule 2 25/10/05 8 9 OP29 OP35 19 17(2) 31/12/05 30/11/05 Drakelow House Version 5.0 Page 25 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. 10 Standard OP38 Regulation 23(4) Requirement The registered person must arrange for all staff on their next duty at the home to attend fire drill training and practice. Timescale for action 25/10/05 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 5 6 Refer to Standard OP7 OP9 OP15 OP16 OP26 OP27 Good Practice Recommendations The registered person should further develop the recording in the daily reports to include the care interventions during the day and night, in addition to the current recordings. The registered person should ensure that there is a means of identification for all service users on their medication records. The registered person should arrange for all staff who prepare cook or serve food to attend basic food hygiene training. The registered person should further develop the recording in the complaints book to evidence that they take service users or their representatives’ complaints seriously. The registered person should redecorate and purchase new carpet in the main lounge. The registered person should arrange for staff to attend training in mental health. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 7 8 9 10 Refer to Standard OP28 OP31 OP33 OP38 Good Practice Recommendations The registered person should ensure that a minimum ratio of 50 trained members of care staff to NVQ level 2 is achieved. The registered person should obtain NVQ level 4 in management and care. The registered person should obtain the views of GPs and other professionals on how the home is achieving goals for service users. The registered person should conduct a monthly written analysis of all the accidents, incidents and occurrences in the care home. Identify any patterns to the accidents, incidents or occurrences. As a consequence of the analysis, minimise the risk of falls through amending staff practice, routines and the deployment of staff or by the review of individual service users care plans. Drakelow House DS0000008553.V254580.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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. 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