Inspection on 19/06/06 for Drayton House

This inspection was carried out on 19th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Drayton House 02/02/10

Drayton House 17/09/09

Drayton House 15/01/09

Drayton House 16/07/08

Drayton House 22/01/08

Drayton House 17/10/07

Drayton House 23/11/05

Drayton House 09/08/05

Drayton House 13/09/04

Drayton House 13/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Drayton House 50 West Allington Bridport Dorset DT6 5BH Lead Inspector Gloria Ashwell Key Unannounced Inspection 19th June 2006 13:00 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 Drayton House DS0000036054.V300554.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. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Drayton House Address 50 West Allington Bridport Dorset DT6 5BH 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) 01308 422835 01308 422835 Miss Andrea Helen Quirk Mrs Isabella Fitzgerald, Mr John Stanley Pitcher, Mrs Mary Josephine Pitcher Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That four persons may be accommodated within the category DE(E). Date of last inspection 23rd November 2005 Brief Description of the Service: Drayton House is registered to provide personal care for a maximum of 19 older people including up to four with dementia. Miss Andrea Quirk is the Responsible Individual; she also owns a number of other registered services, including Glencairn in Dorchester. Drayton House has been without a registered manager since the departure of the previous post-holder on 12 May 2006; since that time Miss Quirk has assumed the responsibilities and manages the home on a daily basis. The accommodation is on the ground and first floors with a small passenger lift serving both floors. 7 of the 13 single bedrooms have en-suite hygiene facilities and there are 3 larger rooms which may be used to accommodate 2 residents who have made a positive choice to share with each other. None of the shared use rooms has en suite facilities; all bedrooms have a wash hand basin. Communal facilities include two lounges, a small dining room and 3 bathrooms including two for assisted use. Drayton House is within walking distance of Bridport town centre with its shops and services. There is space at the front of the house to park two cars; parking is not permitted in the road in front of Drayton House. Behind the house is a steep raised garden accessible only by steps and therefore rarely used by residents of the home. There is a small patio at the side of the house accessible via patio doors from the rear lounge. Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. Fees are charged weekly and at present range between £417 and £450 per person. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. Since the last inspection no formal complaints against the home have been received or investigated by the Commission. The previous registered manager left the home’s employ on 12 May 2006; since that time the day to day running of the home has been managed by Miss Quirk. The inspection was unannounced. The inspector spoke to registered person Miss Quirk, care and household staff, 9 residents and the visiting relative of one resident. The inspector observed staff interaction with residents and the carrying out of routine tasks. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 7 and 8 records relating to the same resident were examined, and the resident spoken with. On the date of inspection 13 residents were accommodated, with a new resident scheduled for admission later on that day. A condition of registration is that the home may accommodate up to 4 persons within the category DE(E); at present only one person in this category is accommodated. Additional information used to inform the inspection process included the monthly reports regularly sent to the Commission by the provider organisation, the Pre-inspection Questionnaire completed by Miss Quirk and 6 comment cards completed and sent to the Commission by residents and one from a visiting doctor. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the service does well: The home provides good care in domestically comfortable premises to residents’ who are mainly of low and medium levels of dependency, Residents are treated with respect, their privacy is protected and staff understand and meet their needs. Residents feel safe and well cared for. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 6 Residents are satisfied with Drayton House; statements on Comment Cards included “the girls (staff) are very good and caring”. Within the limitation of their abilities residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. Meals are appetising and of good quantity and quality. 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. Drayton House DS0000036054.V300554.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 Drayton House DS0000036054.V300554.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply) Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Prospective residents (or their representatives) are provided with information about Drayton House and are encouraged to visit in advance of admission to establish their impressions of life at the home and the standard of available accommodation. Prior to admission, the needs of each proposed resident are assessed and the home then writes to prospective residents confirming the ability to properly care for them. EVIDENCE: The records of a person due to be admitted to Drayton House during the day of inspection included details of pre-admission assessment carried out by Miss Quirk when she visited the prospective resident at a local hospital. In advance of the admission the closest relatives of the prospective resident had visited Drayton House to view the premises and meet the staff. Drayton House DS0000036054.V300554.