Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 03/05/05 for Dunnington Lodge Nursing Home

Also see our care home review for Dunnington Lodge Nursing Home for more information

This inspection was carried out on 3rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The quality of care provided by the staff is good. Residents said the food was lovely and most enjoyable. The home has good staffing levels.

What has improved since the last inspection?

The home has obtained two new hoists which assist the staff when moving and handling residents.

What the care home could do better:

The bathroom areas should have new hoists fitted , all areas of the home would benefit from redecoration. More detailed care plans need to be in place.

CARE HOMES FOR OLDER PEOPLE Dunnington Lodge Nursing Home 34 Church Street Dunnington York YO19 3PW Lead Inspector Jo Bell Unannounced 3 May 2005 09:30 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. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dunnington Lodge Nursing Home Address 34 Church Street, Dunnington, York, YO19 5PW 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) 01904 448676 Mr Richard Hugh Richardson Care home with nursing 19 Category(ies) of TI Terminally ill (4), OP Old age (4) registration, with number of places Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2005 Brief Description of the Service: Dunnington Lodge is a large period building situated in the village of Dunnington on the outskirts of York. It can provide care for up to 19 service users that may require nursing care. It is also registered to care for service users at the end of their lives and service users needing respite care. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 3rd May 2005, this lasted for five hours. The manager was not available at the inspection and the proprietor was spoken with briefly. The nurse in charge assisted when necessary. The residents spoken with felt the standard of care was good and the food was enjoyable. Some of the policies and procedures were not available for inspection and these will be assessed at subsequent inspections. What the service does well: What has improved since the last inspection? 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. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 6 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 Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 7 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) No standards were assessed. EVIDENCE: The statement of purpose was not available for inspection and the home does not offer intermediate care, therefore none of these standards were assessed. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 8 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, & 10 Residents were happy with the care provided, however more detailed care plans need to be in place to identify all the needs of residents. EVIDENCE: Two residents’ care plans were case tracked, one resident who had come into the home on respite had risk assessments in place for the prevention of pressure sores, the use of ‘cot sides’ and a lifting assessment. An initial assessment had taken place which has detailed information. This lady was noted as having a poor appetite, the care plan is for a diabetic and vegetarian diet and does not mention the poor appetite. The only other care plan in place is for personal hygiene needs. The weight and height has not been taken or recorded and no nutritional assessment is in place. A running evaluation of the two care plans takes place but no overall review of the care provided. This would be beneficial as the issues surrounding the poor appetite could be dealt with and managed appropriately. A lady had been admitted under the terminal illness/critical care category, an initial assessment had been carried out which contained relevant information. It was briefly discussed that the symptom control for pain was an issue and the fact that this person may be prone to pressure sores, however the waterlow score for the prevention of pressure sores had been completed but the Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 9 medication area was not completed. It was evident that this person was on steroids and controlled drugs as evidenced in the medication chart. Comments in the progress and evaluation sheet said that pressure sores were noticed on the right upper thigh, which were dry with small black areas. No care plan was in place regarding the treatment of pressure sores and no measurements or wound chart had been completed to ensure the correct treatment would be given. Again, comments in the progress and evaluation stated the resident complained of a lot of pain and abdominal pain. No care plan was in place for this or a pain assessment tool. No nutritional assessment was in place, and funeral arrangements were not discussed, however it was felt this information should be obtained especially if a resident is in the home for palliative care. A discussion took place with the nurse in charge regarding the use of care plans. Generally the manager of the home completed care plans, however it was felt this should be reviewed. An audit of the care plans should take place. The accident book in the home was not available for inspection, however the nurse in charge said there had been very few accidents. The CSCI have only received a small number of regulation 37s regarding accidents or injuries. When speaking with the residents they said that if they want the chiropodist or optician this can be arranged. The local GP is involved with the home and discussions with the surgery and pharmacist were observed throughout the inspection via the telephone. Privacy and dignity were maintained in the home, residents said that staff treat them well and it was evident through observation and discussion that staff had a good rapport with these residents. