CARE HOMES FOR OLDER PEOPLE
Dunmore 30 Courtenay Road Newton Abbot Devon TQ12 1HE Lead Inspector
Mark Sharman Unannounced Inspection 16th November 2005 13:15p 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.V266370.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. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 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 Mrs 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.V266370.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2/8/05 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. The home is located on a hill, and many of the rooms have magnificent views over the town centre, surrounding countryside and Dartmoor. Nearly all of the bedrooms are single rooms, and there are also three double rooms (normally used as single). The bedrooms are arranged over four floors and there is a shaft lift. 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 also a lawn, but this is on a slope and therefore inaccessible for most service users. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection and about three and a half hours were spent at the home. Some time was spent with the manager, and a small sample of records was inspected. Most of the residents were unable to express their opinions about the home due to their level of confusion, but the few that are more able were consulted. Four of the staff and three visiting relatives were also consulted. All of the communal areas of the home and about half of the bedrooms were seen. What the service does well: What has improved since the last inspection?
No requirement was made at the last inspection. The recommendations made then have been adopted, including increasing staff cover at tea time with the addition of a domestic staff member. The manager said that work has continued with fitting valves to the hot water supply to washbasins, thereby reducing the risk of scalds. This is an ongoing programme. Dunmore DS0000047043.V266370.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. Dunmore DS0000047043.V266370.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 Dunmore DS0000047043.V266370.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): None of these Standards was considered on this occasion (but see the last inspection report). EVIDENCE: Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 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): 8, 9 and 10. The residents’ health care needs are being fully met and there is a safe system for handling their medication. Residents are treated with great respect. EVIDENCE: All of the residents are registered with a general practitioner, and there is access to the usual health services. A domiciliary dentist is used, there is a visiting chiropodist and residents have an annual eye test. The home has contact with the specialist mental health team for older people. Specialist pressure care equipment was in evidence around the home. The drugs trolley and a sample of medication administration recording sheets were inspected. The staff who administer medication have had professional external training, and some of these training certificates were seen. Currently one resident is self-medicating. The more capable residents and three visiting relatives were all highly complimentary about the attitude of the staff. Staff on duty treated the residents in a caring and respectful way, and residents confirmed that due consideration is given to their privacy and dignity. All bedrooms are being used as single rooms. Some residents have their own telephone, and for others cordless telephones are available.
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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 and 15. Residents are offered a good range of appropriate activities and entertainment, and the standard of the catering is commendable. EVIDENCE: The manager has a monthly budget for activities and entertainment. The programme of activities for November was displayed on the notice board, showing that there was an activity on offer on many days. Regular events include at least weekly musical entertainment (several different entertainers are used), twice weekly exercise sessions, and a fortnightly crafts/quiz/reminiscence session (run professionally). One of these sessions had taken place on the morning of this inspection and some residents had made Christmas decorations. The regular cook has worked at the home for over ten years and produces a very high standard of meals. The residents and visitors commented on how good the food is (one of the visitors said she had eaten several meals at the home). The main option for lunch was gammon with Lyonnaise potatoes and fresh vegetables, followed by fresh fruit salad. A hot quiche was on offer for tea, and cakes made on the day. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 12 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 Residents/their relatives have confidence that any complaint would be listened to and resolved if possible. EVIDENCE: It is clear that the residents have confidence in the manager and they were sure that any complaint would be dealt with if possible. 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. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 13 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): 24 and 26 The home was very clean, tidy and fresh, and residents are provided with comfortable bedrooms. EVIDENCE: This was an unannounced inspection and all parts of the home were as clean and tidy as at previous announced inspections, including bathrooms and toilets. No unpleasant odour was detected. The laundry is sited in an outbuilding and is adequately equipped, although the vinyl flooring is worn and should be replaced. About half of the bedrooms were seen and these were adequately furnished and equipped. All but four of the bedrooms have en suite toilet facilities. All bedroom doors have locks, and sufficiently capable residents may have a key if they wish. Staff have a master key. Due to their level of confusion most residents are not provided with a lockable storage space. Measures have been taken to prevent residents from falling out of upstairs windows, but the security of the windows in rooms 24 and 25 is questionable and must be checked.
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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 and 28. Staffing arrangements are adequate to meet the needs of current residents, and the target for trained staff has been met. EVIDENCE: Following the last inspection there is now an extra worker on duty during the early evening to carry out domestic tasks. The staff group is stable and staff turnover has been low. The manager and senior staff have worked at the home for many years. The staff are cheerful and work well together, and staff consulted said they enjoy working at the home. The manager has a training budget, and there was evidence (certificates) of recent training for staff in emergency first aid, food hygiene and fire training. About half of the staff have achieved NVQ level 2 or above. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 16 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 and 33. The home has a very experienced, competent and caring manager, and is run in the best interests of the residents. EVIDENCE: The manager has worked at the home for many years and is very highly thought of by residents and staff alike. She has consistently undertaken training to update her knowledge and has achieved the registered managers award (certificate seen). She is a hands-on manager as well as an administrator, and by working alongside the staff knows what is going on. Staff consulted said that she is approachable. A staff meeting is held regularly, and there are daily hand-over meetings to assist communication of information between staff. The home has a quality management policy which includes an annual residents/relatives questionnaire, the responses to which are analysed. This year’s questionnaire responses were available, and one consequence has been
Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 17 the arranging of more trips out for residents. There is also an annual development plan for this year. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 18 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x x x x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 x x x x x Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP38 Regulation 13 Requirement The security of the windows in bedrooms 24 and 25 must be checked to prevent the risk of falls. Timescale for action 02/12/05 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 OP26 Good Practice Recommendations The vinyl flooring in the laundry should be replaced. Dunmore DS0000047043.V266370.R01.S.doc Version 5.0 Page 20 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
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