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The standard of care is good and in accordance with a written plan of care for each resident ensuring that staff have sufficient information upon which to base their care practice. Resident’s health needs are met although periodic audit of accidents is not reliably recorded and thereby risks of recurrence may not always be minimised. Handling of medicines prescribed by doctors must be improved to ensure the safety of residents, the correct administration of medicines and consequent provision of good care. Residents are treated with respect and their privacy and dignity is protected at all times. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 10 EVIDENCE: Residents believe they are properly cared for; comments made during the inspection included “I take it to be my home…they treat us well”. Care records of 3 residents were examined and contained risk assessments forming the basis for care plans and daily records describing the care of each resident. To ensure correct identification of residents records contain a recent photograph of each resident. Records are kept of all accidents but it is recommended that these be periodically audited to identify any patterns or trends, in order that actions to minimise risk of recurrence may be promptly implemented as needs arise. Residents wishing to do so can manage their own medicines in accord with a risk assessment process; none the currently accommodated residents manage their own medicines. Medicine handling is carried out by staff trained in this work and medication administration records were in general properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts but two medicines prescribed for administration to a resident each morning had not been signed to confirm this administration on the day of inspection; it is required that each occasion of administration be confirmed in writing, or a written record made of the reason for omission. To improve the medicine recording systems it is required that handwritten amendments to the printed medicine administration records (MARs) be signed, dated and countersigned by a person who has checked the entry for accuracy and recommended that each medication administration record state the allergy status of the resident, or “none known” when this is the circumstance. It is also recommended that the ‘medicines list’ recorded for each resident, together with the reason for administration be regularly updated to ensure comprehensive accuracy. Residents expressed satisfaction with Drayton House and in the presence of staff appeared relaxed, confident and at ease; staff interactions with residents were of a friendly and considerate manner. Drayton House DS0000036054.V300554.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The quality of daily life in the home is adequate with residents assisted to maintain as much independence as possible. Social and leisure activities are occasionally arranged by care staff to provide residents who wish to participate with a pleasurable pastime. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are appetising and of good quantity and quality. Most residents take meals in the small dining room on the ground floor; others receive them in their bedrooms. EVIDENCE: The inspector spoke to a number of residents; all indicated satisfaction with the home, including the meal provision, staff and premises. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 12 Since the previous inspection the home has ceased the employ of a visiting Activities Organiser; Miss Quirk stated that when more residents are accommodated she will consider recommencing employment of this person. At present care staff are responsible for arranging social and recreational activities for residents; none took place during the afternoon of inspection and most residents dozed in armchairs, sat silently or watched television. The various health conditions of many of the residents frequently prevent them from being able to participate in recreational activities but it is nonetheless recommended that at a regular programme of appropriate social and recreational activities be provided by suitably trained staff to ensure that residents need not feel bored. Visitors are welcome at any time and one visiting at the time of the inspection said they are always made to feel welcome and placed at ease by the staff. During the inspection the serving of lunch took place in the dining room. The meal was attractively presented and evidently enjoyed by the residents. Residents said they were satisfied with the quality, choice and quantity of food provided; one said that the food provided by Drayton House ”suits me fine” and residents stated in Comment Cards that personal preferences were “always asked and catered for” and “always choice given”. Drayton House DS0000036054.V300554.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is generally good. This judgment has been made using available evidence including a visit to the service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint and service users know how to complain. The home adheres to a policy/procedure for the prevention of abuse and staff receive training in this subject to ensure they remain vigilant to protect vulnerable residents from risks of abuse. EVIDENCE: Residents and other service users feel confident that if they had concerns or complaints they will be listened to and taken seriously. In written responses made to the Commission in advance of the inspection a resident stated “no complaints at all”. The home keeps records of complaints received; no complaint against the home has been received or investigated since the previous inspection. The home has developed and implemented written policies and procedures for the protection of residents from abuse or neglect and provides staff with associated training; new staff receive training on this subject during their induction. Drayton House DS0000036054.V300554.