Inspection on 04/01/06 for Dresden House Limited

This inspection was carried out on 4th January 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dresden House Limited 29/06/07

Dresden House Limited 04/10/06

Dresden House Limited 15/08/05

Dresden House Limited 23/03/05

Dresden House Limited 09/10/04

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Maple Lodge

Heathlands

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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 Mrs Wendy Grainger Unannounced Inspection 4th January 2006 09:00 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 Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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 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) Dresden House Limited Miss Lesley Anne Mills Care Home 24 Category(ies) of Dementia - over 65 years of age (7), Mental registration, with number disorder, excluding learning disability or of places dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (7), Old age, not falling within any other category (24), Physical disability (1), Physical disability over 65 years of age (10) Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. PD minimum age 60 years That the Registered Manager undertakes training in Mental Health Awareness and Dementia Care 15th August 2005 Date of last inspection 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 in other bedrooms. Bathing and toilets are located throughout the home accessed by the residents. Three lounges, one being designated as a smokers lounge provides sufficient space for the residents to wander freely. A small well-furnished conservatory 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 who were elderly. A small group of people with mental health care needs were also accommodated. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was completed on the 4th January 2006 with the Deputy Care Manger and the staff on duty all, of whom were competent in their role and demonstrated their knowledge of the residents. The Deputy Care Manager who conducted the inspection with knowledge and experience provided records, reports and documentation. Staff and residents provided assistance and comments for the content of this report. There was a pleasant atmosphere in the home each resident continuing with their life style, breakfast was not rushed, some residents preferred to remain in their rooms. The inspector was told that “this is a good home” “ the Christmas menu was good and after the rich food the menu was varied” “ I like it here everything is done for you by the staff” “ the management were approachable and I had time to discuss any issues” “ I feel supported by the management” “ my supervision of my training and development needs is up to date” The planned accommodation changes with the building of the en-suites had not commenced. This impacted on the decorating and refurbishment of the bedrooms, which were in need of upgrading. The Deputy was unable to tell the inspector when the building was to commence. Upon entry to the home the inspector was concerned that the external gate to the car park was secured with a padlock. Staff had to physically open it, when asked why the security of the home had been changed it seems that two residents attempt to leave the home. The inspector advised that the home needed to contact their fire officer as a matter of urgency to seek advice. This was the only rear entrance onto the car park in the event of a fire. The inspector firmed this advice up by e-mailing the fire officer for the area asking for a visit. Pre admission assessments of an individuals needs continued. Each resident had a plan of support and care required to continued his or her life style. The home had commenced a new system for recording continuous care on a daily basis. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 6 The inspector observed the system and time spent administering medication the first administration was planned for 9am this routine was continued until after 10 30am. The residents after breakfast chose to return to their rooms making the drug administration extended. The next time medicines were administered would be at lunch leaving a very short interval between the first and second drug rounds. The person responsible on the day had to go to each person’s bedroom. The system could be stream lined if the home had a trolley and administered medication direct during the breakfast period when the majority of residents were present. The menus offered a well-balanced selection of home cooked meals. During the inspection a large quantity of food was delivered. The delivery people confirmed that this was a regular weekly delivery. A limited tour of the lounges and bedrooms took place during the inspection. Table linen was changed after breakfast; lounges were comfortable. The smoker’s lounge the inspector was told was not used at meal times to prevent the smoke entering the main dining room. The management were advised to review the smoking policy to see if it needed firming up. At the time of the inspection one resident’s smoking habit was giving concern. Bedroom doors with the exception of three were locked, a minority of residents wandered freely around the home; one of the three bedrooms (no10) was viewed, the carpet would benefit from cleaning. This room may be one where an en-suite is planned. One resident was waiting in her bedroom for a shower and had breakfasted in her room. The other bedroom had a resident who was receiving total bed care. Each of the bedrooms held personal possessions. The staff on duty were friendly, assisted and spent time with the inspector, providing any assistance and information to add to the report. Staff were seen/heard to assist residents with their daily routine. There was a need to monitor the provision and storage of toilet rolls and not to leave them exposed on the cistern; as they may be prone to contamination. What the service does well: The residents at Dresden House were supported by the staff on a daily basis they were knowledgeable in respect of their needs. Residents spoke highly of the staff. Residents were offered a choice of a well balanced diet, the inspector was aware that residents were asked at the time of serving their particular choice of the day. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 7 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. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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 Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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): 1,3,4,5 Standard six was not relevant to this home. The complete documentation was made readily available to any person requiring a placement to the home. Full assessment of needs prior to admission was the practice for the home and written information that the home could meet the service users needs was undertaken. EVIDENCE: The Statement of Purpose and Service Users Guide were located in the front entrance on a lectern. There had been no reason to review the documents at the time of this inspection, as the building work had no commenced. No person would be admitted to the home without a full assessment of his or her needs. A letter confirming the placement is then forwarded. Each person wanting a placement would be offered a visit to meet the staff and other residents. