Inspection on 08/08/05 for Dunraven

This inspection was carried out on 8th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dunraven 28/11/08

Dunraven 24/10/06

Dunraven 27/02/06

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 8 August 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Dunraven Address 12 Bourne Avenue Salisbury Wiltshire SP1 1LP 01722 321055 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) Mrs Brigid OConnor Care Home 15 Category(ies) of MD Mental Disorder (15) registration, with number MD(E) Mental Disorder - over 65 (15) of places Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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. Date of last inspection 7th December 2004 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 O’Connor and Mrs O’Connor-Marsh in the Salisbury area, which have been in operation since the late 1980’s. 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 D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 10:10 to 14:45. A tour of the premises was undertaken and the views of ten of the fifteen residents in situ were sought on an individual and group basis, regarding the care and services provided by the home. The views of four staff were also sought. Records in relation to residents’ medication, menus, complaints, staff recruitment and staffing levels were also checked to ensure that continued compliance is being achieved. The majority of the outstanding requirements from the previous inspection have been addressed. The requirement identified at the previous inspection was also checked which related to the need to ensure that the menu book records all alternatives provided at mealtimes as well as a record being maintained for food and drinks being provided at suppertime. The timing of the inspection was brought forward as a result of the Commission receiving four areas of complaints from a person who wished to remain anonymous. The complaints related to staff under the age of 18 providing personal care, food, residents not being given drinks at night if they ask for them and inadequate medication training. Investigations into these complaints were carried out as part of the inspection process. What the service does well: Residents live 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 bath, shower and toilet facilities. Residents have personalised their bedrooms to varying degrees but to their individual wishes. Adequate laundry facilities are in place to meet the needs of the residents. Residents spoken to commented positively about their standard of accommodation, confirming that their bedrooms are kept clean and tidy. Residents also commented positively about the laundry arrangements in place stating that their clothing is suitably returned in good condition. Residents are supported and protected by the home’s recruitment practices and the home ensures that there are sufficient numbers of staff on duty to meet the needs of the residents. Staff continue to receive ongoing training and are appropriately supervised. Residents spoken to commented very positively about the care provided, stating that staff treat them very well. Staff were also observed to be attentive to the needs of the residents. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 6 Residents receive staff support with regard to their personal care/hygiene according to their requirements. Residents’ health care needs are being suitably met with residents’ medication being appropriately administered by staff, in line with the home’s practice. The rights of residents are suitably respected by the staff. Residents receive a varied and satisfactory diet that takes into account their preferences with special diets being also provided for those who require them. The vast majority of residents spoken to commented positively about the quality and quantity of food provided stating that they receive plenty of food. However, one resident stated that she would prefer diabetic puddings rather than the normal supply of yogurts or fresh fruit, which tends to be the policy of the home. The cook also confirmed that residents receive plenty of food, their preferences are well catered for including special diets and they are provided with an alternative meal if they do not want the meal that is being offered. Information is provided to residents on how to complain should they wish to do so and appropriate procedures are in place to protect the service users from suspicion or evidence of abuse. 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 D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 standard(s) These Standards were not inspected during this inspection. EVIDENCE: Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 standard(s) These Standards were not inspected during this inspection. EVIDENCE: Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 10 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 standard(s) 16 and 17 Staff respect the rights of residents and residents receive a varied and satisfactory diet that takes into account their preferences with special diets being also provided for those who require them. EVIDENCE: The home places no expectation on the residents to be involved in the various daily routines of the home due to their varying abilities, high care needs and their lack of motivation to undertake such tasks. Locks have been fitted to bathroom and toilet doors and although locks have not been fitted to the residents’ bedroom doors, these could be fitted at their request. Staff recognise residents’ bedrooms as being their private space and knock before entering. Residents’ mail is given directly to them unopened. However, staff will assist them 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. Although there is a visitors’ room, residents can choose where to see any visitors. Residents have unrestricted access to the home and grounds. Smoking is restricted to the rear garden. A satisfactory and varied menu is in operation, which provides a choice at breakfast including a cooked meal which is provided some mornings each Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 11 week. Set meals tend to be provided at lunch and teatime. However, alternatives are provided for these meals, where required, to take into account residents’ individual preferences but the home needs to ensure that alternatives are always suitably recorded. Special diets are also catered for and these consist of diabetic and vegetarian diets. The home has two attractive dining rooms and there is an expectation that meals will be taken there. Drinks are also available for residents at other specific times of the day and staff would facilitate this. The vast majority of residents spoken to commented positively about the quality and quantity of food provided stating that they receive plenty of food. However, one resident stated that she would prefer diabetic puddings rather than the normal supply of yogurts or fresh fruit, which tends to be the policy of the home. The cook confirmed that residents receive plenty of food, their preferences are well catered for including special diets and they are provided with an alternative meal if they do not want the meal that is being offered. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 12 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 standard(s) 18, 19 and 20 Residents receive staff support with regarding to their personal care/hygiene according to their requirements. Residents’ health care needs are being suitably met with residents’ medication being appropriately administered by staff, in line with the home’s practice. EVIDENCE: Staff support residents with regard to their personal care/hygiene with the vast majority of them requiring just prompting to varying degrees. Residents can have a bath when they want and some have established their own routines in this respect. Residents can choose what clothes to wear, although staff assistance would be given to those who need it. Where residents are unable to go shopping for clothing, staff will undertake this task on their behalf. Community psychiatric nurses are involved in the residents’ reviews. Residents are registered with one of five surgeries within the Salisbury area and have a choice of General Practitioners. The majority of residents require staff support to make and attend all health care services. Residents normally attend the surgery for any appointments, although home visits would be made for those residents who are too frail. In these circumstances, residents would be seen in the privacy of their bedrooms. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 13 The home’s policy is for staff to control and administer all medication to residents and the home uses the Boots monitored dosage system for this purpose. Examination of service users’ drug sheets showed that these are being appropriately signed for medication administered. Management reported that staff do not administer medication unless they have completed accreditation training or have been deemed competent by a supervisor to do so. Management also stated that there are always two members of staff involved in the process of medication administration. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 standard(s) 22 and 23 Information is provided to residents on how to complain should they wish to do so and appropriate procedures are in place to protect the residents from abuse. 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, the Commission is currently investigating four areas of complaints received from a person who wishes to remain anonymous. These relate to staff under the age of 18 providing personal care, food, residents not being given drinks at night if they ask for them and inadequate medication training. Investigations into these complaints were carried out as part of the inspection process. The home has robust procedures in place for responding to suspicion or evidence of abuse and these include a Whistle Blowing procedure. Copies of the shortened version of the Swindon and Wiltshire Vulnerable Adults Procedures, which are in line with the Department of Health guidance “No Secrets”, have been distributed to all staff. Some staff also confirmed that they have received training in this area. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 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 bath, shower and toilet facilities. Residents have personalised their bedrooms to varying degrees but to their individual wishes. Adequate laundry facilities are in place to meet the needs of the residents. EVIDENCE: The home is a large, comfortable, safe and well-maintained property and the maintenance for this is ongoing with redecoration and renewal of the fabric being undertaken as and when required. Residents’ bedrooms are suitably furnished and they can bring limited 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, however these could be fitted at the request of residents. Residents spoken to commented positively about the level of accommodation provided, confirming that it is kept clean and tidy. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 16 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 do activities. The room is comfortable, informal and was reported to be the ‘hub’ of the home. There are also two dining rooms and residents are divided through assessment. There is a large well-maintained garden to the rear of the property, which is used by residents and has been designated as the smoking areas for both Dunraven Lodge and Dunraven House. 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 do their own washing. Residents’ clothing is labelled with staff undertaking the laundry duties. Residents spoken to commented that they were happy with the laundry arrangements in place stating that their clothing is suitably returned in good condition. . Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36 Residents are supported and protected by the home’s recruitment practices and the home ensures that there are sufficient numbers of staff on duty to meet the needs of the residents. Staff continue to receive ongoing training and are appropriately supervised. 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 and this was evident during the inspection. There is also one member of waking night staff on duty each night. In addition the proprietors spend time in the home everyday. Three domestic staff are employed to work throughout all three homes, providing a full clean in each home once a week with additional cleaning undertaken daily 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 those residents spoken to commented very positively about the care provided by staff and these comments also referred to the younger members of staff employed. Residents stated that the staff treat them very well. Staff were observed to be attentive to the needs of the residents. Two newly appointed staff files were checked and these showed that the home is, in the main, following appropriate recruitment practices which includes obtaining two satisfactory written references, POVA first checks and Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 18 subsequently satisfactory CRB enhanced checks. However, the home needs, where possible, to obtain and record all dates of a person’s previous employment history and record the reason for any gaps within this. The latter has been complied with prior to the production of this report. Evidence was available in the staff files to confirm that the newly appointed members of staff had received an induction training programme, which is normally completed within six weeks. On completion of this programme staff would be considered for NVQ 2 training as well as undertaking various mandatory training. A training matrix has been established by the home, which includes training undertaken and due to be completed by staff. The home continues to ensure that staff attend and update their knowledge through training and this was confirmed by some staff spoken to. There are a range of mechanisms in place for the proprietors to both brief and receive feedback from staff in order to monitor the standard of care and services provided to the residents. These include regular staff meetings, daily handover meetings and both formal and informal staff supervision. Staff spoken to confirmed that they receive formal supervision and they are happy with the level of support available. Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These Standards were not inspected during this inspection. EVIDENCE: Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x x x x 3 2 Standard No 31 32 33 34 35 36 Score x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Dunraven Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 21 Yes 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 17 Regulation 17(2) Requirement The registered individuals must ensure that the menu book records all alternatives provided. (Previous timescale of 31/12/04 is not met) Timescale for action 30/09/05 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 Good Practice Recommendations Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, 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. Extracts may not be used or reproduced without the express permission of CSCI Dunraven D51_D01_S28373_Dunraven_V184608_220605_Stage4.doc Version 1.30 Page 23 - 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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