Inspection on 19/01/06 for Dunelm Nursing Home

This inspection was carried out on 19th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dunelm Nursing Home 26/04/07

Dunelm Nursing Home 28/07/05

Dunelm Nursing Home 28/02/05

Dunelm Nursing Home 06/10/04

Dunelm Nursing Home 19/03/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Dunelm Nursing Home Grove Road Chadwell Heath Romford Essex RM6 4XJ Lead Inspector Jackie Date Unannounced Inspection 19 & 26 January 2006 10:00 th th Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 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 Dunelm Nursing Home DS0000025952.V278607.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 Adults 18-65. 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. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dunelm Nursing Home Address Grove Road Chadwell Heath Romford Essex RM6 4XJ 0208 597 0429 0208 559 0938 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) Redbridge Community Housing Limited [RCHL] Mrs Margaret Lutchmiah Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: Dunelm is a 12-place care home that provides nursing care for adults with learning disabilities. It is one of a number of homes run by RCHL, a not-forprofit organisation. The home was in the grounds of a hospital but this has now been closed and a residential estate has been built. Most of the residents have profound learning disabilities and additional physical disabilities. Residents have little or no verbal communication skills, and limited ability to make decisions about their lives. The home was purpose-built and the ground floor is accessible to wheelchair users throughout. The first floor has an office and staff area. The ground floor has two units each with five bedrooms (one shared) and a large lounge/dining area. The kitchen is between the two units. At present 11 people live at the home. Bedrooms are decorated and personalised, according to the residents likes. Some of the residents attend day services. The home has 2 minibuses and residents go out quite a lot. Activities and physiotherapy are provided in the home. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted for about five hours and took place during the morning and early afternoon. A second visit was made the following week to talk to the manager and to see some further records. It was the second of the two inspections that each home must have during the inspection year. During the two visits all of the key standards have been checked. The manager, staff, two relatives and residents were spoken to. All of the rooms in the house were seen and care and other records were checked. The main purpose of this visit was to monitor the progress of the requirements from the previous inspection. What the service does well: What has improved since the last inspection? What they could do better: Systems need to be in place to ensure that significant incidents are reported to the Commission. There are three requirements from this inspection that are related to recruitment and staff records both of which are dealt with by the head office. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 6 The organisation has been addressing these requirements and they will be checked by a further visit to the head office. 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. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Residents and their representatives now have a written and costed contract/statement of terms and conditions and will therefore be clear about what they are entitled to. EVIDENCE: The residents have a contract between themselves and the Housing Association/provider. Previous inspections have required that the organisation must provide a fully costed contract/statement of terms and conditions to each resident. These have now been developed and include information about individual financial arrangements. The contracts were available at the home and relatives will be asked to sign them at a liaison meeting at the beginning of March. This means that there will be clear information available about the service that will be provided to individual residents. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Residents’ plans focus on their individual needs and abilities and contain detailed information so that staff can meet their needs. EVIDENCE: Each resident has a care plan. These are very detailed and give clear information about each persons strengths, needs, likes and dislikes. For example “likes music, sensory trips, food”, dislikes “ anyone touching her hands or feet, getting up early”. Health-care plans are also in place and these detail healthcare and nursing needs. The degree to which residents can be involved in the development of the plan is very limited due to their profound learning and communication difficulties. Each resident has a daily log and the staff record details of what the person has done, what care has been provided and how the individual has been. Residents have a key worker and also a named nurse. The care plans are reviewed and relatives are invited to these reviews. Some of the reviews were overdue due to relatives not being available but are scheduled. In one case a relative had said to go ahead with the review and to give him feedback. Staff have also been attending daycentre reviews. Information about residents’ needs is comprehensive and Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 10 is kept up to date and therefore gives staff the information that they need to support each individual and to meet their needs. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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 The residents are supported to take part in activities, to be part of the local community and to celebrate special occasions and milestones in their lives. This exceeds minimum standards. Residents are supported to keep in contact with their relatives. EVIDENCE: The residents all have profound disabilities and very high support needs. They are extremely dependent on staff. Some of the residents attend local day centres and others are supported to access activities by the staff team. One of the residents has a one-to-one worker to support her in activities. The residents go out a lot during the week. This includes shopping, bowling, swimming, cinema, and hydrotherapy. The home has the use of two adapted vehicles and a driver/handyman is employed. Residents go out to places of interest in the community or out for lunch. On the day of the inspection two of the residents went out for a belated birthday lunch. The sensory room in the home has been refurbished and new equipment purchased. It includes a ball pool, bubble tubes, music and other sensory equipment. Staff said that most Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 12 of the residents really enjoy using this room. In addition every two weeks an organisation visits with additional sensory equipment. An aromatherapist visits every two weeks and some of the residents have aromatherapy sessions. Residents are taken to different places to worship as required. This includes the church, the mosque and the temple. Special occasions are always celebrated at the home and family and friends are invited. Recently there was a big Christmas party and one of the relatives acted as Father Christmas. There have also been big parties for one residents 40th birthday and another resident’s 60th birthday. The staff team are to be commended for the range of community and social activities offered to the residents and for their ongoing efforts to extend these further. This exceeds minimum standards. Several families and relatives are involved with the home and “ the friends of Dunelm” has been set up for some time. Fundraising and social activities are organised by them. As previously stated there is a liaison meeting with relatives at the beginning of March. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Residents receive personal care that meets their individual needs and preferences. Care is taken to ensure that residents are nicely and appropriately dressed and this exceeds minimum standards Residents receive good quality health care. EVIDENCE: The residents all require a lot of support with their personal care and details of the help that they need and how they prefer to be supported are in their support plans. For example “offer a bath or shower”, “ wash hair twice a week”. The staff team also make a lot of effort to ensure that residents are appropriately dressed especially for special occasions and celebrations. New clothing had been purchased for Christmas and birthday celebrations and photographs showed the effort that had been put into this. One key worker travels to an area where there are a lot of shops selling Asian clothing to ensure that a resident has culturally appropriate clothes. This exceeds minimum standards All of the residents are registered with a local doctor and specialist help is received when needed. Staff take residents to all of their medical appointments. Residents’ files have details of nursing assessments and health care issues and show that residents have regular access to health care Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 14 professionals. Records are kept of medical appointments and these show that residents have checks from the optician, dentist and when needed the chiropodist. A physiotherapist visits the home twice each week and provides physiotherapy to the residents that need this. The family of one resident said that he was very well looked after and as a result of this had that he had not been in hospital for about 18 months, which was very good. Another resident has a special mattress on top of his normal mattress as he has painful joints and arthritis. All of these show that care is taken to make sure that residents are well looked after and kept as healthy as possible. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Staff are aware of issues of abuse and work to protect residents from abuse but not all of the staff have received training in this area. EVIDENCE: The organisation has produced a detailed adult protection policy that tells staff the actions to take in the event of abuse/suspected abuse being discovered. The residents are very vulnerable and the previous inspection required that all staff must receive adult protection training. Some staff received this training in November. In view of this the timescale for the remainder of the staff to receive training has been extended. This will ensure that they are all aware of what constitutes abuse, how to recognise abuse and what to do in the event of a suspicion or allegation of abuse. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 28, 29 and 30 The residents live in a clean and comfortable home that has suitable aids and adaptations for their needs. The staff team continue to work to make the environment as homely as possible and are to be commended for their efforts. EVIDENCE: Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 17 The house is near to the local shops and bus routes. There are two units in the home and the communal space in each consists of a large lounge/diner. There is also a kitchen, laundry room and a garden. The ground floor of the building is accessible for wheelchair users throughout. Two residents share a large bedroom and the rest have single rooms. Special beds had been purchased for the residents that need these. The bedrooms are decorated and furnished to meet individual needs and likes. A lot of effort has been spent in making bedrooms comfortable and homely. They have nice curtains, bedding and soft furnishings. In addition most rooms now have sensory equipment and mobiles. One resident changed bedrooms and in consultation with his family the new room is having a “complete makeover”. The communal areas are large and quite difficult to make homely. However the staff team continue to put a lot of effort into improving the environment with soft furnishings, flowers and plants and photographs and make it is homely and comfortable as possible. There are enough baths, showers and toilets and these are adapted to meet the residents’ needs. New flooring has been ordered for the bathrooms and this will improve their appearance. At the time of the inspection the home was clean and free from offensive odours. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 Staff are competent and receive the necessary training to meet residents’ current needs and to provide a good service for them. The organisation has taken action to address concerns about the robustness of recruitment practice and this will be tested via a further inspection of recruitment files at the organisations head office. EVIDENCE: The staff team comprises nurses and support workers. Shift leaders are all qualified nurses. The staff team have experience of working with people with learning disabilities and staff on duty said that they had received training since they started work in the home. This has included epilepsy, manual handling, LDAF (Learning Disabilities Award Framework) and NVQ. They were clear about their duties and responsibilities towards the residents and have the skills to meet the residents’ needs. During last year an inspection of a sample of personnel files at the organisations head office showed that not all of the required checks on staff could be demonstrated to have taken place. This was discussed with the organisation and the Commission received an action plan of how this was going to be addressed. A further visit to head office will take place to confirm that all of the necessary action has been taken and that the recruitment procedure is Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 19 robust. The requirements with regard to recruitment will remain until this visit has taken place. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41, 42 & 43 The home provides a safe environment for the residents. The organisation has taken action to address concerns about staff records and this will be tested via a further inspection of recruitment files at the organisations head office. EVIDENCE: During last year an inspection of a sample of personnel files at the organisations head office showed that not all of the required staff records were maintained. This was discussed with the organisation and the Commission received an action plan of how this was going to be addressed. A further visit to head office will take place to confirm that all of the necessary action has been taken and that the necessary records are kept. The requirements with regard to records will remain until this visit has taken place. Records showed that there had been incidents that had affected the well-being and safety of residents. Although the appropriate action had been taken at the Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 21 time and the incidents recorded, the Commission had not been notified. It is required that the Commission is notified without delay of any event which adversely affects the well being or safety of any resident. This is to ensure that the Commission can monitor serious events at the home and the action taken. The manager was provided with copies of the specific regulation and of a specimen reporting format. All of the necessary health and safety checks are carried out to the building and the vehicles and records are kept of these checks. A safe environment is provided for the residents. The manager has prepared a costed business development plan for the service as required by previous inspections. Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 X X X X X X 2 3 3 Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 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 YA23 Regulation 13 Requirement All staff must receive Adult Protection training. (Previous timescale of 31/12/05 not met) The registered persons are required to ensure that their recruitment procedure is robust and in line with regulation. The registered persons are required to maintain records for the protection of service users in line with Schedule 2 of the Care Homes Regulations 2001. For new staff before appointment. The registered persons are required to maintain records for the protection of service users in line with Schedule 2 of the Care Homes Regulations 2001. For existing staff. Any significant incident or event must be reported to a Commission without delay and confirmed in writing. Timescale for action 30/04/06 2 YA34 19 31/03/06 3 YA41 17 31/03/06 4 YA41 17 31/03/06 5 YA41 37 28/02/06 Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dunelm Nursing Home DS0000025952.V278607.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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. 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