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,10 The content of the care plans and other relevant documents were well maintained by the staff. Arrangements were in place for the continued care from other health professionals. The system for the administration of medicines could be streamlined. The staff interacted and residents responded to any assistance given. EVIDENCE: A small sample of the care plans were evidenced during the visit. The plans were current and well maintained. Any incidents were recorded in full. A new system enables access to the daily report and plan of care/support easier; these records were stored in the small conservatory area. Each plan had a weekly review of the support during the week. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 11 The inspector was told that the home had excellent support from other professional agencies. Some residents had access to the Community Psychiatric Nurse on a regular basis. Medication was stored in a locked drawer in the conservatory; the records were current. Medications checked against the controlled drugs record were accurate. Advice was given for the recording of this medication that each person should observe the medication taken prior to signing. The system for administering the medicines was prolonged and time consuming. Residents at Dresden House were in the majority mobile and return to their bedrooms or lounges after breakfast. The person responsible for the medicines then had to commence the 9am medication by going to all parts of the home to find the person. It was discussed that a trolley used during breakfast could streamline the system; instead of dispensing individually and locking the drawer each time. The staff promoted a relaxed atmosphere; the less able residents were seen to be supported in their daily routine. Staff at Dresden were committed to the care of the resident group. The staff on duty were polite, respectful, promoting independence where applicable. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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 the following standard(s): 12,13,15 Contacts with families and friends were maintained via the free visiting policy. Residents were provided with a varied social programme to decide from. Each individual had the option to choose from the daily menu. EVIDENCE: The inspector was told of the Christmas celebrations and party arranged by the staff. A Karaoke session was enjoyed; the Production Company provided external entertainment. Visitors were seen to enter the home as were greeted warmly by the staff. The menu evidenced that three roast meals were provided each week; the cook confirmed this. Menus were based on home cooked and fresh produce. Residents were asked on serving their personal choice of the meal. At the time of this inspection the meal of the day was braising steak, or cheese pasta bake, followed by semolina or yoghurt. Residents confirmed that on Sundays they could have a cooked breakfast; and the meals provided were excellent. The required fridge/freezer & food temperatures were well maintained. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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 Residents were protected from abuse via the complaints process, training and experience of the staff. EVIDENCE: The Commission had received one complaint in 2005, this had been investigated and found not upheld. The management had received no complaint about the service provided. Staff training internally and externally ensured that the staff were fully aware of the need to protect individual residents from abuse. The residents, staff and families could easily access Dresden’s House complaint process. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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): 19,20,21,23,26 Residents were provided with a warm comfortable home. Residents can access the rear patio area, and the front of the home. The home was maintained to a high standard of hygiene. EVIDENCE: Located on the busy main road to Dresden the home was registered to offer accommodation to a wide selection of individuals. The home is on a public transport route. The environment in the communal areas was well maintained, with small lounges plus a separate smoking room. The dining facilities and linen were evidenced as being of a good quality. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 15 The projected upgrade of the toilet facilities had not commenced. There was need to monitor the provision/storage of extra toilet rolls, to prevent cross contamination. Evidenced in the delivery of produce at the time of the inspection included protective gloves. A small sample of the ground floor bedrooms were seen, bedroom doors in general were kept locked to protect the personal possessions from any of the residents that chose to wander freely around the home. Bedroom 10’s room may be one of the ones to be upgraded but the carpet needed a deep clean/replacement. Decorating and refurbishment remains curtailed due to the lack of building work. There were plans to increase the censors to all the exit doors. Residents were provided with an environment that was maintained to good hygienic standards. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 The staffing levels were satisfactory for the dependency levels of the present resident group. Staff demonstrated their abilities and competency during the inspection. EVIDENCE: At the time of the inspection there were five staff on duty including the Deputy Care Manger and trainee. One cook, the extra member of staff worked a mixed rota to allow paper work to be completed. The trainee confirmed that she did not attend to any personal care. The main staffing levels reduced by one for the afternoon shift, having a twilight shift ensured that the residents were in safe hands throughout the day. Two waking night staff would be on duty. Staff confirmed that they had completed their level III NVQ in Care. The Deputy Care Manager and Care Manger are in the process of completing the Registered Managers Award Level IV NVQ. Staff told the inspector that their obligatory training was current. They felt supported by the management. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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): 31,32,36,37,38 The registered manager and staff ensured that the residents were safe and secure. The home had a relaxed atmosphere; residents were comfortable in a warm environment. EVIDENCE: The management had plans to increase the censors on the external doors, to further ensure the safety of the residents. The inspector had concerns when arriving at the home, the external metal gate to the property was secured with a lock, which required a key. This is the only exit to the car park in the event of a fire. The inspector advised the Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 18 management to contact the local fire officer for guidance; the inspector in an e-mail firmed this up. Staff confirmed to the inspector that they continued with supervision, and their training needs recognised and respected. The appropriate fire practices and procedures were current, staff signed their involvement in fire drills. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 X X 3 STAFFING Standard No Score 27 3 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X 3 3 Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP21 Good Practice Recommendations To consider the advice to streamline the medication system. Any controlled medication should be witnessed by two staff then signed for To monitor the provision/storage of extra toilet rolls in toilets. Dresden House Limited DS0000008223.V275399.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Stafford Office 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 DS0000008223.V275399.R01.S.doc Version 5.1 Page 22 - 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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