Inspection on 04/10/06 for Dresden House Limited

This inspection was carried out on 4th October 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 04/01/06

Dresden House Limited 15/08/05

Dresden House Limited 23/03/05

Dresden House Limited 09/10/04

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Heathlands

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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 Key Unannounced Inspection 4 October 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.V312424.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. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 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.V312424.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. PD minimum age 60 years That the Registered Manager undertakes training in Mental Health Awaress and Dementia Care 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. This situation remains on hold until the proposed building work commences in February 2007. Some bedrooms had since been decorated; carpets will be replaced later in line with the building work. 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. From the information provided by the care manager in the pre inspection questionnaire the current scale of charges were £314 for a standard room and £324 with an en-suite facility. Additional costing would include hairdressing, private chiropody and any personal toiletries. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was completed on the 3rd September 2006. The care manager was on duty and provided with her staff every assistance to ensure that the inspection was completed with no disruption to the resident’s daily routine. The pre inspection questionnaire provided information, staff were spoken in regard to their training and awareness of procedures. Records, reports, documents and comments from resident s and a visitor will be included in the report. The commission had received a number of comment cards from relatives and residents that will be reflected in areas within the report. A sample tour of the home was made; there remained the need to continue with the decorating throughout the home. The planned building work had been moved pending date now is February 2007 when en-suites will be created. Following this work carpets will be replaced in corridors, bedrooms and other required areas. What the service does well: What has improved since the last inspection? Following the previous inspection in January 2006 the home has commenced some limited decoration of bedrooms. Two new shower chairs had been purchased. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 6 A small quantity of armchairs had been purchased for one of the lounge/dining rooms. The kitchen area had been painted. To comply with the new fire requirement legislation, the home has had additional fire doors fitted at the appropriate location. 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.V312424.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 Dresden House Limited DS0000008223.V312424.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): 1, 3,4. Quality in this outcome area is adequate. This judgement has been made using available evidence including the reading of documents. The Statement of Purpose available did not provide the current details of the registered care manager. A competent person completed Pre assessments prior to admission. EVIDENCE: The Statement of Purpose displayed in the conservatory and available to any person. This document contained limited information in respect of the care manager, her qualifications and experience. There was also a copy of a registration certificate, this document was for the previous care manager and needed to be removed. Evidenced in the care plans were pre assessments completed prior to admission. Where possible pre admission visits were encouraged. Dresden House Limited DS0000008223.V312424.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 adequate. This judgement has been made using available evidence including a sample of the care plans, The care plans were confusing with non-current information contained in the modules. Evidence did not identify the social and emotional need for residents with diverse needs. Arrangements were in place for the continued health care for all the residents. The medication system appeared satisfactory. The staff during the inspection demonstrated their commitment to the residents and their daily routine. EVIDENCE: A sample of three care plans were evidenced, the plans contained a assortment of documents that were out of date making the plans confusing and time consuming. Daily records were evidenced, there was a need to Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 10 ensure that when a report identifies a concern that it is followed up and recorded. One of the residents risk assessments was attributed to falls but only reflected the daytime and falls were occurring at night. The risk assessment was discussed with the care manager and recommended that it was reviewed. There was no evidence in a plan of the emotional/mental health care for a resident with diverse needs. A feed back survey from families, in respect of the service provided was contained in the plans. Arrangements were in place for the continued health care of all the residents from other professional agencies. It is important that when transferring residents in a wheelchair to comply with Heath & Safety that foot rests were used unless there is a medical or physical condition recorded in the care plans that prohibits there use. It was recommended that the jug of juice identified in a bedroom should have a cover to keep it fresh, it should also have been place on a cupboard and not the bin that collects soiled linen. This was pointed out to the care manager on the tour of the home. The staff were observed to check and arrange for medication that had not arrived in the weekly delivery to be forwarded. The records for the administration of medicines were satisfactory. Staff had received training in the safe handling of medicines 2006. The staff during the inspection demonstrated their commitment to the residents and their daily routines. There was no evidence of staff training to meet the needs of residents with a dementia. The home had a relaxed atmosphere promoted by all the staff on duty including the catering staff. Dresden House Limited DS0000008223.V312424.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 good. This judgement has been made using available evidence including speaking to a visitor, residents and reviewing the menus. Contacts with families and friends were maintained. Residents went into the community maintaining contact with the community. The menus identified a well balanced diet with local cultural recipes being prepared. EVIDENCE: The meal of the day was well presented; the alternative of chilli was served to some residents. Menus were balanced and offered choice, both for lunch and at tea. The staff respected the preference of residents as to where they ate within the home. Each week the catering staff had a meeting with the residents to obtain feedback from the residents. The minutes of the meetings were made available. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 12 The inspector sampled the excellent lemon meringue pudding of the day. One visitor spoken with told the inspector that she was “always made welcome” she had been offered lunch and tea while visiting; she had in the past enjoyed the food but now provided for herself. She felt the staff were very good and cared for her friend “very well”. One resident during the inspection went home to his family over night. There was some evidence of activities that had taken place; this record was not current. A resident told the inspector that he had been to the pub for lunch recently. Birthdays were made special for all the residents. It is planned to have a projectionist in to present slides. Staff were committed to giving of their own time to raise funds for the residents, this was evidenced with the “pub crawl” photographs. There was no evidence in records to identify that residents with diverse needs received stimulation via activities/ craft/ outings. This was discussed with the care manager. Dresden House Limited DS0000008223.V312424.