Inspection on 27/04/05 for Dunkeld

This inspection was carried out on 27th April 2005.

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

Dunkeld 04/11/08

Dunkeld 31/10/06

Dunkeld 03/10/05

Dunkeld 27/01/05

Dunkeld 13/07/04

Dunkeld 06/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Dunkeld 94 School Lane Hartford Northwich CW8 1PN Lead Inspector Sue Dolley Unannounced 27 April 2005 10:00 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. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dunkeld Address 94 School Lane Hartford Northwich Cheshire CW8 1PN 01606-74542 Not applicable Not applicable Mrs Barbara Glenys Harrison 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) Mrs Barbara Glenys Harrison Care Home 13 Category(ies) of OP - Old Age (13) registration, with number of places Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Dunkeld is registered to provide care to a maximum of 13 service users within the category (OP) old age. Date of last inspection 27th January 2005 Brief Description of the Service: Dunkeld is situated in Hartford close to Northwich and is within walking distance of shops, post office, church and social amenities. The detached premises provide accommodation in nine single bedrooms and two twin rooms on two floors. The upper floor bedrooms can be accessed by the stairs or with the aid of a stair lift. The grounds include ample parking at the front of the property and a secluded garden to the rear.The home provides care for older people. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place on 27th April 2005 over a period of 6 hours to assess if the care home was meeting the residents needs and to check the response to the recommendations made at an earlier inspection. A partial tour of the premises took place and included all communal areas, the bathrooms and toilets What the service does well: What has improved since the last inspection? What they could do better: Many positive comments were received from service users and staff regarding the high standard of care, food and cleanliness within the home. There were no negative comments after long discussions with residents and all were appreciative of the care provided. Residents described the home as happy with attentive friendly staff and could not suggest ways in which the care or home could be improved. They said the staff always had time for them and that they were very satisfied. Several service users said they didn’t think they could get better care elsewhere. Staff members could have better awareness of adult protection procedures. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 6 The manager and staff are aware of this training need and are awaiting training places, which are to be offered by the local Social Services Department in the near future 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. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 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 standard(s) 3 and 6 All residents have their needs assessed prior to admission to the home. The home gathers information from the prospective residents, their relatives, Social Services and health care representatives to ensure assessed needs can be met. The admission process is well managed to ensure residents individual needs can be met. Dunkeld does not provide Intermediate Care. EVIDENCE: The manager confirmed that there were no new residents during the last eighteen months and there were no current vacancies. From checking a sample of existing care files and from previous knowledge of the home there is a history of thorough assessment of residents needs prior to admission. The management and senior care staff organise the collection of assessment documentation and gather all information regarding each potential resident to identify and fully address care needs and to inform care planning. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 9 2 care files of residents were checked and provided full and comprehensive information, clearly stating the reason for each admission. With the assistance of residents and their relatives, pre -admission documentation is completed by Social Services, health care staff and care home staff. Full and comprehensive needs assessment documentation was available. Dunkeld does not provide intermediate care. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 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 standard(s) 7,8,9, and 10 The health and personal care needs of residents are closely monitored and potential health difficulties are promptly addressed by the appropriate health care services. Staff members are courteous and respectful and residents feel their privacy and dignity is protected. EVIDENCE: Each resident has a plan of care to outline their main areas of assessed need. Two care plans were checked and both detailed the action to be taken by care staff to ensure all aspects of health, personal and social care needs were met. The care files are well organised and contain all up to date information. The sample of care files showed that all care needs were reviewed on a monthly basis and more regularly when necessary. Care plans had been drawn up with the involvement of residents and their relatives, with appropriate risk assessments in place. Residents described staff as attentive, kind and thoughtful, and are appreciative of the care provided. Review notes written by Social Services staff showed that care needs were being met in a warm and friendly home. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 11 Through examining the care records, it is clear that care staff ensure that professional advice about the promotion of continence is sought and acted upon. Residents are registered with various General Practitioners of their choice and have access to specialist medical, dental, chiropody and various community health services according to need. There is close liaison with General Practitioners, district nursing staff and other health care professionals to ensure residents health care needs are met. Hospital appointments are kept e.g. the memory clinic and the existence of relevant information ensures that the psychological health of residents is monitored regularly, and that preventative and restorative care is provided. The proprietor/manager and senior care staff administer medication. The supplying pharmacist calls regularly to the home to advise on any medication issues and to provide instruction and training. Medication is supplied to the home in a weekly monitored dosage system. A lockable space is available in the bedrooms of residents who can self-medicate. The medication records were inspected and were well maintained. Medication is appropriately stored. Residents confirmed that staff members are respectful and take care to ensure privacy and dignity. Through induction,staff training and daily supervision and monitoring, staff members are instructed on how to treatresidents with respect at all times. Residents are encouraged to retain their independence and individuality. Staff members ensure residents have time alone, when required, and are free from intrusion and disturbance. Staff members knock on doors prior to gaining permission to enter and residents have easy access to a telephone for use in private. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 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 standard(s) 12,13,14 1nd 15 A variety of planned social activities enable residents to participate within the local community.Awareness of news and events outside the home are promoted. A high level of liaison and communication between residents, relatives and friends and care home staff enable residents to maintain contact with people important to them. Residents are consulted and encouraged to exercise choice and make decisions for themselves. The food is of a high standard and meals are imaginative and varied with ample choice to satisfy residents preferences and dietary needs. EVIDENCE: The activities diary and folder contains a wide range of activities. Some residents had enjoyed a luncheon club meal and others had been out for a country drive. Residents spoke about the Easter celebrations and the Easter Bonnet competition. A special wedding dinner and tea with cake and bucks fizz was held to celebrate the Royal Wedding and everyone received a small floral spray to wear. The Grand National on the same day was also a popular event and was celebrated with strawberries and champagne. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 13 The diary provided details of several birthday celebrations, a beetle drive and attendance at church services and meetings. In March, a live classical music concert was provided in the home. In April, one of the residents played the piano and this had been much enjoyed. During the course of the inspection two WRVS volunteers brought the regular Library Service, which is run in conjunction with Northwich library. Several residents exchanged library books and said how much they appreciated this service. Large print books and story tapes are also available. At Dunkeld the relatives and friends of residents are invited to special events through posters displays in the home. This involvement is apparent by the family atmosphere. Plans are currently underway to organise the annual Strawberry Fayre and this year the residents will to raise funds at this event for The Alzheimer’s Disease Society. Residents said that they are consulted and encouraged to exercise choice and to continue with their interests and social lives outside of the home. Residents confirmed that they enjoy having friends and family at various events within Dunkeld. The proprietor/manager is a qualified caterer and undertakes the role of cook. Sample menus were checked and showed a wide variety of meals. Breakfast times are flexible and individual needs are catered for each day. Lunch is the main meal of the day with a lighter meal provided in the late afternoon. Alternative meals are always available and special therapeutic diets can be provided. Hot and cold drinks are offered throughout the day. Residents said they enjoyed the home cooking and the range of meals provided. Vale Royal Borough Council presented Dunkeld with a Platinum Food Safe Award for Catering 2004/2005 and a certificate regarding this is displayed within the home. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 14 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 Arrangements for responding to residents and relatives concerns are satisfactory. Close liaison between residents,relatives, friends and staff ensures any concerns are talked through and acted upon promptly. Some staff members are waiting for adult protection training. EVIDENCE: No complaints have been received either by the home or CSCI since the last inspection. The management and staff members were approachable and had plenty of time to listen to residents and respond to their needs and wishes. Residents have daily contact with the homes manager/proprietor. Her open management style ensures any concerns are shared and promptly resolved. All the residents spoken to were complimentary about the home and the level of care and support provided, they had no cause for complaint and were very satisfied. Residents are provided with a copy of the complaints procedure when they move into the home. The home’s brochure includes the telephone contact numbers of the Commission for Social Care Inspection, Age Concern etc. should they wish to raise concerns or seek advice. The home follows Cheshire County Council’s adult protection procedures, and copies are available for staff members to refer to. The National Care Homes’ Association policy and procedures manual is also available at the home and provides supplementary information on reporting bad practice. During induction, staff members are trained on how to report bad practice and some staff members have received protection of vulnerable adults training. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 15 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 and 26 As on previous inspections, Dunkeld is very well maintained, clean and hygienic. It is decorated and furnished to a good standard and this helps to create a comfortable and homely environment for their residents. EVIDENCE: The location and layout of the home are suitable for its stated purpose. The premises are well maintained, bright and presented to a high standard. A programme of routine maintenance and renewal of the fabric and decoration of the building was evident. The grounds are kept tidy; there is ample parking space at the front of the building and an attractive garden to the rear of the property is accessible to residents. The building complies with the requirements of the local fire service. The communal areas, bathrooms and toilets are attractively decorated and carpeted to a high standard. Residents confirmed that there are always high standards of cleanliness throughout the home and that everyone takes pride in the environment. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 16 Staff members are familiar with the requirements of Care of Substances Hazardous to Health (COSHH), and a named senior staff member is responsibe for compliance with the COSHH legislation. The infection control policy from the National Care Homes’ Association manual is followed at the home. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 17 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) 27,29, and 30. The home is adequately staffed with employees who are trained, experienced and competent to care for older service users. Staff turnover is low and staff morale is high and this provides continuity of care for service users from a happy staff team. EVIDENCE: The proprietor/manager explained that the staff team had worked flexibly to cover a period of staff leave and absences. A successful recruitment campaign in April 2005 has resulted in several new staff members joining the team to provide additional support and cover. Most staff members are part time and are able to work relief hours. Sufficient domestic staff hours are provided to ensure the home retains a high level of housekeeping. The staffing levels agreed for the home are three staff members on duty each morning until 2pm, followed by two each afternoon until 10.00pm. Plus in the afternoon between 10.00am and 4.00pm one member of domestic staff is employed. Additional staffing hours are provided to meet particular needs and activities. During the night, between 10pm and 8.00am, two staff members are on duty. One of these is a waking member of staff and another provides on call sleep over cover. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 18 The proprietor/ manager lives on site for the majority of the time, working daily within the home and sleeping over mainly five consecutive nights per week followed by a 48-hour break. One member of staff is currently completing NVQ training to level 3 and may be employed as a third senior carer when the training is complete and be allocated additional responsibilities. Discussions with a new member of staff and an existing member of staff confirmed that a thorough induction programme is in place for staff. The documentation available provided detail of the induction training undertaken and of the range of topics covered. Staffing numbers and the skill mix of staff are appropriate to the assessed needs of the service users, the size, layout and purpose of the home. Several staff members spoken with stated they enjoyed working at the home and confirmed that the staff team is happy and contented and that staff morale within the team is high. The proprietor/manager operates a thorough recruitment procedure. The recruitment files of three new members of staff provided evidence of satisfactory written references, identification, First POVA (Protection Of Vulnerable Adult) checks and Criminal Record Bureau checks. The proprietor/manager is committed to providing training opportunities to ensure staff members have the appropriate skills and knowledge to deliver the necessary level of care to service users. Training is provided at a pace to suit the learner and to ensure the safety of service users. There is a wellestablished induction procedure for new staff with checklists to ensure all aspects of the induction training are satisfactorily completed and signed by the proprietor and the employee to indicate that each topic area has been discussed and understood. This includes three days of introduction or more to the home’s policies and procedures with the proprietor/manager before staff members are included in the staffing rota. Staff members then spend three weeks working in a supernumerary capacity alongside experienced members of staff. Collective and individual staff- training records are kept which show that staff training continues to be undertaken after induction. Ongoing training is arranged in first aid, medication administration, fire safety, food hygiene, safer handling, and the promotion of continence etc. Future training is to be accessed regarding the protection of vulnerable adults. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 19 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, 35, 36 and 38 There are good organisation and recording systems in the home and clear lines of accountability which ensures the home is run in the best interests of service users and that they are safeguarded. EVIDENCE: The proprietor/manager has high standards, which are demonstrated to staff and promoted by example on a daily basis. Due to her level of contact with staff, service users, relatives and other supporters she is able to continually check levels of satisfaction. Examples of review notes provided by social service expressed high level of satisfaction from all parties regarding the success of placements within the home. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 20 An official appointee, employed by social services manages the finances of one service user. The home assists with the management of personal allowances for this person. Service users’ finances are generally managed by service users themselves or by their relatives. Some small amounts of money are kept on behalf of service users. A random sample of personal balances and records were checked and were accurately kept along with receipts for purchases made on behalf of service users. The proprietor/manger is in day- to- day control of the home. Supervision is not necessarily formal although the important points of discussions are recorded within a supervision record. Much of the supervision is informal and takes place daily and is ongoing and time is set aside when topics need to be discussed at length. There is a high emphasis on induction, staff training and reviewing of performance. Group staff meetings also incorporate some training and group supervision. The proprietor/registered manager has daily contact with staff and staff practice is closely observed. The staff team discuss issues at their break times and when they come on duty. The proprietor/manager works alongside staff members and is available to provide support together with senior care workers. The proprietor/manager is for the majority of time available and on site, to ensure the smooth running of the home and to support staff throughout the day, evening and night. All staff members have basic training to underpin their care practice and to ensure the safety of service users. Moving and handling training, first aid training and fire safety training is prioritised. Food safety training is provided and it was evident that there is safe storage and disposal of hazardous substances. The fire precautions book was well- maintained and contained details of all necessary fire safety checks and emergency lighting checks. Clear fire safety instructions were provided. Fire drill evacuations had been undertaken and fire safety training records were satisfactorily maintained. There are individual regulators on each water outlet to regulate water temperatures. The proprietor/manager ensures that risk assessments are carried out for all safe working practice topics and ensures that significant findings of the risk assessment are recorded and action is taken to minimise risks. The accident records were checked and were fully and satisfactorily completed. Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 21 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 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 3 x 3 3 x 3 Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 22 No 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 Regulation None Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard None Good Practice Recommendations Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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 Dunkeld F51 F01 S6594 Dunkeld V222141 Stage 4.doc Version 1.30 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. 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!