Inspection on 02/08/05 for Dunmore

This inspection was carried out on 2nd August 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

Dunmore 16/08/06

Dunmore 16/11/05

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 Announced 2 August 2005 nd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Dunmore Address 30 Courtenay Road, Newton Abbot, Devon, TQ12 1HE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01626 352470 01626 365365 Buckland Care Limited Fiona Elizabeth Snow Care Home 28 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (26) Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4/1/05 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 down a slope and therefore inaccessible for most service users. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A pre-inspection questionnaire completed by the manager was received before the inspection, and two comment cards from relatives were also received. This was an announced inspection which lasted about six and a half hours. Ten of the residents and four staff were spoken to, and a sample of care records was examined. Two relatives who were visiting were also spoken to. All of the communal rooms and some of the bedrooms were seen. What the service does well: What has improved since the last inspection? No requirement was made following the last inspection. One recommendation was made then that the temperature of the hot water supply to the residents’ washbasins should be regulated, since very hot water could present a risk to some residents (particularly those who are confused). This work has not yet been started, but the manager said that a start will be made in the next week (in order of priority of risk). Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 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 D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. Standard 6 is inapplicable. The registered manager is well aware of the importance of obtaining an accurate assessment of a possible new resident’s needs, and no-one moves into the home unless a prior assessment has been carried out (except in the rare event of an emergency admission). EVIDENCE: A sample of files was inspected in respect of residents admitted in the last few months. These included Care Management assessments/care plans in cases where a local authority care manager was involved, and in every case the file contained the home’s own assessment form completed. One of the files included a hospital shared assessment form, where the resident had been admitted to the home from hospital. The manager said that whenever practicable she visits a potential new resident herself in the person’s own home or in hospital. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 9. The residents’ health care and personal care needs are described in an individual care plan, and these needs are being well met. There is a safe system for handling residents’ medication. EVIDENCE: A sample of care plans was examined. A bought-in format (Standex System) is used, and these covered residents’ health and social care needs. There was evidence that the care plans are being reviewed, although not every month in every case. Due to their level of confusion many of the residents are unable to participate in their care plan, but a close relative (if any) should be asked to sign the care plan instead. All of the residents are registered with a general practitioner, and there is access to the usual health services. A domiciliary dentist is used, and there is a visiting chiropodist. Residents have an annual eye test. The home has good contact with the specialist mental health team for older people. For example there was discussion about one resident who was recently seen by the team’s psychiatrist, and who is visited by a community psychiatric nurse. This resident is also provided with a special pressure mattress and a hoist in his bedroom. One resident currently is self-medicating. The drugs trolley was inspected, and the medication administration recording sheets. The staff who administer Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 10 medication have had professional external training, and some of their certificates were seen. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 14. Residents are offered a range of appropriate activities and entertainment, and are able to maintain contact with relatives and friends. EVIDENCE: There is a monthly budget for activities and entertainment, and the programme is displayed on a notice board each month. Regular events include at least weekly musical entertainment (several different entertainers are used), twice weekly exercise sessions, and a monthly crafts/quiz/reminiscence session (run professionally). The monthly session took place on the morning of the inspection, and several of the residents said that they enjoyed it. The person running the session had also spent time with a few residents individually in their own rooms, and one of them showed the inspector some craft items she had made that morning. Residents also said how much they enjoyed the musical entertainers who visit the home. Many residents receive regular visitors, and some had visitors during the inspection. Two of these were spoken to, and both said they were very satisfied with the care provided to their relatives in the home. The husband of one resident visits her in the home every day. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. Residents are confident that any complaint would be taken seriously, and there are satisfactory arrangements to ensure that they are protected from abuse. EVIDENCE: Although many of the residents are significantly confused and unable to express their opinions, those who are more capable said they were sure that any complaint would be dealt with. 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 the staff spoken to were aware of). With regard to personal finances the manager said that all current residents have support from relatives or professional advisers. Most of them have an attorney under the power of attorney procedure. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 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 standard(s) 19 and 26. The home is well maintained, providing an attractive and comfortable environment, and was clean and tidy. EVIDENCE: A good impression is created on entering the home, and the communal areas are well decorated and carpeted and comfortably furnished. There is level access onto a patio near the front door, provided with garden furniture, and this area contained a lot of attractive flowers. Unfortunately this is not a secure area, so that residents who are confused need staff supervision to access it. The bedrooms which were inspected were well decorated and furnished. There was no unpleasant odour. There are infection control procedures in place. The laundry is sited in an outbuilding, and a new commercial washing machine (with sluicing function) has recently been installed. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. The staff team is appropriately experienced and trained and the staffing levels are generally adequate, although staffing some evenings needs to be increased. Staff morale is high and the home’s recruitment practice is satisfactory. EVIDENCE: The staff group is stable and most staff have worked at the home for a number of years. The manager and senior staff have worked there for many years. All of the residents and relatives spoken to said that the staff were competent and very caring. Concern about the number of staff on duty in the evenings has been expressed by two relatives, and this should now be reviewed. Many of the residents are confused, and they are accommodated over four floors. Accordingly a total of three staff on duty in the evening, when many residents need help to get ready for bed, is regarded as insufficient. (On some evenings there is a fourth staff member on duty). Some files of the newer staff were inspected, and all of these contained a satisfactory Criminal Records Bureau disclosure and two written references. Over half of the staff have attained NVQ level 2 (or above), and staff on duty said they felt the training opportunities are good. The manager has a training budget. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 and 38. The home has an experienced and competent manager, and is run in the best interests of the residents. The arrangements for ensuring their health and safety are satisfactory. EVIDENCE: The manager has worked at the home for many years and has now obtained the registered managers award, although the certificate was not yet available. She has a lot of contact with residents and their relatives, thus gaining feedback on their progress and problems, and they spoke highly of her. Residents’ financial interests are taken care of, mainly by relatives or professional advisers. Many residents have appointed an attorney. With regard to health and safety issues, the latest report (13/12/04) by an environmental health officer stated “satisfactory” (with certain recommendations). Many staff training certificates were available in respect of manual handling, emergency first aid and food hygiene, and professional fire Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 16 training will take place in a few weeks. Hazardous substances are kept secure and the manager said that all upstairs windows are restricted (a few were checked at this inspection). Water samples are checked periodically in respect of legionella, and documentation was seen. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 x x 3 Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 18 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation 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. 2. 3. Refer to Standard 27 33 38 Good Practice Recommendations To keep staffing levels under review and to maintain four staff on duty during the early evening until 8 pm. To conduct a satisfaction survey among the residents and/or their relatives (if more appropriate). To make contact with the environmental health officer in respect of his recommendation about risk assessments contained in his report of 13/12/04. Dunmore D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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 D54-D07 S47043 Dunmore V231708 020805 Stage 4.doc Version 1.40 Page 20 - 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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