Inspection on 31/10/06 for Dunkeld

This inspection was carried out on 31st October 2006.

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 03/10/05

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 Unannounced Inspection 31st October 2006 09:00 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.V319864.R01.S.doc Version 5.2 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.V319864.R01.S.doc Version 5.2 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.V319864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 3rd October 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. The fees for Dunkeld currently range from £348.00 to £370.00 per week. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 31st October 2006 and lasted 6 hours ad 30 minutes. The visit was carried out by, Sue Dolley, a Regulatory Inspector. This visit was just one part of the inspection. Before the visit the home owner/manager was also asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents were also spoken with and they gave their views about the service. 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. Since the last site visit there has been a great deal of redecoration work, which has included the main lounge, main corridor, dining room, sun lounge, rear corridor and four bedrooms. Residents have been involved in helping to choose the new decoration. Staff members have continued to make progress with NVQ training and qualification. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 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.V319864.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessments are completed thoroughly to ensure prospective residents needs, can be met within the care home. Intermediate care is not provided. EVIDENCE: The pre-admission documentation and initial assessments for three recently admitted residents were checked. All care needs had been identified and addressed. The reason for admission was stated and the proprietor/manager and senior staff had liaised closely with prospective residents and their family supporters to gather information for an initial assessment. This action had helped to determine individual needs and the level of support necessary. Each prospective resident and/or their supporters had been encouraged to visit the home to assess suitability, to help them make an informed choice and to meet with staff and residents. Residents spoken with confirmed that they, or their relatives had visited the home prior to them accepting a placement or that they had moved into the home following a personal recommendation. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 9 The assessment documentation provided clear concise information that included important contact information and provided a good medical history. Photographs of the three residents were not available on the files although photographs had been taken and were awaiting processing. Intermediate care is mot provided at Dunkeld and therefore National Minimum Standard does not apply and was not assessed. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health and personal and social needs. Attentive staff members closely monitor the progress of residents, to ensure all needs are met and reviewed and to make appropriate referrals to medical professionals as appropriate to ensure wellbeing. EVIDENCE: The three plans of care checked detailed action to be taken by staff to ensure all aspects of health and personal care needs were met. Risk assessments were conducted appropriately and review information available from social services departments provided evidence of good quality care and support provided, and of a high level of satisfaction from residents and their supporters. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 11 The individual daily progress reports provided detailed information about residents, their care needs and abilities. They carefully reflected the level of care provided and gave detailed information to evidence continuity of care. The initial assessments and care plans were thorough and identified existing and emerging needs. Care needs were clearly explained and appropriate action had been swiftly taken to address needs and to refer to appropriate health professionals. Act had been taken to refer to the hearing clinic, chiropodist and dentist. Details of resident’s medical history provided care staff with useful background information and helped to raise awareness. The outcome of General Practitioner visits and hospital appointments were clearly recorded and assessment reviews had been undertaken frequently. All assessment review notes were thoroughly written and very informative, providing an accurate picture of residents needs and demonstrating a high level of monitoring and care. Longer- term aims were well documented. There was evidence of improvements in continence due to establishing continence routines and the registered manager and staff members had worked well together and made progress to manage some difficult and unexpected behaviour. Advice was given as a small amount of language used in the progress records was inappropriate and in need of adjustment. The care files recorded individual preferences, likes and dislikes and pen profiles described residents well. Five residents spoken with provided very positive comments about the care and support received and described all staff as attentive and friendly. Each of the residents said they felt safe and secure in the home, they said that they had confidence in the staff team and in their abilities. None of the five residents spoken with a length could suggest ways in which the home and care could improve. Residents said ‘The home is so nice’, and ‘The support is very good’. Three residents spoken with together agreed that they would recommend the home to anyone and described the care as excellent. One resident said, ‘The general atmosphere and the company make this a pleasant place to be’. One resident said the home benefits form good management and staff and another resident said ‘Staff want to make us happy and love their jobs’. Samples of three Medication Administration Records were checked. Two were correct. The third indicated that medication had been administered on the morning of the site visit, but had not been signed as given. This omission was immediately corrected. The management of medication has been consistently good at previous site visits and there is a good liaison with local General Practitioners and with the supplying pharmacist who has provided some staff training. Four additional staff members are currently completing a two- part course to enable them to administer medication. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 12 Residents confirmed that they are treated respectfully and that staff members uphold resident’s rights to privacy and dignity. Staff members were heard to address residents with their preferred names. Interaction was friendly, good humoured and courteous and personal care was given in the privacy of resident’s rooms. Care plan information included details about preferred rising and retiring times and about resident’s preferred daily routines. Through induction and initial training, staff members are observed and supervised and receive training to help promote resident’s rights to privacy, dignity, choice and independence. Staff members were observed to spend time talking to individuals and to groups of residents and to have a lively level of communication and good rapport with residents and their visitors. During the site visit the manager and staff were observed to discourage some unacceptable behaviour and the incident was managed respectfully. A resident made positives comments about the staff. The resident explained that staff come to say hello and introduce themselves to everyone at the start of their shift and take the trouble to say goodbye before they leave. