Inspection on 15/02/06 for Durham House Residential Home

This inspection was carried out on 15th February 2006.

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

Durham House Residential Home 20/04/07

Durham House Residential Home 19/10/05

Durham House Residential Home 09/02/05

Durham House Residential Home 03/06/04

Durham House Residential Home 07/01/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Durham House Residential Home Mains Park Road Chester Le Street Durham DH3 3PU Lead Inspector Rachel Dean Unannounced Inspection 15th February 2006 09:30 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 Durham House Residential Home DS0000007465.V288641.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 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. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Durham House Residential Home Address Mains Park Road Chester Le Street Durham DH3 3PU 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) 0191 3871265 0191 3875916 Sortuseful Limited Mrs Eileen Oates Care Home 35 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (35) of places Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: Durham House is a family owned and run establishment that aims to provide care in a friendly and homely atmosphere. The home is registered to provide residential personal care for up to 35 older people. Up to 20 of these people may have dementia care needs. The home consists of a large period house that has been extended and improved to provide spacious and comfortable accommodation. The home is located in Chester-le-Street, close to the local high street with shops and amenities. The accommodation is arranged over two floors, with stair and lift access available to both. It consists of 13 single and 1 double bedroom with en suite toilet and washing facilities, and 14 single and 3 double rooms without en suite facilities. Communal space is located throughout the home, with a selection of lounge areas, a conservatory, a quiet room, a smoking room and dining room. Residents also have access to an enclosed courtyard garden. Communal toilet and bathroom facilities, including specialist bathing equipment, are located conveniently through out the home. Durham House Residential Home DS0000007465.V288641.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 that took place on 15th February 2006. It was carried out by two inspectors. The inspection focused on the following areas of care practice and life at the home; the way people are admitted to the home, the records the home keeps about the care people need and receive, the health care people receive, the way the home helps people with their medication, how people are treated in the home, the opportunities available for people to take part in activities and social events, arrangements for visitors, the choice and control people have while living in the home and the meals that are provided. During the inspection a number of people who live in the home were spoken to about their experiences of living at Durham House. Discussions were held with the management team about their views of how well the home managed the areas being inspected. Several staff members were spoken to about their views of the service provided by the home, including the cook and care staff. In addition to talking to these people the inspectors made observations, inspected a number of the home’s records and received four comment cards from the relatives of people who lived in the home. What the service does well: What has improved since the last inspection? The management of Durham House have improved the areas that were identified during the last inspection. This has included introducing more frequent fire drills for all staff and more regular tests of the hot water supply to make sure that people living and working in the home are not at risk. The home has also developed and improved the way that activities and social stimulation are provided, with more activities being offered and provided. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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 Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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): 3 All service users who are admitted to the home are thoroughly assessed before admission, to make sure that Durham House can meet their needs. Durham House does not provide an intermediate care service, so assessment of standard six was not necessary during this inspection. EVIDENCE: Durham House has in place effective assessment and admission procedures. During this inspection admission and assessment records were inspected and found to be detailed and comprehensive. They showed that information was gathered from prospective service users, their family and other professionals, so that the management were sure that the home could meet each person’s needs before they were admitted. Information about each person was made available to staff in the home’s records and the home’s procedures make sure that staff read these records and are fully aware of the needs the residents as soon as they are admitted to the home. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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): 7, 8, 9 & 10 All service users living at Durham House have a detailed and up to date plan of care and record of the care and support that they receive. Systems are in place at Durham House to make sure that service users get the health care that they need. Safe systems are in place for the storage and administration of medication at Durham House. Service users are treated with respect and their dignity and privacy is maintained. EVIDENCE: During this inspection a number of care plans and care records were inspected. The home has in place thorough recording and care planning systems and the records inspected were detailed, up to date and being used in a pro-active way that was beneficial for service users. For example, records of the hourly checks that staff do during the night included if people were awake or asleep. These records had then been used to identify people who were experiencing disruption to their normal sleep pattern, so that help could be sought from the Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 10 person’s doctor if necessary. The deputy manager was able to demonstrate how she carried out spot checks and cross referenced records to make sure that staff were completing them correctly and accurately. However, it would be beneficial for the home to develop specific care plans covering mental and psychological health, including challenging behaviour. This is important because the home is registered to provide dementia care and many of its service users will have special care needs that are related to these areas. The care records that were inspected contained records of all visits and input from doctors, district nurses and other health professionals. Arrangements were in place for regular chiropody and eye tests with professionals arranged by the home, although people could choose to use their own chiropodists and opticians if they preferred. During this inspection the arrangements for the storage and administration of medication were inspected. A selection of records relating to medication were inspected and found to be accurate and up to date. The deputy manager showed a good understanding of the importance of knowing what different medication is for and how this knowledge can be used to identify problems and improve people’s quality of life. For example, medication that might be causing an increased risk of falls or increased tiredness. Staff confirmed that they had received training on the safe handling of medication and systems were in place for checking that medication was being administered safely. For example, by regularly checking records and stock balances. A few minor improvements that could be made to the storage of medication were discussed during the inspection, such as a larger storage cupboard and a small medications fridge, and the management team are considering these suggestions. Observations made during the inspection showed staff helping and assisting service users in polite and respectful ways. For example, staff knock before entering people’s rooms, personal care is carried out in private and visitors are able to see their relative in private if they wish. Comments made about the care and attitude of the staff at Durham House included ‘Durham House is very nice and the staff very helpful and caring’, ‘they do their best for us and work hard at all times’, ‘shes young, but she always friendly and helpful’ and ‘if you’ve got any problems you can speak to her’. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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 the following standard(s): Opportunities for activities and social stimulation are being developed in the home. Visitors are made welcome at the home, with visitors being able to visit at times that are convenient to themselves and their relative. People are able to make choices about their daily lives and routines, such as what to eat, where to spend their time, whether or not to join in with activities and when to get up or go to bed. A varied and balanced diet is provided at the home, with a choice of meals and alternatives to the menu being available. EVIDENCE: The management has been trying to improve the provision of social stimulation and activities at Durham House. They have introduced more opportunities for social stimulation, such as formal group quizzes, games and music, and less formal opportunities, such as book, jigsaws and games being left out so that people can do them as and when they wish to. However, the management stated that it is sometimes difficult to get people to join in with organized activities. The service users spoken to said that the activities being offered suited their current needs, but that there could be more, while one relative Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 12 suggested that more entertainers or outings would be appreciated by the residents. The home does not place unnecessary restrictions on visiting times and service users are able to have visitors at times that are convenient to them and their family and friends. Restrictions on visiting have only occurred where this has been in the best interests of the individual service user, with the appropriate records, risk assessments and other professionals being involved in the decision. The service users and relatives consulted during this inspection confirmed that they were welcomed into the home and could see their relative in private if this was what they wanted. Questionnaires that had been completed by service users were available to show how service users had been involved in making decisions about life in the home. Choice was also available about daily life in the home, including what people ate, when they got up and went to bed, whether or not they wanted to join in with activities and where they wanted to spend their time. The care plans included information about people’s individual preferences, so that staff were aware of these. A new cook has recently been employed by the home and had undertaken relevant training during his previous employment. The home now employs two cooks, one covering week days and the other covering weekends. During the inspection a number of service users were asked about the meals and food provided in the home. Their comments included, ‘hes a canny lad and can cook well’, ‘we get too much’, ‘we have a good choice of food’ and ‘we can eat our food in our rooms if we want to’. Staff and residents confirmed that the home consulted them on choice of food available and that alternatives to the menus were available if people didn’t like the main choices. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 A complaints procedure is in place and complaints are handled appropriately by staff in the home. Procedures for handling suspicions and allegations of adult abuse are in place and staff have received training on recognising and reporting abuse. EVIDENCE: Durham House has in place a complaints procedure that details how complaints made about the home will be handled. There have been no recent complaints made either to the home or directly to CSCI. Staff had been given training on how to deal with complaints and minor concerns had been dealt with in an appropriate way. Procedures for handling suspected abuse and adult protection issues are in place. These include ‘whistle blowing’ procedures for staff who identify bad practice in the home. Staff confirmed that they had received training in the protection of vulnerable adults and there had been no recent adult protection referrals made to the local authority. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 14 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): These key standards were not fully assessed during this inspection. They were assessed during the last inspection and only outstanding issues were followed up during this inspection. EVIDENCE: Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 15 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): These key standards were not fully assessed during this inspection. They were assessed during the last inspection and only outstanding issues were followed up during this inspection. EVIDENCE: Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 16 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): These key standards were not fully assessed during this inspection. They were assessed during the last inspection and only outstanding issues were followed up during this inspection. EVIDENCE: Durham House has in place a strong family management team, who collectively have the experience, qualifications and skills needed to manage a residential care home. However, consideration needs to be given to the requirement for the actual registered manager to have a management and care qualification that is the equivalent to NVQ level 4. The management of Durham House have improved the areas that were identified during the last inspection. This has included introducing more frequent fire drills for all staff and more regular tests of the hot water supply to make sure that people living and working in the home are not at risk. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 Score X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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. 2. 3. Refer to Standard OP7 OP12 OP31 Good Practice Recommendations It would be beneficial for the home to develop specific care plans covering the areas of mental and psychological health and challenging behaviour. It is recommended that opportunities for activities and social stimulation continue to be developed in the home. It is recommended that the registered manager should be qualified to NVQ level 4 in management and care (or equivalent) by the end of 2005. Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Durham House Residential Home DS0000007465.V288641.R01.S.doc Version 5.1 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!