Inspection on 10/10/05 for Durban House

This inspection was carried out on 10th October 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

Durban House 11/09/09

Durban House 09/10/08

Durban House 28/08/07

Durban House 25/09/06

Durban House 06/02/06

Durban House 19/01/05

Durban House 24/05/04

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

CARE HOMES FOR OLDER PEOPLE Durban House Hodgsons Road Blyth Northumberland NE24 1PN Lead Inspector Suzanne McKean Unannounced 10 October 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. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Durban House Address Hodgsons Road Blyth Northumberland NE24 1PN 01670 354181 01670 326632 durban.house@ashbourne-homes.co.uk Exceler Healthcare Services Limited 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 Ann Mielnik CRH 50 Category(ies) of DE(E) Dementia - over 65 (50) registration, with number of places Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: One service user is under 65 years of age. The Commission for Social Care Inspection must be notified immediately should this service user leave the home, so that this condition can be removed. Date of last inspection 19th January 2005 Brief Description of the Service: Durban House is a purpose built two-storey building of traditional brick and tiled roof construction. It has a car park to the front of the building, which allows level access to the main entrance. It is situated in a predominantly residential area with easy access to the centre of Blyth town centre with its shops and other public amenities. It is also on a main bus route being only approximately one mile from the main bus terminal. The home is registered to provide care to a maximum of fifty service users within the category of Nursing and Social Care for people who have a Dementing illness. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over three and a half hours by the inspector, who has visited the home on a number of previous occasions. The manager was on duty during the visit and assisted the inspector with the inspection process. Ten residents were spoken to during the visit and four relatives, the inspector also spoke to six of the staff in process of the inspection visits. Records examined included, five care plans, training records and the records for complaints as well as the health and safety, accident and kitchen records. There were no requirements or recommendations identified during this inspection. What the service does well: What has improved since the last inspection? The standard of decoration has continued to be improved and is now to a good standard. The bathroom and toilet areas have been improved to not only offer a good decorative standard but effort has been made to make them pleasant and comfortable. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 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. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 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 Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 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, 6 There is a comprehensive assessment undertaken by the staff prior to admission, which forms the basis for the development of the care plan. The home does not offer intermediate care. EVIDENCE: Five care plans were examined and each had a detailed and comprehensive pre-admission assessment, these had either been done by the Manager or the senior staff in the home. The majority of the residents also have a care management assessment by the Care Manger from Social Services or Health Authority, a copy of which is given to the home on admission. It is from these documents that an individual care plan is produced and then developed further during the residents stay in the home. The home is not registered for intermediate care and therefore does not offer it. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 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, 10 Individual care planning is undertaken and the care is being delivered in line with these plans. The residents are having their health care needs met. Staff treat residents with respect and maintain their privacy when they are caring for them throughout their daily life. EVIDENCE: Each resident has an individual care plan, based on the admission assessment and then added to during the placement. Five care plans were examined which were completed to a good standard. Assessments are in place for nutrition, wound care, moving and assisting, and continence promotion. The home also carry out a dependency assessment of their overall needs. There were risk assessments in place for specific areas for example use of bed rails. The plans show regularly reviewing and updating and that reviews are regularly held with residents and their representatives. The care plans show residents have access to NHS services and facilities as necessary. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. The recording of nursing action for wound care was satisfactory with evaluations dated and signed. There was evidence Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 10 that the home seek expert advice from external professionals, including Psychiatrists, Psychologists and General Practitioners. Staff are aware of the need to maintain residents privacy and are doing so as part of their day to day delivery of care. The residents interviewed were complementary about the care they received and said that the staff treat them well. An example of the comments made was that the staff were “lovely” and “the staff couldn’t be better”. Staff were observed throughout the day to address the residents by their preferred name and there was a good relationship noted between the residents and the staff as well as the visiting relatives. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 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) 15 The food being served is being prepared safely by knowledgeable staff and offers choice to the residents. The home offers the resident a balanced diet and there is sufficient quantity of both food and fluids to meet their needs. Staff are aware of the importance of a balanced diet and the way it is served. EVIDENCE: The catering is provided by an external company by contract, and on discussion with the Manager, staff and the Cook it is evident that there is a good, effective relationship between them. The Manager is able to influence the provision of the food in the home and has included the cook in the training programme including Dementia Care. The Cook had a good knowledge of the needs of individual residents by spending time with them and the care staff. The menus for the home have a varied content and a selection, which offer choice and flexibility. The cook understands the nutritional needs of the client group and is planning the food provided with this in mind. The home does not have residents who would require specific food due to religious or cultural needs. The residents are asked for their daily choice of the meals available, however a large of number of the residents are not able to participate in this and the staff had a good knowledge of their preferences. Staff giving assistance at meal times were courteous and friendly and provided assistance on a one to one basis. Nutritional assessments are carried out on all residents and updated monthly with special diets provided as necessary. