Inspection on 15/08/05 for Dresden House Limited

This inspection was carried out on 15th August 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dresden House Limited 29/06/07

Dresden House Limited 04/10/06

Dresden House Limited 04/01/06

Dresden House Limited 23/03/05

Dresden House Limited 09/10/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

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Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Dresden House Limited 81 Trentham Road Dresden Stoke-on-Trent Staffordshire ST3 4EE Lead Inspector Wendy Grainger Announced 15 August 2005 9:00 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. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dresden House Limited Address 81 Trentham Road Dresden Stoke-on-Trent Staffordshire ST3 4EE 01782 343477 01782 335813 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) Dresden House Limited Miss Lesley Anne Mills CRH 24 Category(ies) of DE(E) 7 registration, with number MD 3 of places MD(E) 7 OP 24 PD 1 PD(E) 10 Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 PD minimum age 60 years 2 That the Registered Manager undertakes training in Mental Health Awareness and Dementia Care. Date of last inspection 23 March 2005 Brief Description of the Service: Dresden House is a large detached Victorian house located alongside a busy road in Dresden near to shops and community facilities. The town of Longton can be accessed via public transport,parking is at the rear of the home. A small concrete garden with tables and chairs provided external space for residents.The kitchen is located off the main rear entrance while small is able to cater for all the needs of the residents.Bedrooms are single occupancy, three bedrooms at the time of this report had an en-suite facility; there are plans to increase en-suite facilities. Bathing and toilets are located throughtout the home accessed by the residents. Three lounges,one being designated as a smokers lounge provides suffcient space for the residents to wander freely. A small well furnished concervatory provided extra space. The home had a rolling programme for the refurbishment and decoration of the home. at the time of this inspection some bedroom decoration had been put on hold waiting for the en-suites to be built.Dresden house provides care for twenty-four people the majority of whom were in elderly . A small group of people with mental health care needs were also accommodated. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out on the 15 August 2005 by one inspector. This was the first inspection by this inspector who was welcomed by the staff, management and residents; who all contributed to the inspection report. Documents, records, reports, policies and procedures were made available during the day. The Commission received ten resident comment cards; five comment cards from families were completed. The families recorded no additional comments; each one was satisfied with the home and the care provided. Of the ten comments received from residents four had no additional comments. Six residents had taken the opportunity to add comments, “J” its better here than other places I have stayed” ”C” is happy to be at Dresden House” “M” would like to be at home but is unable to, she likes it here” “”A” commented that she was comfortable” “”K” he is very happy to be living here “ “N” is fine and had no problems” it was pleasing to see that residents while being assisted by the staff with the cards signed each one where possible. The majority of the residents were spoken with during the inspection each one confirming their comments about the home, staff and management. Breakfast would be served in the well appointed dining room or where the resident was at the time. Alternative days a cooked breakfast was offered, a full English breakfast was offered on Sundays. Residents were seen to wander freely into the garden throughout the day, some chose to have lunch in the garden. No resident would be admitted to the home unless a full assessment of his or her needs had been completed. Each resident had a care plan, daily reports were maintained in a separate folder, when full transferred to the main care plan. Within the daily report would be a synopsis of the care required. Arrangements were in place for all the residents to have continued care where necessary from other professional agencies. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 6 The system for the administration of medication was discussed with management who told the inspector they had always administered medicines in the same manner. Ideally and for the safe handling of medicines the medication in total should be taken to the person and not carried in an open pot. Residents were offered a varied selection of activities internally and externally. Observed during the inspection was a game of Hoop La. Residents when spoken with were aware of the complaints procedure. Management would respond to any concerns within the required time scale. During the tour of the home it was observed to be well maintained and of a good hygiene standard. The Director was aware that certain bedrooms were in need of decoration. This was on hold waiting to commence the building of extra en-suites where possible. Staff were trained and observed by the inspector to address the needs of individuals, the interaction was light and respectful. There was a requirement for the home to review their system when employing new staff and to ensure that all the required documents were in place before commencing duty. What the service does well: What has improved since the last inspection? With decoration of the majority of bedrooms on hold, the management had decorated bedrooms not to be affected by the planned provision of en-suites. The management had employed three new staff since the previous inspection. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 7 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. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,5, Standard six was not relevant to this home. The documentation provided would ensure that the relevant information about the home and staff was current. Assessments were operational prior to admission to ensure that the home can meet individual needs. EVIDENCE: The Statement of Purpose and Service Users Guide was made available to any person at the home; it was displayed within the entrance hall on a lectern. The document had pictures making identification of staff easier. No resident was admitted to the home without a full assessment of his or her needs; this would include any person on respite care. Documentation provided supported the assessment. As normal practice for the home any person considering a placement would be offered an invitation to spend time prior to admission. Transport can be arranged if necessary. