Inspection on 27/02/06 for Dunraven

This inspection was carried out on 27th February 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

Dunraven 28/11/08

Dunraven 24/10/06

Dunraven 08/08/05

Dunraven 07/12/04

Dunraven 03/08/04

Dunraven 02/03/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Dunraven 12 Bourne Avenue Salisbury Wiltshire SP1 1LP Lead Inspector Thomas Webber Unannounced Inspection 27 February 2006 10:30 th Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 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 Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 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 Adults 18-65. 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. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dunraven Address 12 Bourne Avenue Salisbury Wiltshire SP1 1LP 01722 321055 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 Brigid O`Connor Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (15) Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 15 service users with a Mental Disorder OR with a Mental Disorder, over 65 years of age at any one time. 8th August 2005 Date of last inspection Brief Description of the Service: Dunraven House is a privately owned care home, which offers accommodation and personal care to 15 younger adults with a mental disorder or 15 adults over 65 years of age or a combination of the two categories. Dunraven House is one of three registered care homes operated by Mrs OConnor and Mrs OConnor-Marsh in the Salisbury area, which have been in operation since the late 1980s. Dunraven House is a large detached Victorian house, which is located next door to one of its sister homes, Dunraven Lodge. The location of the home is convenient for residents who make use of the facilities and amenities of Salisbury. The administration of all the homes is centred at Dunraven House and staffing is also organised centrally for all three homes. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, undertaken during the course of one day from 10:30 to 14:00. The primary focus of the inspection was to ascertain the views of the residents regarding the care and services provided. To this end, eight residents were spoken to on an individual and group basis. Standards were also assessed in relation to residents’ assessments, care plans, decisionmaking, risk taking, food menus, complaints, environment, staffing levels, management of the home and health and safety. What the service does well: The home is run and managed by persons who have either considerable or suitable experience within the relevant care setting. The home ensures that there are sufficient numbers of staff on duty to meet the needs of the residents. The staff team reflects the gender composition of the residents and residents spoken to commented very positively about the care provided by staff. The health, safety and welfare of the residents and staff are promoted and protected. Residents live in a comfortable, safe and well-maintained environment, which meets their individual and collective needs. The home is kept clean and tidy and provides sufficient communal space together with adequate bath, shower and toilet facilities. Residents have personalised their bedrooms to varying degrees and to their individual wishes. Suitable laundry facilities are in place to meet the needs of the residents. Residents spoken to commented positively about the level of accommodation provided and confirmed that these are kept clean and tidy. Residents also commented that they were happy with the laundry arrangements in place stating that their clothing is suitably returned. Residents are assessed prior to admission and to ensure that the home can meet prospective residents’ needs and copies of all relevant assessment documentation is obtained as part of this process. Residents are encouraged and supported to make decisions about their lives within a supportive environment. Residents are supported to take risks within a risk management framework. Residents are able to access and take part in a range of activities both within the community and arranged by the home. Residents also maintain contact with their families, friends and relatives in accordance with their preferences. Residents receive a varied and satisfactory diet and residents spoken to commented very positively about the quality and quantity of food provided stating that they receive plenty of food. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 6 Information is provided to residents on how to complain and the home has not received any complaints since the last inspection. Residents spoken to commented that they had no complaints/concerns. 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. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Residents are assessed prior to admission and to ensure that the home can meet prospective residents’ needs and copies of all relevant assessment documentation is obtained as part of this process. EVIDENCE: The home, as part of its admission process, always obtains copies of detailed information including copies of the care programme approach, client history and management plan/risk assessment completed by social services and relevant information from other agencies is obtained prior to admission in respect to any prospective resident. In addition, the home also undertakes its own assessment. Appropriate documentation was in evidence with regard to the two new admissions case tracked and admitted since the last inspection. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 All residents are provided with a reasonable long term assessment/care plan. Residents are encouraged and supported to make decisions about their lives within a supportive environment. Residents are supported to take risks within a risk management framework. EVIDENCE: All residents are provided with a long term assessment/care plan and these are initially reviewed within the first month of admission which provides the basis for the future development of the care plans. Short-term goals are identified one at a time and once one has been met, another is identified. The care plans of the two most recently admitted residents were case tracked and these were still quite basic. However, Mrs O’Connor-Marsh was advised of the need to ensure that residents’ care plans record residents’ wishes and preferences and from the outset. Residents receive a psychiatric review every six months. Residents are encouraged and supported to make their own choices and decisions within their capabilities and residents, who are capable, can come and go without restriction. There is some flexibility regarding mealtimes. Residents can choose to get up and go to bed when they want within reason, as there are no reported rules regarding this routine. Residents spoken to Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 10 confirmed this. Some residents make their own medical appointments and purchase their own clothing whereas others require staff support to do so. With regard to residents’ finances, Mrs O’Connor-Marsh reaffirmed that she does not hold any cash, bank or post office books on residents’ behalf. Some residents handle and manage their own finances and Mrs O’Connor-Marsh stated that where residents require money or goods she would provide the money and then invoice the residents’ families, solicitor or Court of Protection for reimbursement. Copies of residents’ “pocket money” sheets are maintained by the home and are provided to their families, solicitor or Court of Protection to confirm that residents have received their appropriate allowance. As Stated in Standard 2, copies of prospective residents’ risk assessments and previous history are sought from the prospective resident prior to admission. Risk assessments are also completed by the home in respect to residents as part of the standex recording system, which would identify any specific risks in relation to residents’ day to day care. Residents take risks within a supportive framework. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 16 and 17 Residents are able to access and take part in a range of activities both within the community and arranged by the home. Residents also maintain contact with their families, friends and relatives in accordance with their preferences. Residents receive a varied and satisfactory diet. EVIDENCE: The home provides and encourages residents to participate in house activities. However, a number of the residents lack the motivation to do so. As stated in Standard 7 residents who are capable go out on their own with others being taken out by staff or by their families. Only two residents have chosen to participate in valued daytime occupation with one attending the Amesbury Activity centre four times a week and the Winterbourne social club once a week. The other resident attends Bemerton Lodge twice a week and also attends the Evergreen day centre once a week. The home has an open policy on visiting hours and residents can choose where to see their visitors, either in their bedrooms, the front lounge or in the dining room. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 12 The home places no expectation on the residents to be involved in various daily routines of the home due to their varying abilities, high care needs and their lack of motivation to undertake such tasks. Currently there are no locks fitted to residents’ bedroom doors, although these could be fitted if requested by residents. Staff do not open residents’ mail which is given directly to them. However, staff will assist residents to understand the contents of their mail, if required. Residents can choose how and where to spend their time and this was evident during the inspection. Residents have unrestricted access to the home and grounds and smoking is restricted to one of the “Chalets”, which is located at the bottom of the rear garden. A satisfactory and varied menu is in operation, which provides a choice at all mealtimes except for the main meal at weekends. Residents’ special diets are also catered for which include diabetic and reducing diets. Residents tend to eat their meals in the attractive dining room, although a few currently use the activities room as the other dining room has changed its use to a bedroom to accommodate and meet the requirements of a specific resident. Drinks are also available for residents at other specific times of the day and staff would facilitate this. Residents spoken to commented very positively about the quality and quantity of food provided stating that they receive plenty of food. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These Standards were not checked during this inspection as the core standards were satisfactorily assessed at the last inspection. However, the visiting pharmacist was present during the inspection undertaking an inspection of the home’s system of medication which included reviewing of residents’ general medication. She has also offered to provide staff with additional training in respect to medication. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Information is provided to residents on how to complain. EVIDENCE: The home has established an appropriate written complaints procedure and each resident has been provided with a copy. The procedure informs complainants that they can contact the Commission for Social Care Inspection at any stage should they wish to do so. The proprietor reported that she has not received any complaints since the last inspection. However, a new monitoring form for dealing with any complaints has been developed and implemented in line with their other two homes. Residents spoken to commented that they had no complaints/concerns. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 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, 26, 27, 28 and 30 Residents live in a comfortable, safe and well-maintained environment, which meets their individual and collective needs. The home is kept clean and tidy and provides sufficient communal space together with adequate bath, shower and toilet facilities. Residents have personalised their bedrooms to varying degrees and to their individual wishes. Suitable laundry facilities are in place to meet the needs of the residents. EVIDENCE: Residents live in a safe, comfortable, well-maintained environment, which is furnished to a good standard. There is an ongoing maintenance programme for the property and renewal of the fabric and decoration is undertaken as and when required. Since the last inspection some carpets have been changed and some redecoration has been undertaken to enhance the residents’ living environment. However, the proprietor was advised that the bedroom located on the ground floor, which use to be used as a dining room, is in need of redecoration. Residents’ bedrooms are suitably furnished and they can bring items of personal possessions to make their bedrooms more homely. Residents can and have personalised their bedrooms to varying degrees but to their individual wishes. Residents’ bedroom doors are not provided with locks, Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 16 however these could be fitted at the request of residents. Residents spoken to commented positively about the level of accommodation provided and confirmed that these are kept clean and tidy. The home provides adequate bath and toilet facilities that meet the needs of the residents accommodated. These facilities consist of three bathrooms and a separate shower room together with seven toilets, three of which are separate from the bath and shower facilities. There are also toilets located within the en-suite facilities to four of the residents’ bedrooms. All bathroom and toilet doors are fitted with suitable locks. The home has a lounge at the front of the building that is generally known as the visitors’ lounge. The room is ornately furnished and is only generally used to meet with visitors to the home. A second large communal lounge is located to the rear of the building which has been divided to provide sitting space as well an area to undertake activities. The room is comfortable, informal and was reported to be the ‘hub’ of the home. There is also a separate dining room. There is a large well-maintained garden to the rear of the property, which is used by residents weather permitting. The home continues to be maintained to a good standard being clean and tidy. There is a laundry room located on the ground floor which consists of an industrial washing machine and a smaller washing machine for residents who wish to undertake their own washing. Residents’ clothing is labelled and staff tend to undertake the laundry duties, although three residents do their own washing. Residents spoken to commented that they were happy with the laundry arrangements in place stating that their clothing is suitably returned. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 The home ensures that there are sufficient numbers of staff on duty to meet the needs of the residents. EVIDENCE: The deployment of staff ensures that there is a minimum of two members of care staff on duty throughout the waking day and often there are more staff on duty. There is also one member of waking night staff on duty each night. In addition the proprietors spend time in the home every day. Three domestic staff are employed to work throughout all three homes, providing a full clean in each home once a week with additional cleaning being undertaken on a daily basis by the care staff. A cook is specifically employed to work within the home. The staff team reflects the gender composition of the residents and residents spoken to commented very positively about the care provided by staff. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The home is run and managed by persons who have either considerable or suitable experience within the relevant care setting. The health, safety and welfare of the residents and staff are promoted and protected. EVIDENCE: Mrs O’Connor has primary management responsibility for the home and has considerable experience in the care profession. Mrs O’Connor was previously an enrolled nurse. However, the deputy manager, who has achieved the NVQ level 3, has day to day responsibility for the care provided to the residents Management ensures that there are safe working practices within the home and these comply with the relevant legislation. Risk assessments are in place to ensure a safe working environment. All bedroom windows are fitted with window restrictors. Evidence was available to show that appropriate testing and servicing of equipment is being carried out. All staff have received training in respect to health and safety within the last year. Mrs O’Connor-Marsh reported that the Health and Safety Officer for Salisbury District Council carried out a health and safety inspection of the home about six months ago. As a Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 19 result of this visit, the home was advised of the need to develop the content within the health and safety risk assessment (slips and trips/falls). Mrs O’Connor-Marsh reported that the Health and Safety Officer will make a further visit to the home to review this recommendation. Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 3 X X X X 3 X Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 21 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 Dunraven DS0000028373.V275586.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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. 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