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 10 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) 12,13,14 & 15 Residents enjoy the activities on offer and friends and relatives can visit at anytime. The food is good and residents have a choice in day to day activities. EVIDENCE: Residents in the lounge said that they enjoy activities on a Monday and Wednesday afternoon; one carer who is responsible for activities discussed the range of activities provided. These included dominoes, cards, trips around Dunnington, pub trips and entertainment in the home. An activities folder is kept which highlights the activities and the residents who participate in them. It was suggested that the activities resource pack from Age Concern would be beneficial to expand the range of activities provided. In the lounge newspapers, television and music were available, and staff said they will chat with residents on an afternoon whilst giving residents their afternoon drink and snack. Two residents said they were waiting to be taken out by their relatives in the afternoon, they said visitors were welcomed at any time, staff confirmed this. The home does not have a visitors book which needs to be in place to ensure the home knows who is in the building if an emergency occurs. One visitor was observed chatting to his relative, and the mobile phone was given to a resident to take a call from a friend. Four residents spoken with said they could get up and go to bed when they chose. On an evening staff ask the residents who would like to go to bed. The Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 11 residents in the lounge said they usually watch television for a while and then go to bed quite early through choice. At lunchtime food was observed being eaten, one lady said the food was lovely and the dining room had material table cloths and napkins with glasses for juice on each table. Residents were observed exercising independence. Most residents seemed to enjoy their food. Staff were seen to offer an alternative dessert to one resident who did not like what was on the menu. The chef was spoken with and the kitchen was inspected. Plenty of fresh fruit and vegetables were available and the menu ran on a four week rolling programme. All food was stored and dated correctly. It was identified that residents do not know what food they are having prior to sitting down at the table. Three residents in the lounge said they would like to know what was for lunch and tea. This was discussed with the nurse in charge , a menu should be available for the residents to view. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 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 & 18 Residents are encouraged to discuss any complaints with the home. Residents legal rights are not protected. EVIDENCE: Residents stated they were happy to discuss any issues with the manager or nurse in charge. No complaint shave been made direct to the CSCI. The home has a complaints procedure, but this was not available for inspection. A general discussion took place in the lounge with residents regarding the voting system (the general election was on 5th May 2005). One resident said she always does a postal vote, however a further four residents said they would like to vote but did not know how to as they were in this home. This was discussed with the nurse in charge who said she would telephone the proprietor to find out. The inspector was in the office with the nurse in charge when the proprietor was contacted, the response was that it was none of the CSCI’s business how civic rights are maintained. As the manager was on holiday it was difficult to clarify this situation. However the residents did not have an understanding of how to exercise their civic rights, this must be addressed. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 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) 21 The number of bathrooms is sufficient, the manual hoist in the downstairs bathroom is not adequate EVIDENCE: An issue regarding a triple room has previously been discussed, the requirements from the previous inspection remain inside the required timescale and therefore will be assessed at the next inspection. The bathrooms were inspected and the downstairs bathroom should have a replacement hoist (supporting piece only). The seat of the hoist is fine but the support pieces underneath are corroded. One member of staff said she felt this manual lift was unsafe if a resident started to slip down the seat. Residents spoken with said the amount of bathrooms was fine but sometimes manouvering the hoists was a problem. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 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 Staffing levels and skill mix of staff in the home is very good. EVIDENCE: Residents said that there were always enough staff available. Call bells were answered promptly and staff were observed chatting with residents in the afternoon. Staff spoken with said the staffing levels were good which contributed to a high staff morale. Many staff have been with the home for many years and staff had a good rapport with all the residents. The off duty was inspected and confirmed that there was one qualified staff and four care staff on duty during the day, with one qualified staff and one care staff on duty overnight. There are currently15 residents occupying the home. NVQ Level 2/3 information was not available, and training records were not accessible. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 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) EVIDENCE: The manager was on annual leave and therefore these standard were not assessed on this occasion. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 16 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 x 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 1 COMPLAINTS AND PROTECTION x x 1 x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 1 x x x x x x x x x Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 17 NA 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. 2. Standard OP7 OP7 Regulation 15 15 Requirement When a need is identified a care plan must be produced Details of the wishes of service users relating to funeral arrangements must be documented Care plans must be reviewed on a monthly basis A copy of the menu must be made available to service users Service users must be made aware of how to exercise their civic rights The supports on the ambu lift bath hoist downstairs must be replaced Timescale for action 3rd June 2005 3rd June 2005 3rd June 2005 3rd June 3rd June 2005 3rd July 2005 3. 4. 5. 6. 7. OP7 OP15 OP17 OOP21 15 12 12 16 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 OP8 OP13 Good Practice Recommendations Nutritional assessments should take place on each service user A visitors book should be made available J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 18 Dunnington Lodge Nursing Home 4. Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross York YO32 9GZ 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 Dunnington Lodge Nursing Home J53-J03 S28000 Dunnington Lodge V223058 030505 Stage 4.doc Version 1.30 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. 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!