Inspection on 03/10/05 for Dunkeld

This inspection was carried out on 3rd October 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 27/04/05

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 Cheshire CW8 1PN Lead Inspector Sue Dolley Announced Inspection 3rd October 2005 09:15 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 Dunkeld DS0000006594.V253286.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. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dunkeld Address 94 School Lane Hartford Northwich Cheshire CW8 1PN 01606 74542 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) Mrs Barbara Glenys Harrison Mrs Barbara Glenys Harrison Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th April 2005 Brief Description of the Service: Dunkeld is situated in Hartford close to Northwich and is in easy 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 DS0000006594.V253286.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An announced inspection took place on 3rd October 2005 over a period of 6 and a half 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? Dunkeld continues to provide good quality care to the very evident satisfaction of residents and their supporters. Since the last inspection there has been some redecoration work to the toilets, a bathroom and the hall stairs and landing. New light fittings have been installed to the hall to make the area brighter and a new fire door to the exterior of the building has been fitted by choice to renew and improve the facilities in keeping with the rest of the premises. Staff members have continued to make progress with NVQ training and in June 2005 one member of staff progressed to senior care status. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5. Prospective residents and their carers are provided with useful information about Dunkeld to enable them to make an informed choice about accepting a placement at the home. The assessment process is thorough and well managed to ensure that the people, who live at Dunkeld, and their relatives, know what to expect and that their needs will be met. Prospective service users and their carers are encouraged to visit the home and to meet with staff and residents to view the facilities and to assess the suitability of the home. EVIDENCE: Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 9 The home’s brochure provides useful information for prospective and existing residents. Prospective residents are encouraged to visit the home before deciding to move in on a trial basis. The proprietor/manager liaises with social services representatives; residents and their family supporters to gather information for an initial assessment and to determine if needs can met. Each resident is given a copy of their statement of terms and conditions at the point of moving into the home. Examples of these were seen and provided clear concise information about the care and services covered by the fee, any additional charges and the terms and conditions of occupancy. Each placement is initially for a trial period of six weeks and there is a four -week period of notice. A sample of three residents care files were checked and they contained very thorough assessments. These had been completed within a short period after admission when staff had had the opportunity to identify all daily living needs. Following admission there was evidence of good liaison between residents, their supporters and staff within the home to ensure continuity of care. Care plans were detailed and the daily progress notes provided evidence of holistic care and support. Care records are well organised and contain up to date information. They contained evidence of close monitoring and observation by staff to ensure all physical, social and emotional needs were met. The care records carefully reflected any changes, and any decline or improvements were evident to the reader and detailed any action to be taken as a result. Dunkeld DS0000006594.V253286.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): 11 The staff group gather information about resident’s wishes concerning terminal care and arrangements after death and liaise to ensure wishes and needs are identified and met. EVIDENCE: Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 11 A copy of The National Care Homes Association procedure,’ Dying and Bereavement’, is available at the home for staff to refer to for guidance. Some of the service users wishes concerning terminal care and arrangements after death have been discussed with them or are known to family members. Information concerning service user’s wishes about terminal care and arrangements after death is gathered by the home over a period of time and recorded when known. The privacy and dignity of service users who are dying is maintained at all times and service users are able to spend their final days in their own rooms, surrounded by their personal belongings, unless there are strong medical reasons to prevent this. The manager recognises and has documented the need to provide care and support to resident’s family members and to staff who are involved in providing the care to residents in the last stages of life. All parties are provided with support, respect and sensitivity. Several relatives of past services users continue their contact with the home in appreciation of care given. They make social visits to the home to keep contact with other residents and with staff and some provide practical assistance and support on day trips out etc. Dunkeld DS0000006594.V253286.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): 12,15. A variety of planned and social activities inside the home and within the community enable residents to satisfy their social, religious and recreational interests. Staff members ensure residents are made aware of news and events outside the home and residents remain alert, interested and involved. Food provided is of a high standard and meals are imaginative and varied with ample choice to satisfy resident’s preferences and dietary needs. EVIDENCE: An activities folder was seen and contained information and photographs of the activities undertaken. Trips out had been enjoyed by residents, staff and volunteer escorts . Since the last inspection there had been trips to Shugborough House, Chester Zoo, Delamere Forest and Roker Park. Recently there had been a trip to Llandudno including a trip on the Great Orme tramway. In conversation residents recalled these outings and said how much they had enjoyed them. They also spoke of the many events organised within the home including a Strawberry Fayre and the forthcoming Halloween events planned. Several of the residents continue their involvement with local churches and community groups and every effort is made to ensure residents keep their interests and remain involved in activities important to them. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 13 Recently there was a religious service in the home in memory of a past resident and a harvest festival service was also held. Residents were entirely satisfied with the level of activity organised and praised staff for their efforts in organising activities and for keeping them informed and aware of events locally and generally. The proprietor/manager is a qualified caterer and undertakes the role of cook. Sample menus show 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 how much 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 2005/2006 and a certificate regarding this is displayed within the home. This is the fifth consecutive year that the home has received the highest level of award. The residents spoken with were all agreed that these awards had been well deserved. