Inspection on 08/07/05 for Drakelow House

This inspection was carried out on 8th July 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 24/10/05

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 SK4 4JR Lead Inspector Kath Oldham Unannounced 8 July 2005 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 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 F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Drakelow House Address 64 Parsonage Road, Heaton Moor, Stockport, SK4 4JR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161-432-4033 Miss G D Patten Miss G D Patten Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 18 OP. Date of last inspection 1 December 2004 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 F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 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 in July 2005, starting at 8:00am and finishing just after 4:00pm. Comment cards were provided to the home to distribute to service users and relatives, and the inspector distributed some further comment cards on the day of the inspection. Service user and relatives’ comments are included in this report. The home was also provided with an inspection questionnaire, which will be used in the evaluation process. Time was spent on the inspection in conversation with service users, the manager and staff in addition to observing care practices and the examination of a sample of records that must be maintained in line with the regulations. There had been progress in developing the home since the last inspection. What the service does well: Staff said they felt they worked well as a team; most of them had worked at the home for some time and were flexible, helping out in all areas of the home for the benefit of service users. Service users said they liked the staff and found them helpful. Drakelow House has created a warm and friendly atmosphere where service users feel safe and well looked after. The home is small, accommodating up to 18 service users; invariably they accommodate less than this and try to create a homely feel by its design and style, and by the recruitment of a small dedicated staff group. Service users commented on feeling safe and described the staff team as creating a “lovely atmosphere” and the carers “smashing”, “angels”. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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 F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 Information is provided to prospective service users so they can make an informed decision about whether the home can meet their needs and preferences. EVIDENCE: Relatives said they received enough information about Drakelow House “it was spot on”. Copies of the statement of purpose were observed on service users’ files, which had been signed by them. The statement of purpose needs some slight amendment to ensure the legislation that is quoted in the document is current. Service users’ relatives said they received a copy of the inspection report from the Internet to check what the home had to offer. One relative said they looked at a number of homes, chose a couple and took their cared for relative to look at those. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 9 Service users said they spent time at the home before they decided to stay and had a meeting to confirm their decision. Examination of service user files identified that a pre-admission assessment had been completed by the home. A signed contract was in place in the sample of service users’ files examined. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Care planning for service users’ needs was not sufficient to ensure that all needs would be met. 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; service users spoken to were able to describe care needs that had not been recorded in their care plans. Service users said they felt looked after, and doctors, district nurses and chiropodists visit them periodically. An individual record is maintained of all health professional visits to service users. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 11 Examination of the medication records identified that they were fully completed in line with good practice guidelines. Service users were observed receiving their morning medication, which was given sensitively, taking into account service users’ needs and abilities. One service user said they always receive their tablets each day. Another service user said that they were reliant on the staff giving them their medication when they need them. There was no risk assessments in place for service users who self medicate, this must be undertaken to ensure that it is safe for service users to do so. Service users were spoken to and treated in a respectful manner by staff. Staff showed patience and kindness when supporting service users who were forgetful or slightly confused. Personal care was given discreetly, showing sensitivity to service users’ abilities and understanding. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Service users have a flexible lifestyle in the home, maintain contact with their families or friends, and receive an appropriate diet. EVIDENCE: Some service users said they went to church services when and if they wanted to. A number of service users go out of the home to visit tearooms and the shops. One service user goes out to friends each weekend. Activity is undertaken at the home, some service users like go for a walk with staff. During the inspection one service user was seen to be playing snakes and ladders and I spy, which she said she was good at. Other service users said they like to watch television or spend time in their rooms. The mobile library visits the home and some service users spend their time reading. Past inspections have reported that there was not enough activity at the home in the opinion of visitors. The deputy is to speak with service users and relatives to see if there were any activities service users took part in previously or would be interested in that would be of enjoyment to them now. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 13 Service users said their visitors came to the home at their convenience and stayed as long as they want. One service user said they had visitors in their room or in the lounge, and that they are very comfortable when visiting in their room. Service users’ meetings are routinely arranged when a variety of topics are discussed. One service user said they felt that they had some control over what they do and felt that they had a say in what happens at the home. A record is maintained of the food served so a judgement can be made, if needed, of its nutritional content in line with regulations. The food served on the inspection was appetising and enjoyed by service users. One service user said they enjoyed their three-course lunch and the light meal in the evening. Service users have their own routines in relation to where they have their meals. One service user said they enjoyed meeting up with friends for breakfast and lunch and have tea in their room. New staff have been appointed to undertake cooking duties. Care staff undertake preparation of meals in the evenings and when the cook is not on duty. 