CARE HOMES FOR OLDER PEOPLE
Drumconner 20 Poole Road Bournemouth Dorset BH4 9DR Lead Inspector
Debra Jones Unannounced 18 May 2005 09:30 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. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Drumconner Address 20 Poole Road Bournemouth Dorset BH4 9DR 01202 761420 01202 762158 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) Drumconner Houses Limited (Bournemouth) Helen Margaret Campbell CRH (N) - Care Home With Nursing 35 Category(ies) of OP - Old age (35) registration, with number of places PD - Physical disability (6) PD(E) - Physical dis - over 65 (4) Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No more than 25 service users in need of nursing care may be accommodated. 2. A maximum of 4 service users in the category PD(E) and 6 in the category PD may be accommodated at any one time. These service users may require either nursing or non-nursing services. Date of last inspection 7 February 2005 Brief Description of the Service: Drumconner cares for up to 35 people in an attractive period house. It is set back from the busy main road that runs between Westbourne shopping area and the town centre of Bournemouth. The home is suurounded by an attractive garden and some parking is available. The home is on 3 floors with a passenger lift between the ground and the first, and a stair lift and several stairs leading to the 2nd floor. There is a variety of aids and adaptations around the building to allow residents to move about more independently. There are 27 single rooms, fifteen of which have en suite facilities. The remaining 4 rooms are all doubles with en suites. There are additional communal toilets and bathrooms around the home. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 5 and a quarter hours and was one of the two anticipated inspections of the year. The 2 requirements made at the last inspection were followed up to see the progress made towards meeting them. The Inspector looked around some of the building and a number of records were inspected. The matron, 1 member of staff and 2 visitors were spoken to. Half of the inspection was spent talking in depth with 6 residents to get a real feel for what it was like to live at Drumconner. At the time of the visit 29 people were living at the home, 19 receiving nursing care, 10 for residential care. Three were under the age of 65. What the service does well:
Drumconner aims to provide a family atmosphere and does so successfully in a house decorated and furnished in a homely way. One resident described the home as ‘free and easy, the way I like it’ and said that life there was ‘very agreeable.’ Others talked about ‘having no worries.’ The home is well organised and the care and contentment of residents is at the heart of the way the home is run. Information about Drumconner is available for prospective residents to help them decide if the home is right for them and the home carries out pre admission assessments to ensure that only people whose needs can be met are offered places at the home. The and feel and matron and her staff have developed good relationships with the residents this results in a supportive and caring environment in which the residents secure and comfortable. Staff were described as ‘kind, friendly, helpful cheery.’ Residents are well cared for and treated with respect and dignity. Care plans and notes are thorough and regularly updated to make sure that staff know how to care for the residents living at the home. Care and nursing staff are supported in caring for residents by community health professionals and the complimentary therapist employed at the home. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 6 Visitors are made welcome at the home and are treated as ‘part of the family.’ Residents are able to have visitors whenever they like and to make decisions as to how they live their lives. Meals are varied and planned around the likes and dislikes of residents. Meal needs and preferences are always taken into account and mealtime arrangements are flexible enough to accommodate individual preferences and residents’ social activities. The complaints and quality assurance procedures reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home is well maintained, comfortable and safe for the residents living there and anyone visiting. The home is kept clean and smells pleasant. Sufficient nursing and care staff are employed to meet the current needs of residents. What has improved since the last inspection? What they could do better:
The home is always looking to improve the service they deliver at the home. Recently they have been looking at the environment and are about to start replacing carpets throughout the home. I asked residents if they could think of anything the home could do better for them and none could think of anything. One resident said that they ‘would not want it to change too far from what it is at present’ as it is so good. After someone from the home has carried out a pre admission assessment the home needs to confirm in writing that the home is able to meet the potential residents’ needs to give them the necessary reassurance that the home is right for them.
Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 7 It would be good if more care staff had an NVQ level 2 qualification in care. This would make care staff more knowledgeable about the job they do and potentially improve the quality of care delivered to residents at the home. The Department of Health gives a target of 50 of all care staff at the home to have this qualification by 2005 and the home is not on target to achieve this. The home carry out surveys of residents views every year and also asks other people that visit the home what they think in order to improve services for the residents. It would be good if the home would pull all the responses together and write a report about what they have found. 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. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 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 Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 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, 3, 4 and 5. 6 is not applicable to this home. Information provided about the home and a good admissions procedure enables prospective residents to make informed decisions about admission to the home and ensures that only service users whose needs can be met by the home are offered places there. The home does not assure prospective residents in writing that their needs can be met. EVIDENCE: The Statement of Purpose and Service User Guide contain all the information required about the home and its facilities. These documents are well written and informative and give a good indication about what a prospective resident can expect from the home. Files of recently admitted residents showed that prior to people moving to the home their needs are fully assessed by a senior member of staff from the home. The person is given the opportunity to visit the home as are their representatives. The residents spoken to all talked about how they had come to move into the home. One had had a family member live there before and so knew the home well from when they used to visit, another was
Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 10 recommended by their GP and had come to look around with their spouse and another had been found the home by a friend. Resident talked of how ‘fortunate’ they were to be there. The home offers respite care and trial periods to residents giving people time to make this very important decision. Whilst the home clearly gathers all the information they need to decide if they can provide care for a prospective resident this assessed ability to care is not confirmed to the prospective resident in writing. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 11 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 and 10 There is an excellent care planning system in place to make sure that staff have the information they need to meet the needs of the residents. The health needs of the residents are also well met with evidence of good support from community health professionals. Residents confirmed that they felt treated with respect and that their right to privacy was upheld. EVIDENCE: Residents said that they were well looked after ‘they are here to look after you and my god they do!’ ‘They couldn’t look after you better.’ I asked one resident who was about to have a bath if the staff were gentle ‘Ooh they are that’ she said. Care plans seen were of a high standard. They flowed from the assessments made by the home, were easy to read, to the point and informative about the needs of the resident and how the home was to meet their needs. All information contained in the care plans was relevant and up to date with plans being reviewed monthly. Both day and night care plans are in place – which is excellent. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 12 One file showed how much a resident had changed from the time she had been assessed, of how her care plan had had to be altered and how other professionals had been engaged to carry out further assessments. Risk assessments are also in place for residents that also result in action plans being developed to minimise any risks identified. Accidents are recorded and analysed and feed into the updating of care plans. Daily notes support and evidence the delivery of care to residents. These are comprehensive and give a good picture of the daily lives of residents, the care that is delivered to them by staff in the home and by visiting community health professionals. The home also has a complimentary therapist who visits the home twice a week and who provides, amongst other things, reflexology, massage and counselling to residents. This is paid for by the home and is free of charge to residents. Residents thought this was excellent. Residents confirmed that they were treated with dignity and their privacy respected by staff always knocking on doors, being polite and courteous; ‘they are good like that.’ Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 13 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) 13, 14 and 15 Residents’ lives are enriched by the high degree of choice they are able to exercise in their daily lives at the home. The meals in this home are very good offering both choice and variety and are served in a pleasant environment. EVIDENCE: Friends and relatives are made welcome at the home and any restrictions would only be at the request of residents themselves. The matron confirmed that people can visit at any time ‘ no appointment necessary’ ‘it’s no difference here day or night.’ Residents and visitors spoken to said that visitors were always made welcome. One visitor talked of how she came and had lunch with her husband on most days and of how when they had visitors from abroad the home made the library available to them as a place to meet and provided them with refreshments. The visitors’ book confirmed the number and range of visitors to the home. Nutrition assessments and plans are in place for residents as well as information about what people like to eat. Menus are based around the known likes and dislikes of the residents. Residents are offered meal choices the day before. The meal served on the day of inspection was roast chicken or fishcakes with a range of vegetables. As vegetables are served separately residents are in control of what they have
Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 14 and how much. The home has a ‘pudding trolley’ from which residents can choose from a range of hot and cold puddings anything they like for dessert. Afternoon cakes are home made. All residents praised the food ‘ plenty of it!’ and ‘varied’ ‘they always ask you what you want’ ‘excellent food with a reasonable variety.’ One resident talked of how she was embarking on a special diet as advised by the home’s therapist and of how well the kitchen staff were helping her to stick to it. ‘I don’t have to worry that they‘ll remember.’ Residents said they could have meals where it suited them. The home has a pleasant dining room that residents can eat in if they wish. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 15 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 and 18 A system is in place to deal with any complaints that might be made by residents. The home’s adult protection policy and staff training demonstrates the homes commitment to understanding abuse and of protecting residents. EVIDENCE: The home has a complaints policy / procedure that is included in the information given to residents. No complaints have been received by the home since the last inspection or by the Commission. Residents spoken to said that they had nothing to complain about and if they had any concerns they would be confident in bringing them to the attention of staff or the matron. ‘I certainly would!’ ‘If anything goes wrong they’ll say sorry.’ ‘They are receptive to what you’ve got to say.’ They also said that they felt ‘safe.’ The home has an adult protection policy and there is ongoing staff training in this subject at the home. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 16 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) 19,20,23,24,25 and 26. Ongoing investment in the upkeep of the home maintains the comfortable and safe environment for the residents living there and anyone visiting. Bedrooms are well decorated, well furnished and personalised to suit the residents. Adequate facilities are available to meet the number and needs of the people living there. The home is kept clean and smells pleasant thereby making daily life for all in the home more pleasurable. EVIDENCE: The home is well decorated and it is obvious that the management of the home consider that their residents deserve the best that can be provided. The matron talked of how all the carpets in the home were about to be replaced and one room was undergoing extensive refurbishment. Lounges and dining areas are well and comfortably furnished. Quiet areas are available e.g. the library and one lounge where residents can listen to music, entertain guests or just sit quietly.
Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 17 There are a number of communal bathing areas in the home. The majority of rooms have en suite facilities. One resident without an en suite talked of how there were toilets ‘close to hand.’ Aids and adaptations are available throughout the home and some residents with particular needs have their own personal equipment to assist with their independence. Adjustable beds are in place for those who need them. Residents are able to personalise their rooms with furniture and general belongings. There is a passenger lift in the home, enabling easy access between the ground and first floor. A stair lift combined with some stairs lead to the top floor where only the more mobile can live. There are emergency alarm bells throughout the home. The home was clean and there were no unpleasant odours. Suitable facilities and procedures are in place in respect of laundry and the disposal of clinical waste. Gardens are maintained to a high standard. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 and 29 Sufficient nursing and care staff are employed and deployed to ensure that the care needs of residents can be met. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home although not all new staff have got their full Criminal Record Bureau certificates back yet. EVIDENCE: Clear staffing rosters are in place that show who is on duty and when. A qualified nurse is on duty at all times, with 2 on duty on weekday mornings. 4 or 5 health care assistants are on duty between 8am and 8pm and three care assistants are on duty at night. Residents said that they felt there were generally enough staff working at the home, but that there might be times when they had to wait a little when many residents wanted things at the same time. One resident said that she felt that the home ‘choose staff carefully’ and they were all ‘most pleasant.’ The manager talked confidently about the recruitment procedures at the home and was knowledgeable about the recent changes that have come with the introduction of the Protection of Vulnerable Adults list. Well-ordered files are kept that demonstrate the recruitment process in action. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 19 Criminal record bureau certificate / Protection of Vulnerable Adult list applications are made for all staff and where these are not yet returned staff are well supervised. The home employs some of workers from abroad. It was clear from the files that the home was gathering the right sort of information about people’s rights to work in the country and any restrictions on that work. More care staff are becoming interested in studying for the NVQ level 2 in care. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 25 and 38 The matron leads her staff by example to ensure that residents receive a consistently high quality of care. The home is well organised and the care and contentment of residents is at the heart of the daily management and running of the home. Staff fire training records do not demonstrate that residents would be as safe as they could be in the event of a fire breaking out. EVIDENCE: The home is managed by Helen Campbell who is an experienced nurse and manager. Ms Campbell has a hands on approach to her job and this has a positive impact on the home in that she leads staff by example and residents know her well. Ms Campbell has a designated deputy and it is always clear who is in charge at any time in the home. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 21 One member of staff talked of what a good place it was to work and that they always had the things they needed to do their job. The home has recently started to carry out their annual quality assurance survey to find out more what people think about the home. Once the survey is complete a report needs to be written based on the analysis of the results of the survey. This report can then be circulated to any interested parties. The Proprietor and general manager of the company that owns the home regularly visit and reports are made of some of these visits as required by law. The matron spoke highly of the way in which the company supported her and of how they supported the ongoing improvement agenda at the home. All records were available as requested. An up to date insurance certificate was on display along with Drumconner’s registration certificate. The home keeps some money belonging to residents and a good system is in place. Clear records are kept of expenditure and balances along with receipts. A number were sampled and found to accord with the details in the records. Fire records were in place and internal checks are being carried out and an external company carries out quarterly checks of the fire equipment. Fire training records for staff did not show that all staff, both day and night, had had fire training at the required intervals. Staff did not sign to say that they had attended training or had taken part in fire drills. Accident records and accident analyses were looked at. Some accident records were excellently completed in that they were clear about how staff came across accidents. Ideally all records would contain information such as e.g. ‘heard a bang’; ‘heard a patient fall’ ‘said he banged his head’ ‘called by other resident’ ‘responded to call bell’ etc. Analysis of such records would provide the home with important information as to the effectiveness of the emergency systems in operation and of any further measures that could be put in place to minimise risks to residents. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 22 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 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x x 2 Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 23 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 4 Regulation 14 Requirement The registered peson must confirm in writing to the resident that havng regard to the assessment the care home is suitable for the purpose of meeting their needs in respect of health and welfare. The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care at the home. Staff fire training must take place at the required intervals i.e. 3 months for night staff and 6 months for day staff and records be kept. Timescale for action 1 July 05 2. 24 33 1 September 05 1 July 05 3. 38 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 28 38 Good Practice Recommendations It is recommended that 50 of all care staff have a qualifcation at NVQ level 2 in care or equivalent by 2005. It is recommended that fire records are kept in such as way as to be able to tell at a glance when fire training is
D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 24 Drumconner due and when it has been completed, with staff signing to confirm their attendance. Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole Dorset 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 Drumconner D55 S20451 Drumconner V228409 180505 Stage 4.doc Version 1.30 Page 26 - 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!
