CARE HOMES FOR OLDER PEOPLE
Drumconner 20 Poole Road Bournemouth Dorset BH4 9DR Lead Inspector
Debra Jones Unannounced Inspection 18th October 2005 09:40 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 Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 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. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Drumconner Address 20 Poole Road Bournemouth Dorset BH4 9DR 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) 01202 761420 01202 762158 sarah@watkins19.wanadoo.co.uk Drumconner Homes Limited (Bournemouth) Helen Margaret Campbell Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (6), Physical disability of places over 65 years of age (4) Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 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. No more than 25 service users in need of nursing care may be accommodated. 18th May 2005 2. Date of last inspection 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 surrounded 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 are 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 DS0000020451.V259934.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 2 and a half hours and was the second of the two anticipated inspections of the year. The 3 requirements and two recommendations made at the last inspection were followed up to see if there had been any progress made towards meeting them. During the inspection a number of records were looked at. The Inspector walked around the building and met with residents who spoke positively about the home ‘It’s very nice.’ The deputy matron assisted the Inspector in her work. Prior to the inspection the Commission asked the home to send out a number of comment cards to get people’s views of the home. 37 were returned. 16 were from residents, 4 were from Health and Social Care Professionals, 3 from Care Managers, 6 from General Practitioners, and 11 from relatives. The majority returned were very positive about the staff and service provided at the home. Two GP’s commented ‘……always very helpful, clean, clients / patients well cared for’ ‘……Seems to offer a high standard of care’ A solicitor said ‘(I am) absolutely (satisfied with the overall care provided) I have no complaints for my clients.’ Relatives commented ‘Friendly, professional, helpful staff. I feel they offer a high level of service to residents and relatives.’ ‘The building was not built as a nursing home but it has been modified as far as possible. In these circumstance the staff are doing a good job.’ On the day of inspection 29 residents were living at the home. 17 of them were in need of nursing care. What the service does well:
Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 6 Drumconner aims to provide a family atmosphere and does so successfully in a house decorated and furnished in a homely way. Medication is well managed and residents can have confidence that staff look after their medicines well and administer them properly. Stimulating social activities are available at the home, which residents can join in with as they wish. Sufficient nursing and care staff are employed to meet the current needs of residents. The home has continued to function at the high standard that has been noted at previous inspections. The home is well on the way to total compliance with the standards set by the Department of Health. What has improved since the last inspection? What they could do better:
Regular training is important for care staff to ensure that they are competent to care for residents. Staff also need to have refresher training in areas such as moving and handling. A record must be made of any training they undertake. Files inspected did not indicate that this was happening. 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 carries out a survey 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. Once a year the home has to pull all the responses together and write a report about what they have found.
Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 7 In order that residents in the home are as safe as they should be staff need to have regular fire training. Day staff must be trained 6 monthly and any staff working at night must be trained 3 monthly. Currently training is not being carried out at the required intervals. 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 DS0000020451.V259934.R01.S.doc Version 5.0 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 Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 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): 4. (Standards 1,3 and 5 were met at the last inspection. 6 does not apply.) Following needs assessments carried out by the home Drumconner assures prospective residents in writing that their needs can be met. EVIDENCE: Files of recently admitted residents contained letters to the resident from the home confirming that, following the pre admission assessment of the prospective resident, the home considered themselves able to meet their needs. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 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): 9. (Standards 7 8 and 10 were met at the last inspection.) The medication at this home is well managed promoting the good health and well being of residents. EVIDENCE: A robust system for the ordering, administering and recording of medication is in place at the home. Medication at Drumconner is only administered by the qualified staff who are all confident in carrying out this task. Medication records sampled were up to date and properly completed. Where it is recommended that 2 staff sign to confirm balances of certain medicines this was seen to be happening. Staff record the date, and where appropriate the time, that medicines are opened/ brought into use. Medicines and dressings were tidily stored in appropriate places e.g. medication cupboards, trolleys and in the fridge. The maximum and minimum temperature of the fridge used to store medication is correctly monitored. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 11 The home is in the process of making arrangements for the disposal of medicines that have not been used through a licensed waste disposal company. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 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. (Standards 13, 14 and 15 were met at the last inspection.) Stimulating social activities are available in the home and residents are able to make choices as to whether they take part in them or spend their days in pursuit of individual interests. EVIDENCE: The home employs an activities organiser who works 4 days a week. The activities organiser runs regular activities in the home such as bingo and also arranges for entertainers to come to the home. There are also opportunities for residents to go on outings, as groups or individuals. Residents can choose whether to join in with organised events or not. Records demonstrate that residents are always encouraged to join in but their wishes are respected if they don’t want to. Residents have radios and televisions as they wish. On the ground floor there is a lounge with a TV, another where there is usually classical music playing and another quiet room – ‘the library’. The home employs a complimentary therapist who provides massages and reflexology to residents and staff.
Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 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): (Standards 16 and 18 were met at the last inspection). These standards were not assessed on this occasion. EVIDENCE: Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 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): (Standards 19, 20, 23, 24, 25 and 26 were met at the last inspection). These standards were not assessed on this occasion. EVIDENCE: Whilst these standards were not inspected on this occasion it was noted that a number of carpets have been replaced in the home – both in residents’ bedrooms and in communal areas e.g. corridors. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 and 30. (Standard 29 was met at the last inspection). Sufficient nursing and care staff are employed and deployed for the current needs and numbers of residents living at the home. Not all staff have received the training required to ensure that they are competent to do their jobs. 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. 5 health care assistants are on duty between 8am and 8pm and three care assistants are on duty at night. This staffing level is appropriate for the number of people in nursing need currently living at the home. On the day of inspection 29 residents were living at the home. 17 of them were in need of nursing care. Care staff are supported in their work by domestic, laundry, administrative, housekeeping, gardening and kitchen staff. At present 3 of the 18 care staff have NVQ level 2 in care. More care staff are interested in studying for the NVQ level 2 in care and it is anticipated that they will be able to start to study for the qualification in the near future. The home owns a number of training videos which are available to staff. Staff are given time to watch these video and complete the questionnaires accompanying them. Certificates are issued for their successful completion.
Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 16 Records are held of training that staff undertake. The files that were sampled showed that some staff had not had training this year, and in some cases had not had their mandatory refresher training e.g. moving and handling. The Inspector was told that some training had taken place and there may be a problem with the keeping of records rather than in the delivery of training. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 and 38 (Standard 35 was met at the last inspection) The matron leads her staff by example to ensure that residents receive a consistently high quality of care. Whilst there is nothing to demonstrate that the home is not run in the best interests of residents the quality assurance system has not been fully implemented yet this year. 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 in the home.
Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 18 At the last inspection in May 2005 it was noted that the home had recently started to carry out their annual quality assurance survey to find out more what people think about the home. Staff at this inspection were not aware of a report based on the analysis of the results of the survey having been produced or circulated to any interested parties. Fire training records for staff did not show that all staff, both day and night, had had fire training at the required intervals i.e. day staff every six months and night staff every three. Staff who had had attended training or had taken part in fire drills are now signing to confirm their attendance. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 3 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x x x x 2 Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP24 Regulation 33 Requirement The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care at the home. (timescale of 1/9/05 not met) 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 of 1/7/05 not met) Staff must have training appropriate to the work they perform. Timescale for action 01/04/06 2. OP38 23 01/11/05 3 OP30 18 01/04/06 Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP28 OP38 Good Practice Recommendations It is recommended that 50 of all care staff have a qualification 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 due and when it has been completed. Drumconner DS0000020451.V259934.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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