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 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 the following standard(s): 16,17 Residents and their supporters are provided with information about accessing available advocacy services to assist residents to protect and promote their legal rights. EVIDENCE: No complaints have been received either by the home or CSCI since the last inspection. A number of cards of thanks were seen and reflected appreciation for the high level of care and support provided to residents and their families. The management and staff are approachable and have time to listen to residents and to respond to residents needs and wishes. Residents were complimentary about Dunkeld and the staff. They said they felt lucky to be at Dunkeld and had no cause for complaint. They said the home was always clean and warm and several residents added, ‘You couldn’t get better than this’. Residents described the staff as respectful and friendly. They described the meals provided as ‘ lovely’ and said everyone within the home always had lots of attention and laughs. 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 and for Age Concern should residents wish to raise concerns or seek advice. Dunkeld can provide residents and their supporters with details of how to access the services of an advocate should this be necessary. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 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 the following standard(s): 20,21,22,23,24,25. As on previous inspections, Dunkeld is very well maintained, clean and hygienic. It is decorated and furnished to a good standard providing a comfortable and homely environment for residents. EVIDENCE: The communal lounges and dining room are well decorated and furnished to provide a homely, comfortable environment. The sun lounge overlooks a secluded and colourful garden area to the rear of the property. Residents have been encouraged to personalise their bedrooms and many rooms contain residents’ own possessions and furniture. There are differently sized rooms and different layout options to suit individual needs. The hall stairs and landing and some toilet and bathroom areas have been freshly decorated and new light fittings provided to the hallway have made the hallway area much brighter. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 16 There are sufficient bathrooms and toilets within the premises. Residents are individually assessed for mobility equipment and are appropriately referred to the occupational and physiotherapy departments for any necessary equipment to aid mobility. Some mobility aids and equipment are provided and available for communal use. The home is well maintained and there is a high standard of cleanliness throughout the premises. The heating and lighting is well maintained and the premises are sufficiently warm and ventilated. Recently a new fire exit door was fitted to access outdoors. The manager independently decided upon this change to bring about improvement and to update facilities. The building complies with the requirements of the local fire service. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 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 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): 28 Staff members are well trained, experienced and competent and as a result residents feel well cared for, safe and secure. EVIDENCE: The proprietor/manager lives on site for the majority of the time, working within the home and sleeping over most nights per week. Currently, there are five senior care staff. All senior staff members have been trained and are authorised to administer medication. Four of these staff have achieved NVQ level 2 and 1 has achieved NVQ level 3. NVQ level training is progressing and staff members are keen and enthusiastic to undertake relevant training to inform the work that they do. There is a high emphasis on induction training and on observational supervision to ensure competence. Good training records are kept. Training is provided at a pace to suit the learner and to ensure the safety of service users. Within the last twelve months staff members have received training on various subjects including, continence, dementia care, basic food hygiene, fire safety and the use of fire extinguishers, and training from the Inland Revenue regarding taxation. Adult protection training is to be arranged within the near future. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,37 The registered manager/proprietor is qualified competent and experienced. She has an open management style and communicates a clear sense of direction and leadership. An open, positive and inclusive atmosphere has been encouraged within the home and both residents and staff feel supported and valued. EVIDENCE: The proprietor/manager’s previous profession was catering prior to opening “Dunkeld”, and she holds City and Guilds qualifications in Advanced Management in Care and in Catering. She also holds NNEB and an award from the Royal Institute of Public Health and Hygiene. She has many years experience in managing care for older people. The processes of managing the home are open and transparent and the proprietor/manager communicates a clear sense of direction and leadership. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 19 The home is small and the proprietor/manager and staff work together closely with service users to create a homely atmosphere in which service users and their relatives feel part of an extended family. Staff members are alert to changes, cheerful and friendly. They were seen to relate well to each other and to those they were caring for. The staff team are confident in their delivery of care and support. They are approachable, and able to demonstrate that they have a good knowledge of residents. Visitors were warmly welcomed into the home and one volunteer/visitor during the inspection praised the home and staff for the high level of care and support provided. She described the staff as respectful and friendly and said they provide prompt care and attention. She described the home as lovely and clean and warm and said residents relatives known to her felt relieved and assured by the good quality care provided. She felt that staff members make great efforts to ensure that residents are involved in conversation. She said residents are kept involved and that the home provides a high level of activity and different opportunities for residents and their family members. Records are kept of all transactions entered into by the registered person and suitable accounting and financial procedures are adopted to ensure there is effective and efficient management of the business. Insurance cover was in place. It was evident that residents have access to their records and to information held about them by the home, as well as opportunities to help maintain their personal records. Records were secure, up to date, well maintained and accurate. Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X X 3 3 3 3 3 3 X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 X X 3 X Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation 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. Refer to Standard Good Practice Recommendations Dunkeld DS0000006594.V253286.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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. 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