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including this service. Staff members enable residents to participate in a wide social activities inside the home and within the community. Food is standard and meals are imaginative and varied with ample choice resident’s preferences and dietary needs. EVIDENCE: Since the last site visit residents had a wide variety of activities. There had been birthday celebrations, communion services, beetle drives, pancake making, bingo, Easter bonnet making, singing, croquet on the lawn, musical events, a garden party, and celebrations for the Queens 80th birthday. There had been community strolls, a picnic, tea tasting and various craft events. Residents spoke about enjoyable trips out to Dunham Massey and Shakley Mere and about a trip on the Manchester Ship Canal. The residents had been involved in a presentation of a cheque to a local charity, had been to the theatre and pursued their own interests, attending local clubs and churches. a visit to variety of of a high to satisfy Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 14 During the site visit, Halloween was being celebrated. Dunkeld had been decorated with pumpkin lanterns and other Halloween decorations. The majority of residents were having great fun taking part in apple bobbing, other residents declined to take part but were happy to observe and watch their friends bobbing for apples hanging from strings. Residents were cheering each other on and laughing as photographs were taken. Throughout the course of the site visit some residents read the newspapers, chatted, completed crosswords individually or in groups or were engaged in knitting Christmas novelties. Staff and residents had been involved in teaching each other to knit. Residents and staff talked about plans for Christmas and the social events listed in the diary. Plans were being made for staff to shop for presents for residents and for residents to go shopping to buy presents and to prepare for Christmas. Every effort is made to ensure residents keep their interests and remain involved in activities important to them. Relatives of residents have been very supportive, have participated in many of the activities and have acted as escorts during trips out when necessary. Family involvement is encouraged and appreciated. 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/manger 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 meals, describing them as excellent. A special Halloween menu had been prepared for the day of the site visit. Vale Royal Borough Council presented Dunkeld with a Platinum Food Safe Award for Catering 2006/2007 and a certificate regarding this is displayed within the home. This is the six consecutive year in which the home has received the highest level of award. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s interests are safeguarded and residents feel confident that any concerns raised would be taken seriously and acted upon. EVIDENCE: No complaints have been received by the home of Commission for Social Care Inspection since the last site visit. 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 relatives and to respond to residents needs and wishes. Residents spoken with were positive and complimentary about the home and the staff and said they had no cause for complaint. Residents are provided with a copy of the complaints procedure when they move into the home, The home’s brochure included the telephone contact numbers of the Commission for Social Care Inspection and for Age Concern should residents wish to raise concerns or seek advice. The staff training records were checked and indicated that three members of care staff had completed adult protection training. It is recommended that adult protection training be provided for all the care staff. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well- maintained clean and pleasant home, which is decorated and furnished to a good standard providing a comfortable and homely environment for residents. EVIDENCE: A tour of the home was undertaken and included the communal lounge and dining areas and several bedrooms. Since the last site visit there has been a great deal of redecoration work, which has included the main lounge, main corridor, dining room, sun lounge, rear corridor and four bedrooms. Residents have been involved in helping to choose the new decoration. Each of the four bedrooms checked had been redecorated to a good standard. One bedroom had been re-carpeted and in a shared room there was a privacy curtain around the sink area. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 17 Everywhere was fresh and clean and rooms had been personalised with resident’s own possessions and furniture. In discussion with residents, positive comments were made about the good standard of cleanliness throughout the home. Dunkeld is well maintained and risk assessments are undertaken to ensure the safety of residents and staff. There are differently sized rooms and different layout options to suit individual needs. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing is generous to ensure staff members have time to spend with residents. There is a well-chosen, loyal and well- trained staff group available to meet the needs of residents. EVIDENCE: Staffing levels are generous to ensure care needs can be met. Throughout each morning there are 3 care staff on duty usually involving one or two seniors plus one domestic. From 2pm there are 3 care staff plus an additional member of staff if there are special activities planned. Two evening staff members are on duty between 4pm and 10pm. During the night between 10pm and 8am there are two night staff on duty, one of which provides a sleep-in duty. The proprietor/manager lives on site for the majority of the time, working within the home and sleeping over most nights per week. In total there are 14 care staff and 3 ancillary staff. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 19 There are, 8 care staff with NVQ level 2 or above and 9 staff hold a current first aid certificate. There is a thorough induction programme for new staff and there is observational supervision to ensure staff competence. Records of staff training are well maintained. Staff members are keen to learn, training is encouraged and a wealth of appropriate training is provided. In addition to NVQ training, in the last twelve months staff members have received training about fire safety in care homes, food safety training, medication and adult protection. One resident in conversation remarked that she thought that the manager was extremely good at choosing staff and also said that she couldn’t speak to highly of carers. Two recruitment files were checked. The recruitment process was evidenced and was thorough. All appropriate recruitment checks had been completed to protect residents. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager/proprietor is qualified competent and experienced. Residents and staff feel safeguarded, supported and valued. EVIDENCE: The registered manager/proprietor’s previous profession was catering prior to opening “Dunkeld”, she holds a City and Guilds qualifications in Advanced Management and Care and in Catering. She also holds a child care qualification, has an award from the Royal Institute of Public Health and Hygiene and has many years experience in managing care for older people. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 21 The processes of managing the home are open and transparent and the proprietor/manager communicates a clear sense of direction and leadership. The home is small and staff work closely with residents to create a supportive atmosphere in which residents and their relatives feel part of an extended family. Staff members are knowledgeable, alert to changes, cheerful and friendly. The staff team are confident in their delivery of care and were observed to relate well to residents and their visitors. Although there is no formal quality assurance tool in use, there is continual discussion with residents and family supporters to ascertain their views and to act upon suggestions. The home is mainly populated as a result of personal recommendations within the local area. 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. Three examples of resident’s money were checked against records kept and all balances were correct with appropriate receipts stored. 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 and contribute to their personal records. The registered manager ensures that risk assessments are carried out and recorded in respect of all safe working practice topics. Equipment within the home had been regularly serviced. The accident records were checked and accidents were thoroughly recorded. The fire policies and procedures manual was checked and provided evidence of satisfactory fire safety checks and training. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 X X X x X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 23 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. 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. 1 Refer to Standard OP18 Good Practice Recommendations Ensure all care staff receive adult protection training to help raise awareness. Dunkeld DS0000006594.V319864.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000006594.V319864.R01.S.doc Version 5.2 Page 25 - 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. 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