Inspection on 16/08/06 for Dunmore

This inspection was carried out on 16th August 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

Dunmore 16/11/05

Dunmore 02/08/05

Dunmore 04/01/05

Dunmore 13/07/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Dunmore 30 Courtenay Road Newton Abbot Devon TQ12 1HE Lead Inspector Mark Sharman Unannounced Inspection 16th August 2006 10:00 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 Dunmore DS0000047043.V293256.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. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dunmore Address 30 Courtenay Road Newton Abbot Devon TQ12 1HE 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) 01626 352470 01626 365365 Buckland Care Limited Fiona Elizabeth Snow Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (28) Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/11/05 Brief Description of the Service: Dunmore is registered as a care home providing personal care for up to twenty eight people aged 65 and over, who may also suffer from dementia and/or physical disability. In fact the home principally cares for people who suffer from dementia. Currently the weekly fees range from £363 to £500. The home is located on a hill, and many of the rooms have magnificent views over the town, the surrounding countryside and Dartmoor. All but three of the bedrooms are single rooms, and the three double rooms are also normally used for single occupation. The bedrooms are arranged over four floors, and there is a shaft lift and assisted baths and hoists for people with reduced mobility. There are two comfortable lounges and a separate dining room, all on the ground floor. Outside the front door there is a patio area with garden furniture, and there is ample car parking on the road outside. There is a lawn, but this is on a slope and therefore inaccessible for most service users. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home. As part of the inspection process a pre-inspection questionnaire was provided by the manager together with other documents. A completed comment card was received from one resident (most are significantly confused), eight comment cards were received from relatives and one from a community nurse. Several of the residents (including the more able), four visiting relatives/friends and five of the staff were spoken with during the visit. A sample of the home’s records was inspected. All of the communal parts of the home and several of the bedrooms were seen during the day. What the service does well: What has improved since the last inspection? Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 6 The one requirement made at the last inspection visit relating to the security of two upstairs windows has been dealt with. The only recommendation made then has also been dealt with, namely the renewal of the flooring in the laundry room. Some other environmental improvements have also been made. Three bedrooms have recently been refurbished, and two air conditioning units have been installed in the conservatory/dining room (which gets hot in sunny weather). A chilled water dispenser has been installed on a trial basis, which may encourage some residents to drink more. The manager has now started to write a monthly newsletter, which will help to keep residents and their relatives/friends aware of forthcoming events etc. 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. Dunmore DS0000047043.V293256.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 Dunmore DS0000047043.V293256.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is inapplicable. Quality in this outcome area is good. The registered manager knows that a prior assessment of a potential new resident’s needs is essential, and no-one moves into the home unless this has been done (except in the rare event of an emergency admission). EVIDENCE: A sample (three) of the residents’ individual files was examined, and in all these cases an assessment of needs form had been completed by the manager in line with the Standard. Assessments/care plans written by local authority care managers are obtained (and are in evidence) in cases where a new resident is financially supported by a local authority. The manager said that whenever practicable she visits a potential new resident herself in the person’s own home or in hospital. Indeed she had arranged to visit and assess a lady in her own home on the morning of this unannounced inspection visit. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9 and 10. Quality in this outcome area is good. The residents’ needs are described in individual care plans and are being well met, and they feel they are treated with respect. There is a safe system for handling their medication. EVIDENCE: Three of the residents’ care records were examined. A commercial care plan system (Standex System) is used, and these care plans covered the residents’ health and social care needs. There was a section in each care plan which recorded the social activities which the resident had participated in, and a section containing notes of visits/contacts by general practitioners and district nurses. The care plans examined had been reviewed regularly. All of the residents are registered with a general practitioner. A domiciliary dentist is used and there is also a visiting chiropodist and optician. The home is in contact when necessary with the specialist mental health team for older people, and one resident had been seen recently by that team’s psychiatrist. Residents are weighed monthly (some records were seen), and to facilitate this special sit-on scales have been bought (seen by the inspector). A community nurse commented (via a comment card) that “the staff here are very professional and are held in high regard by the members of our community Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 10 nursing team”. A community nurse visited the home to attend to one of the residents in the afternoon. The drugs trolley and a sample of medication administration recording sheets and the controlled drugs register were inspected. There is a separate lockable refrigerator for storing medicines. The senior staff administer medication to the residents and they have had professional external training (training certificates were seen). The manager said that further refresher training has been arranged for three of them in the near future. The more capable residents and four visiting relatives/friends were all highly complimentary about the attitude of the staff. They treated the residents with respect and were careful to preserve their dignity (for example by ensuring that toilet doors were closed). All of the bedrooms are being used as single rooms. Some residents have their own telephone, and the home has three cordless telephones which can be used by residents (in private if required). Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 11 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, 13, 14 and 15. Quality in this outcome area is excellent. Residents are offered a good range of appropriate activities and entertainment on a very frequent basis. They are able to maintain contact with their relatives and friends. The catering arrangements are good. EVIDENCE: The residents able to express their opinions were very happy with the activities and entertainment on offer, and one resident’s daughter wrote that “the entertainment is excellent”. There is a substantial monthly budget for this purpose. The programme of activities for the month was displayed on a notice board in the hall and was very full. Several different musical entertainers are employed regularly. Musical entertainment is laid on at least weekly (often more), and including one day each weekend. Two organisations providing activities such as crafts/quizzes/reminiscence sessions are employed. There are twice weekly exercise sessions to music (professionally run), one of which took place on the afternoon of this visit. A regular communion service is held in the home. There are bus outings which can take about a dozen residents each Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 12 time, and some of the residents said they look forward to these very much. Two of the more able residents said they go out for short walks together near the home (unaccompanied by staff). A relative commented on the “lovely atmosphere” at the recent summer garden party and appreciated the fact that all the senior staff were there. The residents who were consulted said they were happy with the meals provided and confirmed that alternatives were available. It was pointed out to the manager that one resident’s relative felt that more care should be taken to find out what her likes and dislikes are. The menu for the day is displayed on a notice board. The manager said that a chilled water dispenser for the residents’ use was to be installed the following week, which will hopefully encourage some to drink more. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Residents and their relatives are confident that any complaint would be taken seriously, and there are satisfactory arrangements to ensure that they are protected from abuse. EVIDENCE: There is clear evidence that the residents/relatives have confidence in the manager. All were complimentary about her, and the residents and one resident’s daughter said that she is always very willing to listen and will respond to concerns expressed. There is an appropriate complaint procedure which was displayed on a notice board. No complaint has been received by the Commission for Social Care Inspection since the last inspection. The home has policies and procedures on adult protection issues, including a whistle blowing policy (which staff spoken to were aware of). With regard to personal finances the manager said that she does not administer the personal money of any of the current residents. They are supported in this respect by relatives or professional advisers and some have appointed an attorney under the Power of Attorney procedure. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. Quality in this outcome area is excellent. The home is always well maintained, providing an attractive and comfortable environment. It was very clean tidy and fresh, and residents have comfortable spacious bedrooms. EVIDENCE: This was an unannounced inspection and all parts of the home which were inspected were as clean and tidy as at previous announced inspections (including bathrooms and toilets). No unpleasant odour was detected. Feedback from residents and relatives is that the home is always kept clean and tidy. The windows in two bedrooms have been made more secure, as required at the last inspection. Redecoration and improvement is ongoing and two bedrooms have recently been completely redecorated (another was being done on the day of this visit). Some carpets have been replaced, including in the hallway. Two air conditioning units have just been installed in the conservatory/dining room. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 15 The laundry is sited in an outbuilding and is now equipped with a new washing machine (with sluicing function), and the flooring has been replaced. All of the residents’ clothing looked well laundered and they were smartly presented. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good and staff morale is high. The staffing arrangements are satisfactory, and the staff team is experienced and appropriately trained. The home’s recruitment practice is thorough. EVIDENCE: The more able residents (and most of the relatives who commented) felt that enough staff are deployed to meet their needs. One relative felt that there should be more staff on duty at night (there are two staff awake on duty). The staff rota was inspected. The manager is happy with current staff levels, and said that she has the discretion to put extra staff on duty if she thinks it necessary. The manager and senior carers have worked at the home for many years. The staff on duty were cheerful and worked well together, and they said they enjoy working at the home. The files of the two newest staff members were examined and were found to be satisfactory. Each contained two written references and a satisfactory Criminal Records Bureau disclosure. (There was an enhanced disclosure for the new cook when a standard disclosure would probably suffice, but this thorough approach is commendable). The manager has a staff training budget. More than 50 of the care staff have now achieved NVQ level 2 or equivalent and one of the senior carers has recently achieved level 3. Training this year has included professional fire training and training in food hygiene and basic first aid. A large number of certificates of attendance were seen. Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is excellent. The home has a very experienced, competent and caring manager, and is run in the best interests of the residents. The arrangements in respect of health and safety are satisfactory. EVIDENCE: The manager has worked at the home for many years and is very highly thought of by residents and staff. The relatives seen during this visit were also very complimentary about her attitude. She has the registered managers award, and has regularly undertaken training to update her knowledge (for example refresher medication training recently). She is a hands-on manager as well as an administrator and often works alongside the staff. Staff consulted said that she is approachable. The home has a quality management policy which includes a residents/relatives questionnaire. Some recent responses from relatives were Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 18 seen. Staff hand-over meetings take place early each morning, at which notes are taken (recent ones were seen). The manager has started to write a monthly newsletter which is displayed on the notice board in the hall (seen). The company’s general manager always makes a monthly visit to the home, and sends a copy of her report to the manager and to the Commission for Social Care Inspection. There is an annual development plan for this year, which was available. With regard to health and safety issues, the requirement made in respect of the security of two upstairs windows has been dealt with. The manager said that the hot water supply to most of the washbasins has now been regulated for temperature. A lot of safety checks of the home’s equipment have been carried out this year, including water quality. The manager has a staff training budget, and three staff have obtained NVQs this year. Staff received professional fire training in March this year (certificate of attendance was seen). Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x 3 x 4 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 4 4 3 x 3 x x 3 Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 20 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 Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Dunmore DS0000047043.V293256.R01.S.doc Version 5.2 Page 22 - 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!