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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) 7,8,9,10 11 All aspects of an individuals personal and health needs were identified in the care plans. Appropriate arrangements were in place for the continued care from other professional agencies. The system for the administration of medication left the staff vulnerable. Other systems including training and documents were generally satisfactory. EVIDENCE: Three care plans were seen today, each resident was spoken with during the inspection, the records provided for the inspector confirmed the resident’s needs. The daily report was maintained in a separate file and accessed by the staff as and when necessary. A synopsis of the care plan was retained with the daily reports. It was suggested to management that for the resident receiving full care, her care plan could be streamlined to highlight pertinent current care required. This resident was comfortable in her room, which was well ventilated and warm. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 11 Arrangements were in place for the continuing care of individuals by other professional agencies. The previous inspection report required the home to monitor the weights of residents more regularly. Records provided confirmed that this had been addressed. Medication was stored in the conservatory within a set of locked drawers; the Care Manager will monitor the occasional gap in the records. Records confirmed training had been provided for the staff responsible for medicines. The home was well supported by the pharmacist; who undertakes a quarterly inspection followed by a report. A monitored dose system is used at Dresden House; the inspector had concerns as to the method used when administering medicines. The staff dispensed medication into open pots then transferred it to the resident. This practice leaves the staff vulnerable in the event of tripping with medication. Medication should be taken to the individual in the container it arrives in. The management told the inspector medication had always been administered this way. The National Minimum Standards 9.8 required that records for the administration of controlled drugs should be in a Controlled Drugs Register; this was pointed out the Director and Manager. During the inspection, staff were observed to address the needs of residents where necessary. Other residents needed emotional support, which was also provided. The staff and residents had a positive relaxed interaction together. Staff recognised and respected individuals for their own personalities. All care would be provided at the end of a resident’s time at the home. Families were welcome to be at the home, there was no limit on the time spent with their loved one. Staff had policies and procedures to access if necessary. Bereavement training had been provided for the staff in 2004. The inspector was told that the home had excellent support from other professional agencies. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 Staff were seen to be interacting with all the residents, creating a relaxed atmosphere to suit individuals abilities and needs. Links with the Community were good and supported residents life style, while enriching the social opportunities. The menus and meals in the home were balanced, offering both a choice and variety while catering for individuals needs. EVIDENCE: Residents at Dresden House were offered a comprehensive activity programme a detailed monthly programme was displayed; these activities can be and are variable to suit the day and residents. A recent outing to Blackpool was the choice of residents; each one spoken with relalayed the day and enjoyment they had experience. Some residents had chosen the option to stay locally and to visit the recently restored Trentham Gardens. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 13 Spiritual needs were met to suit individuals, seasonal times of the year were made special with contact from the Community. Musical entertainment was provided over a twelve month period. Residents told the inspector that they went out to the pub for lunch. Visitor were asked to respect mealtimes when visiting. The menus for the month were varied, offering choice at each meal. The records maintained by the cook identified that she had weekly contact with residents seeking ideas about the menu. From the information gathered management would shop locally and able to purchase family size portions. Dining facilities varied with the lounges being used for small groups of residents. One resident would be served her meal in her bedroom due to her frailty. Residents confirmed their appreciation of the meals served. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 18. The home provided a complaints procedure made available to any person with a concern. Staff training records ensured that staff were aware of the need to monitor care practices in the event of any form abuse. EVIDENCE: The complaints process was part of the homes admission process, and given to residents. Other required documentation contained the procedure. The Commission had received no complaints; in house complaints would be addressed within the time scale and a record maintained. Records identified that new staff were provided with training in the recognition of forms of abuse as part of their induction programme. The home did not handle any financial matters, independence was promoted and other agencies were responsible for supporting residents. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 20 21 23 25 26 The home was warm and comfortable. Residents were provided with a homely environment. Residents had the opportunity to personalise their personal space. The management recognised that redecoration was required. The plans to upgrade facilities will further enhance the life style for residents. EVIDENCE: Located alongside a busy road, the home was suitable for the stated purpose; the parking was at the rear of the home. This area was used as the main entrance, the door at the front of the home was rarely used. Residents’ communal accommodation was well furnished, there had been new carpets laid which were of a good quality. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 16 The home maintained good standards of hygiene, residents were provided with a comfortable safe environment. Bathing and toilet facilities were located near to communal and bedroom areas. There are plans with the Commission to further enhance the toilet facilities for residents by building more en-suites. The Director and manager recognised that some bedrooms were in need of redecoration and some refurbishment of furniture; this has been on hold until the building work was completed. The bedrooms seen were personalised to suit individual tastes, bedrooms complied with the requirements of the Standards; containing the required fixtures and fittings. Radiators were protected, as were the residents with regular checks of the water accessed in their bedrooms. Bathrooms had a fail safe devise fitted, records are maintained for both areas. The laundry was located on the second floor, while small it contained the require equipment to meet the needs of the residents and home. Staff had COSHH training via the induction process. Information was also made available in a printed form. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 29 30 The levels of the staff were deemed to be acceptable for the number and dependency of the residents. Appropriate staff training was demonstrated by the way in which the care of the residents was addressed during the inspection. There was a requirement to ensure that all the procedures when employing new staff were met to protect the safety of the residents. EVIDENCE: The Director and Provider supported the care manager and her deputy. The role of manager was a joint role with alternative shifts being worked by the two managers. The staffing levels on the day of the inspection were satisfactory. It is planned that with management, two care staff, plus a trainee from 11am –7pm were on duty at any one time. One extra carer was on duty Monday Wednesday & Friday from 9.30 12.30 to allow the managers to catch up on paperwork in the office. This system appeared to be working as paperwork was well maintained. The trainee person was part of the non-care support for residents; they were required to commence NVQ in Care Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 18 The home operated a twilight shift from 5pm 11 pm when the two night staff then commenced duty. There were no vacancies for staff at the time of the inspection. Two cooks are part of the team, covering seven days, with the main cook providing meals six days each week. The management explored training needs. Records provided identified that mandatory training was on going. Challenging behaviour training had been completed. Staff during the inspection confirmed that they had received training and more was planned. Health & Safety was booked for August 10 2005, Food Hygiene booked for August 4/11 2005 Awareness of Mental Health for September 2005 as was elderly abuse in October 2005. Discussed with management was to pursue training as a possible distance learning course for Infection Control. 80 of the staff had NVQ Level II or III this was above the required levels in the National Minimum Standards. Following the inspection of the records it was identified that the last two people to be employed had commenced duty prior to a current Criminal Record Bureau check being completed. The Director and manager were unaware that the CRB’s on file were not transferable and had applied as normal practice for further checks. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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) 31 32 33 36 37 38 The Director & manager ensured that the residents were safe and secure in their environment. The regular audits highlight any defects within the home. Surveys of the stakeholders’ relatives’ residents provided constructive information in respect of the care provided. The home had good systems in place to protect residents. It is important that the home had a full compliment of staff with fire drill training, failure could leave residents and staff at risk. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 20 EVIDENCE: The registered care manager continued with the Registered Mangers Award, she had completed Level III in Care. Her current training needs were satisfactory. Mandatory training where applicable would be provided. The Commission had interviewed Miss Mills who had been successful for her role of the registered care manager. The ethos of the home was relaxed and comfortable. The daily routines continued with the committed caring staff addressing the needs of residents. Staff spoken with expressed that they felt supported by the management. An open door policy for any person at the home was operational. Records of a quarterly staff meeting were seen. Surveys were sent out to relatives, residents and professionals on an annual basis. A monthly newsletter provided information about the home and any changes planned. A copy of the monthly managers report was handed to the inspector. This monthly audit ensured that the quality of the home continued. Staff confirmed that they received supervision on a regular basis. Records were maintained, the inspector did not access these records. Records were maintained in an appropriate manner secured in the office on the first floor. Fire records were inspected, from the records; there was a need to ensure that night staff were involved in a fire drill. Other records seen included. Health & Safety checks 25 3 04 Gas installation 11 7 05 Central heating 11 7 05 Environmental Health Officer 11 1 05 Lift 7 6 05 Hoists 211 2 05 &7 3 05 Wheelchairs monthly. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 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 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x N/A 3 3 3 Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? 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 29 Regulation schedule 2 Requirement No person should be employed unless the required police checks had been completed with satisfaction Timescale for action on going 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. Refer to Standard 38 9 Good Practice Recommendations To review the records to ensure all the night staff had been involved in a fire drill. To monitor the gaps in the medication. Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Dresden House Limited E51-E09 S8223 Dresden House Limited v239771 150805 Stage 4.doc Version 1.40 Page 24 - 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. 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