Inspection on 06/02/06 for Durban House

This inspection was carried out on 6th 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

Durban House 11/09/09

Durban House 09/10/08

Durban House 28/08/07

Durban House 25/09/06

Durban House 10/10/05

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 Inspection 6th February 2006 13:30 X10015.doc Version 1.40 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 DS0000000507.V257783.R01.S.doc Version 5.0 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 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. DS0000000507.V257783.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Durban House Address Hodgsons Road Blyth Northumberland NE24 1PN 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) 01670 - 354181 01670 326632 durban.house@ashbourne-homes.co.uk Exceler Healthcare Services Limited Mrs Ann Mielnik Care Home 50 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (45) of places DS0000000507.V257783.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 19th January 2005 Date of last inspection 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. The home is situated in a predominantly residential area with easy access to the centre of Blyth town 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 fourty five service users within the category of Nursing and Social Care for people who have dementia. The home also has a small unit registered for 5 adults who in additon to the registered category also have learning difficulty. DS0000000507.V257783.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 3 hours. It is the second unannounced inspection the home has had in this year. All of the core standards have been examined over the two inspections. It is therefore suggested that both reports are looked at to get the full picture of the home. Seven residents and three staff were spoken to and others chatted to briefly. Two relatives were spoken to directly although others were in the home. Four care plans, training records and records for medication were examined. Also staff files, training records and health and safety documentation was looked at. There were no requirements or recommendations made at the last inspection. During an additional visit a requirement was identified for all staff to use safe moving and handling methods at all times and this was met by this inspection by providing additional training and increased monitoring. 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. There has been a recent introduction of coloured bedroom doors to try to make them more easily identified by the resident as their own. The number of social activities offered has been significantly increased since the last inspection with a large variety of choices available. DS0000000507.V257783.R01.S.doc Version 5.0 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. DS0000000507.V257783.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection DS0000000507.V257783.R01.S.doc Version 5.0 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 the following standard(s): Standards 3 and 6 were examined at the last inspection. Standard 3 was met and standard 6 does not apply, as the home does not provide intermediate care. EVIDENCE: DS0000000507.V257783.R01.S.doc Version 5.0 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 the following standard(s): 9 Standards 7, 8, and 10 were examined at the last inspection and were met. Although standard 7 was not examined the care plans looked at for evidence of social activities showed that they have continued to be maintained to a good standard. The residents are given their prescribed medication in line with safe working practices. The medicines in the home are recorded effectively and well managed. EVIDENCE: The systems for managing medicines in the home were appropriate, the staff check the medicines required on a monthly basis, the requests are sent tot he relevant General Practitioner and then the prescriptions are then checked on return they and are then sent to the Chemist for dispensing. The medicines are then again checked against the records when received into the home so that any errors can be picked up. The home has a contract with a Pharmacist, which included giving advice as necessary. No residents are currently managing their own medication in the home. There were no gaps in the recordings and there is evidence that the staff continuously review the medication in relation to their effectiveness and adverse reactions and then seek medical advice to address any problems. DS0000000507.V257783.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 Standard 15 was examined during the last inspection and was met. Residents are offered a flexible routine for daily living and activities, which are appropriate to meet their cultural, social, religious and recreational interests and needs. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. EVIDENCE: The staff described the ways they encourage the resident’s to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. Relatives confirmed that the staff encourage resident to make choices about how they spend their day. However this is not always easy as it is acknowledged that the majority of the residents are unable to express themselves through words and the staff have to rely on their reactions to the activity as to their level of enjoyment. It is also necessary for the staff to use the information they have about residents to judge if they are likely to enjoy particular activities. There is a large amount of organised activities available and staff said that residents are able to choose whether or not they are involved, however due to the dependency level of some of the residents and their tendency to become DS0000000507.V257783.R01.S.doc Version 5.0 Page 11 distracted at times a number of the activities offered are less group based and provided on a more one to one basis. The home employs an activities co-ordinators for 30 hours per week and there are a number of events, which occur on a regular basis, there is also evidence that all of the staff become involved in different types of activities through the day. Those activities advertised on the wall at the entrance of the building included pie and pea suppers, coffee mornings, arts and craft sessions, luncheon club, trips out in the mini bus, and a baking day, which were all weekly. And a two weekly programme of wine and cheese parties, quiz nights, a tea dance, and movie nights. A number of these activities are open to relatives and there has been some success in involving them in taking part. This allows for shared time with relatives, which helps to maintain good relationships. A number of the activities have been recently introduced and it will be interesting to see how successful they are, this will be discussed at the next inspection. The method of recording the daily activities has been recently changed one in which a code is recorded. It is recommended that the Manager reviews this to satisfy herself that this allows staff to identify how much the resident took part and even if they showed signs of enjoyment so that future planning can take this into account. A recommendation was made about this. Residents have visitors at any time and are able to use their own rooms, the small lounge or the larger, busier lounges to receive them. Relatives are given information within the residents’ guide about visiting arrangements. Relatives said they were satisfied with the arrangements for visitors and that staff welcome them. DS0000000507.V257783.R01.S.doc Version 5.0 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 the following standard(s): Standards 16 and 18 were examined at the last inspection and were met. EVIDENCE: DS0000000507.V257783.R01.S.doc Version 5.0 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 the following standard(s): 19 Standards 19 and 26 were inspected at the last inspection and were met. The home is well decorated and it is being maintained in a satisfactory way with a programme to ensure that it remains so. The bedrooms are single occupancy and are decorated and equipped in a homely and personalised way. EVIDENCE: The home 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 redecoration-taking place as necessary. The home was clean and was odour free on the day and the residents’ bedrooms were personalised reflecting individual choices and preferences and the residents. Since the last visit there has been ongoing redecoration work and the home has introduced coloured bedroom doors with letterboxes and knockers. This was done to give distinction to individual bedrooms so that the residents would be able to recognise their own more easily. This will be discussed at the next inspection to see if it has been successful. DS0000000507.V257783.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Standards 27, 28, & 29 were examined at the last inspection and were met. The staff in the home are being provided with a good range of training including the statutory training in moving and handling, fire, first aid and food handling and hygiene. During the last inspection it was noted that 83 of the care staff had achieved NVQ level 2 or over. EVIDENCE: There is evidence of a significant amount of training in both statutory and clinical areas of practice. The staff is receiving training in line with the company policy and statutory requirements for fire training, moving and handling, first aid, food handling and hygiene and a plan is in place to address this on an ongoing basis. The home has 83 of the care staff trained to NVQ level 2 and some have level three. She is continuing to encourage the remaining staff to see this as a training objective. During an additional visit undertaken on 5th January 2006 two staff were seen moving a resident inappropriately in her chair, although this was not a method which was likely to cause an injury to the resident it was one which increased the risk to the staff involved. A requirement was made about this and since then all of the staff have received additional training in safe moving and handing techniques. Moving and handling training had been carried out prior to this. DS0000000507.V257783.R01.S.doc Version 5.0 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 38 Standard 33 were examined at the last inspection and was met. Resident’s personal finances are managed appropriately. Mrs Mielnik receives support from the company to make sure that the health and safety of the residents is maintained. EVIDENCE: The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. DS0000000507.V257783.R01.S.doc Version 5.0 Page 16 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 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. DS0000000507.V257783.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 DS0000000507.V257783.R01.S.doc Version 5.0 Page 18 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. 1 Refer to Standard OP12 Good Practice Recommendations It is recommended that the way the home documents the resident’s participation and enjoyment in activities is recorded. DS0000000507.V257783.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Cramlington Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000000507.V257783.R01.S.doc Version 5.0 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!