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 F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Procedures for dealing with complaints were in place, however this had not been tested in practice in the last 12 months. EVIDENCE: A complaints procedure is in place which details the action that the home will take in response to any complaints or comments. The procedure states that the home would like to know about any comments, however slight they might be, so that they can try to address them. The recording in the complaints book did not detail any complaints or comments since July 2004, which does not validate the procedures in place. Service users spoken with said they did not have any complaints regarding the care they receive at Drakelow House. Service user meetings were described as an opportunity to talk things over and put forward any ideas for change. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Service users live in a safe and well-maintained environment. EVIDENCE: The home was well maintained throughout and provided comfortable accommodation. A programme of replacing lounge chairs was ongoing. Service users commented on being comfortable in the home and using the different rooms at differing times in the day. One service user said they always sit in the same chair and wouldn’t have it any other way. Other service users were aware of this arrangement. The grounds of the home were well kept and attractive. One service user said they spent many an hour in the garden looking at the plants and wildlife. A number of service users’ bedrooms were seen, these were furnished and equipped to a comfortable standard, many had been personalised by the occupants. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 16 The home was clean, tidy, bright and airy throughout and free from any unpleasant odours. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 29 Robust recruitment and selection procedures are in place to ensure, as far as possible, the safety of service users. Staffing levels meet the needs of service users. EVIDENCE: Staff spoken to stated that staffing levels were usually satisfactory and that there was no use of agency staff. Duty rosters indicated that staff numbers are maintained in line with previously agreed minimum levels. Staff said that it had made a big difference to them since the appointment of domestic staff, not only on the time they can spend with service users but also the number of shifts they needed to cover. There is a small staff group at the home and the staff cover for one another during holidays and sickness. In the event of vacancies at the home, these are also covered by the remaining staff group which, when this is long-term, has an impact on the staff team. Two care appointments have also been made at the home which has reduced the number of shifts that staff team need to cover. Inspection of the duty roster identified that staff continue to work long shifts, which may have a detrimental effect on the quality of care provided to service users. It is the responsibility of the registered person to ensure that the quality of care support is of a high quality at all times during a shift. Hours of work must be to meet the needs of service users and not for the convenience of staff. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 18 Examination of staff files identified that recruitment and selection procedures are followed and that application forms contained sufficient information, references are received and all staff have “POVA First” checks or CRB checks in place before commencing employment. Induction programmes are completed and staff have the opportunity of shadowing experienced staff prior to undertaking tasks on their own. Two staff have obtained NVQ level 2 and a further staff member has studied health and social care at college. Service users confirmed they received good care and were satisfied with the manner in which staff conducted themselves and the manner in which they were treated. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 Practices within the home ensure that the health and safety of service users are promoted and protected. EVIDENCE: Records showed that staff had taken part in fire drills and training. The home has received fire inspections and environmental health inspections. The requirements and recommendations identified were reported as having been addressed by the home. Questionnaires have been sent out to relatives but they also need to be sent to health professionals and other placing authority workers to get their views on the home and the quality of care provided. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 20 Accident reports were completed correctly. The accident records were held within individual service users’ care files. Best practice would be to maintain these records centrally. The home does not carry out an audit of accidents, which would identify if there were any patterns to the accidents experienced by service users. Maintenance and servicing of equipment was undertaken to ensure all the equipment was safe for service users’ use. Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x 2 x x x x 2 Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 22 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 OP1 Regulation 4&5 Requirement The registered person must amend the statement of purpose and service user guide to detail the correct legislation. (Previous timescale of 31/01/05 not met). 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. 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 timescale of 31/01/05 not met). The registered person must install radiator guards or have guaranteed low temperature surfaces on pipework and radiators in the home. Timescale for action 01/10/05 2. OP7 15 01/10/05 3. OP9 13 01/09/05 4. OP25 23 01/10/05 Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 23 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. Refer to Standard OP7 OP15 OP28 OP31 OP33 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 arrange for the cook to attend basic food hygiene training. 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 introduce an annual development plan for the home based on a systematic cycle of planning, action, review, reflecting aims and outcomes for serice users. Conduct an internal annual review of the quality of service provision. 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. 6. 7. OP33 OP38 Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, 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. Extracts may not be used or reproduced without the express permission of CSCI Drakelow House F54 F04 drakelow house U s8553 v225196 080705 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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