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 good. This judgement has been made using available evidence, including speaking with the staff and residents and by evidencing documents. The complaints procedure was displayed in documents and on the notice board. Residents were protected from abuse via training including NVQ qualifications. EVIDENCE: The commission had received a complaint in 2006 and since the last inspection. The provider had investigated it and the five issues raised were not upheld. During the inspection the inspector discussed a further part of the concerns that had been raised. The care manager denied that the staff had not been present for a particular training session. She did agree that the venue of the training was inappropriate. Part of the concern was that staff did not demonstrate their commitment to the session and there was no plan of who was to care for the residents. The care manager confirmed that staff did attend to residents’ needs and that alternative arrangements should have been made. The homes complaint procedure was displayed in the Statement of Purpose and within the house. One resident confirmed that he would know whom to complaint to if he had a complaint. The staff confirmed that they were aware of the need to protect residents and that they would report any concerns in line with the complaints process and would if necessary contact the commission. Dresden House Limited DS0000008223.V312424.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 20 23 24 25 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a tour of the home. Residents in parts of the home were provided with less that an acceptable environment. EVIDENCE: The planned en-suite facilities had failed to commence when expected. It was planned to decorate bedrooms throughout when building work had finished. Some bedrooms however had been decorated, although not carpeted, One resident who at the time of the inspection was receiving bed rest after her return from hospital appreciated the results. She told the inspector that she was particularly pleased with the location of her new room and blinds that allowed her to watch the traffic. Four more bedrooms were planned for decoration, the theme colour was again to be magnolia. The planned building work was to commence February 2007. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 15 There had been major fire prevention work within the floors, this work was to comply with the new fire legislation. The carpets on the corridors on the first floor were badly stained with wear and tear. These will be replaced after the work has been completed. Some new chairs had been purchased for one of the lounges, the chairs in the smoking lounge were in a poor condition with cushion covers that did not fit, displaying plastic underneath. This room was due to be decorated and carpet cleaned. At the time of the inspection the lounge did not provide a homely environment. It was identified that the room was without a fire extinguisher. Advice was offered that the fire officer should be contacted to give an opinion if one was necessary. One bathroom was in an unacceptable condition with a dirty bath hoist seat and bath with what appeared to be urine stained. The door jam paintwork had dried faeces smeared on the paint. The bathroom was smelly; this may have been from the mop left in dirty water in the corner. The housekeeping is part of the staffs’ role as carers, the majority of the work being completed at night. At the time of the inspection the medication had arrived and the person responsible for housekeeping had remained with residents while the medication was checked. The major planned work will include moving the office to the ground floor, a conservatory built onto one of the lounges at the front of the home. The present conservatory will be rebuilt and extended. The kitchen will then be located in the area of the existing conservatory providing a lot more space. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 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): 27,28,29,30 Quality in this outcome area is good. This judgement had been made using available evidence including speaking to residents, staff and reviewing records. The staffing levels appeared adequate to meet the needs of the residents. Recruitment practices ensured the safety of the residents. EVIDENCE: At the time of the inspection five of the staff came to the home to sign up to commence NVQ in Care level III. With the exception of one staff member who has yet to complete Level II all the staff have the qualification. This includes the main caterer who on occasions has a mixed role. Dresden House has four shifts including a twilight shift, at the time of this inspection the home had a vacancy for one night shift employee. Recruitment for staff would be via the local paper. The records identified that the care manager with the exception of the trainee who only had one reference, had complied with the National Minimum Standards. The care manager hopes to complete the Registered Managers Award by Christmas 2006. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 17 Residents spoken with told the inspector that they were well looked after and any problems they may have were dealt with. One resident confirmed his knowledge of the care manager and that they would help him if necessary. Staff when spoken with confirmed obligatory training this was evidenced from the records provided. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 18 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 36 38 Quality in this outcome area is good. This judgement has been made using available evidence including records, speaking to the staff and manager. The home was operated in the best interest of the residents, the home was relaxed, and staff met the needs of the individuals. EVIDENCE: The daily routine for the residents appeared relaxed with the staff taking care of their needs. The care manager was part of the working team, with some supernumerary time during the week. Records and documents including a fire risk assessment in respect of the fire were current. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 19 Staff on duty confirmed that they had received supervision. Their obligatory training was up to date. The manager informed the inspector that the home did not manage any of the residents finances. This was the individuals or families responsibility. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 20 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 3 Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement The registered person shall prepare written care plans of how the residents mental and divers needs were to be met. The registered person shall ensure that all parts of the home are kept clean and reasonably decorated. The registered person shall ensure that staff are training to undertake their role as carers this includes training to include dementia care Timescale for action 12/11/06 2 OP19 23 (2) (d) 12/11/06 3 OP30 18 12/11/06 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 OP1 OP7 Good Practice Recommendations To update the homes Statement of Purpose to provide the relevant information to the residents and public. This document needs to be kept under review. To review the care plans and ensure that they were “live” plans, the streamlining of the plans would reduce the non DS0000008223.V312424.R01.S.doc Version 5.2 Page 22 Dresden House Limited 3 OP8 4 OP38 useful information. Wheelchairs used to transport residents around the home, unless there is a recorded reason why the use of the rests causes discomfort; that they should be in place at all times. To seek advice in respect of the provision of a fire extinguisher for the smokers lounge. Dresden House Limited DS0000008223.V312424.R01.S.doc Version 5.2 Page 23 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.V312424.R01.S.doc Version 5.2 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. 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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