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Drayton House is a domestically homely and comfortable home. On the day of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: Drayton House is a traditionally built house, with a purpose built extension. It offers homely bedrooms, bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. On the day of inspection the home was clean, tidy and comfortable throughout. Staff said they had suitable and sufficient equipment and felt well supported in their work. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 15 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, 28, 29 & 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: Experienced care staff lead the care teams and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. No new staff have been employed since the last inspection; staff turnover is low. The records of two staff members were examined and found to contain all essential information including two written references, evidence of identity and Criminal Records Bureau (CRB) disclosures. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 16 There is a positive approach to staff training; recent topics include First Aid, moving and handling, infection control and fire safety. At present 6 of the 11 care staff currently employed by the home hold a National Vocational Qualification in care; the home thereby meets the standard for at least 50 of the care staff to hold an NVQ in care. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is generally good but arrangements for obtaining the opinions of residents should be improved. This judgment has been made using available evidence including a visit to the service. The home is well managed and staff understand their work and receive training appropriate to their needs. Residents are satisfied with the home and feel staff care for them well and put them at their ease. The home does not manage the finances of residents. The premises and equipment are properly maintained in good condition. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 18 EVIDENCE: The previous registered manager left the home’s employ on 12 May 2006; since that time the day to day running of the home has been by registered individual Miss Quirk who intends to employ a replacement manager at the earliest opportunity. The home has a system for quality assurance; a satisfaction survey was issued to service users during October 2005; it is recommended that the results be audited and made known to residents and other service users. It was noted that the comment cards returned to the Commission in advance of this inspection were all in the same handwriting; the home confirmed that they had been written by a member of staff in consultation with residents unable to complete these forms themselves. To provide confidentiality and thereby ensure the validity of residents’ comments it is recommended that arrangements be made for friends, relatives or other representatives of residents, not in the employ of the home, to assist them in registering their opinions of Drayton House. To ensure continuity of approach the home operates in accord with an extensive selection of policy and procedure documents, including those for care provision, management and the premises. The home does not manage the finances of residents. Staff trained in First Aid and health care are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal. Details of equipment servicing and maintenance were provided to the Commission in a questionnaire. The inspector examined some records to verify this information including the following: - records of regular checks/tests of fire safety equipment - passenger lift: routine service 16 February 2006 - gas installation safety inspection: 26 October 2005. On 17 November 2005 Dorset Fire & Rescue Service wrote that the findings of their inspection of Drayton House were “no deficiencies; well run establishment with an excellent attitude to fire safety requirements”. Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 20 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 OP9 Regulation 13 Requirement Handwritten entries in medication instructions must be signed and dated by the writer and countersigned by a member of care staff who has checked the entry for accuracy. Each occasion of medicine administration must be confirmed in writing, or a written record made of the reason for omission. Timescale for action 19/07/06 2. OP9 13 19/07/06 Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 21 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 OP8 Good Practice Recommendations It is recommended that accidents and incidents be periodically audited to identify any patterns or trends, in order that actions to minimise risk of recurrence may be promptly implemented as needs arise. It is recommended that each medication administration record states the allergy status of the resident, or “none known” when this is the circumstance. It is recommended that the ‘medicines list’ recorded for each resident, together with the reason for administration be regularly updated to ensure comprehensive accuracy. It is recommended that a regular programme of appropriate social and recreational activities be provided by suitably trained staff. It is recommended that arrangements be made for friends, relatives or other representatives of residents, not in the employ of the home, to assist them in registering their opinions of Drayton House. It is recommended that the results of service user surveys be audited and made known to residents and other service users. 2. OP9 3. OP9 4. OP12 5. OP33 6. OP33 Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Drayton House DS0000036054.V300554.R01.S.doc Version 5.2 Page 23 - 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!