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 12 Drinks are offered frequently throughout the day and snacks on request. A number of residents require assistance with feeding and this is provided using a two sitting system. The kitchen appears well organised and clean and there is a checklist for cleaning schedules, which was up to date. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 13 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 The home ensures that the residents and relatives are made aware of the complaints policy and that it is available in a variety of places. There is a system for managing and dealing with complaints, which ensures that they are investigated and action taken to address any issues identified. The residents are protected by ensuring that the staff are given Protection of Vulnerable Adults training and whistle-blowing as well as knowing that they must report any concerns to the Manager. EVIDENCE: There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The records of complaints made to the home was examined, there has been four complaints recorded this year and the records of these were detailed including the response to the complainants and the action taken in response to the issues raised. Two of the residents interviewed were asked about the way in which they would have any problems dealt with, both could describe how this would be done. Three relatives who were visiting were knew about the complaints procedure but had not needed to use it. The Manager encourages the staff to record all expressions of concerns so that they can be used in the quality assurance process. This is to be commended. The home has policies and procedures regarding prevention of abuse and whistle blowing. The staff are being trained in the principles and practices of the policies. And two staff asked about it were aware of the issues and could Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 14 describe the types of abuse and the action they would take should they ever become concerned in any way. The home ensures that the residents and relatives are made aware of the complaints policy and that it is available in a variety of places including the front entrance and in the service user guide. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 15 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, 26 The home is well decorated and is safe and it is being maintained in a satisfactory way with a programme to ensure that it remains so. The bedrooms are all single occupancy and are decorated and equipped in a homely and personalised way. There are suitable, well equipped and nicely decorated toilets and bathrooms. The necessary specialist equipment is provided in the home and when required appropriate advisors are brought in to offer advice and assess residents needs e.g. Physiotherapy. EVIDENCE: A tour of the home was conducted both with staff and alone to assess the general condition of the home. It was tidy and organised to make sure that the residents are able to use the home safely. It is purpose built and is well maintained and there is evidence of ongoing refurbishment and redecorationtaking place as necessary. The home is clean and was odour free on the day and the residents’ bedrooms were personalised reflecting individual choices and preferences and the Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 16 residents. Those asked about their bedrooms said they were happy with the decoration and that they were kept clean by the staff. The sluices were tidy, clean and odour free and the disinfectors operational. Staff were observed to follow infection control policies throughout the day. The laundry was judged to be small but well organised with wheeled racks and individual baskets for clean clothing. The equipment consists of appropriate numbers of commercial type washing machines and dryers; there is a domestic iron and a rotary iron. The light and emergency call cords were all clean and all emergency cords reached skirting level. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 17 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, 28, 29 The home is staffed with appropriate numbers of staff and there are qualified nurses on duty in sufficient numbers to meet the needs of the residents. The staff are recruited and selected using a system which ensures that they are able to care for the residents and have not been identified as posing a risk to their welfare through Criminal Record Bureau and the Protection of Vulnerable Adults List. There are now 83 of the care staff who have achieved NVQ level 2 or over. EVIDENCE: Staffing rotas showed that the Manager is ensuring that enough staff are on duty to meet the staffing levels set down prior to the change to the CSCI without reduction. It was noted that when sickness and staff holidays occur it is usually covered by home staff. Late reporting of sickness does occasionally result in fewer staff being on duty for short periods. Three staff records were examined and were all complete including two references and a completed application form, the requirement to have a CRB and POVA check in place is applied to all of the staff in the home. The Manager has now managed to have 83 of the care staff achieve the NVQ level 2 and is continuing to encourage the remaining staff to see this as a training objective. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 18 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) 33, 38 The Registered Manager, Mrs Mielnik, ensures that she has systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. She is continuing to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. Mrs Mielnik receives support from the company to make sure that the health and safety of the residents is maintained. EVIDENCE: There are records to support the Managers confirmation that she attempts to ensure safe working practices for moving and handling, first aid, food hygiene and infection control. The home has arrangements to make sure that staff receive suitable training in fire prevention including fire drills and training in the procedures to be followed in the case of fire. There is a system in place to review health and safety in the Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 19 home involving the staff for which records are available. Mrs Mielnik frequently walks around the home to see that the staff are complying with health and safety guidance. She also does a number of audits including those of care plans, kitchen and the environment. Records of the staff meetings were examined, they are regular and the contents suggest that a broad spectrum of relevant issues are discussed and staff are kept up to date with changes in the home. The Manager also organises meetings with the relatives and residents. And although they are not attended in great numbers most visitors approach the manager or senior staff directly if they wish to make any comment or get information they need. Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.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 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 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 21 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. Refer to Standard Good Practice Recommendations Durban House B53-B03 S507 Durban Hse V226518 101005 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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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