Inspection on 15/12/05 for Durland House

This inspection was carried out on 15th December 2005.

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

Durland House 20/06/07

Durland House 02/08/05

Durland House 10/01/05

Durland House 19/07/04

Durland House 17/12/03

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Durland House 160 High Street Rainham Gillingham Kent ME8 8AT Lead Inspector Anne Butts Announced Inspection 15th December 2005 2.30 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 Durland House DS0000029067.V262942.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. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Durland House Address 160 High Street Rainham Gillingham Kent ME8 8AT 01634 364305 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Margaret Agnes Hartley Mr Royston George Hartley Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. admission of resident below 65 Three service users with dementia whose dates of birth are as follows:31.12.1915, 31.12.1915 and 02.02.1923. 2nd August 2005 Date of last inspection Brief Description of the Service: Durland House is a listed building in Rainhams High Street. The home is nicely decorated and care has been taken to ensure that it is in keeping with the age of the property. Although the house is close to the main road traffic noise is not noticable within the property. There is parking accessed at the side of the building and there is a small garden and patio area to the rear. As it is situated in the High Street it is close to local shops and amenities. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place during the afternoon of the 15th December 2005. The owners were present during the inspection process. Time was mainly spent viewing documentation and following up on any requirements or recommendations made at the previous visit. Overall this was a positive inspection and any shortfalls identified were issues that the owners were aware of. What the service does well: What has improved since the last inspection? What they could do better: Record keeping and maintenance of staff and service user records would still benefit from further continuity and improvement. Although care plans have overall improved they need to be reviewed on a more regular basis and reflect changes to care needs. All risk assessments need to be updated and then reflected into the care plans. Although the majority of staff has completed an NVQ award – there are still outstanding training needs in particular with regards to adult protection and movement and handling which need to be addressed. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 6 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. Durland House DS0000029067.V262942.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 Durland House DS0000029067.V262942.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): 2, 3 and 5 Having a contract of residence, with a written statement of terms and conditions, protects Service users. Service users benefit from assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Service users and families benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: Service users are issued with a written contract and statement of terms and conditions on moving into the home, and this was seen to contain the relevant information required to protect service users. The home has an assessment form in place, which is used to ensure that the home obtains all the relevant information about an individual and assists to ensure that they can meet the needs. Assessments are also obtained from the Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 9 care manager. Care plans are written from the needs assessments and the daily records are used to support this. All service users and their families have the opportunity to visit prior to moving into the home. They are encouraged to stay for a meal, have a look around and meet with other service users. There is also a trial period in place, which ensures that the service user is happy within the home, and that the home can meet their needs. The owners demonstrated a commitment to ensuring that the home can meet individual needs. The home does not provide intermediate care so standard 6 is not applicable. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 10 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 and 10. Service users benefit from fairly comprehensive care plans that are aimed at supporting them in meeting individual needs. However their safety may be put at risk since the care plans are not supported by risk assessments that address how to fully support service users in meeting their needs. Health needs are met and service users have full access to all professional health care services as required, and the home promotes and protects service users privacy and dignity. EVIDENCE: Care plans were viewed and these evidenced an overall improvement. The home has now implemented a key worker system, and the appointed key workers are now involved in writing care plans. The majority of care plans have been re-written with input from key workers – service users and their families have also been involved in this. Daily records are completed on a regular basis, and are comprehensive and any issues arising are discussed at the ‘handover’ stage so that the next shift is aware of any immediate needs of the service users. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 11 Care plans would still benefit from being reviewed on a monthly basis and any changes implemented into the care plans. There are risk assessments in place, but they are in need of updating and the owners were advised to implement these as a matter of urgency – especially with regards to movement and handling and the risk of falls. The home ensures that service users health care needs are met, and records evidenced visits by G.P.’s and other relevant health care professionals. The home supports service users in attending appointments. Care plans also reflected the health care needs of service users. The home places a high value on the privacy and dignity of individual service users, and staff were observed treating service users with courtesy and respect. Service user choice with regards to assistance with any personal care is documented into the care plan and the home actively promotes service users maintaining contact with family and friends. Service users are able to meet with visitors either in one of the communal areas or in their own rooms. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 12 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 and 14. Service users benefit from daily living routines that are flexible and suit their needs and preferences but the choice of organised activities are limited. Service users can be confident, however, that they are able to exercise choice with regards to their daily living. EVIDENCE: The home continues to promote activities and informs service users of local events and shows. The manager stated that they have continued to try to organise outings but service users still often changed their minds at the last minute. The owners also stated that they promoted in house activities as far as possible and this included bingo and other entertainment games, visits from local entertainers and as the festive period was drawing close – the local school choir was visiting and a melody makers group. The home does not have organised activities but arranges with service users on a daily basis, this does take into account service users needs – it was recommended, however, that ‘an activities book’ is introduced which records activities service users take part in, but would also evidence any outings or trips the home had tried to organise. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 13 Some service users visit local clubs on a regular basis and visits to their families are promoted. Service users, who wished, are supported in attending local churches and ministers also visit the home on a regular basis. Service users are promoted in making their own decisions and their choices and preferences are taken into account in their daily lives – this is reflected by the home taking into account service users who do not wish to take in organised activities. Staff were observed spending time talking to service users. Service users are also actively encouraged to visit family and friends and visitors are promoted. Staff will take service users to local shops and resources as required. Overall the home takes into account service user choice. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 14 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): 18 Service users may be put at some risk because not all staff are trained in adult protection protocols. EVIDENCE: The home is committed to protecting service users and their recruitment practices include ensuring that all prospective employees have a satisfactory CRB check undertaken and no member of staff works unsupervised prior to the home receiving this. Training in adult protection has not been undertaken, though, and a requirement is being made that this is addressed. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 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 the following standard(s): 19 Service users benefit from living in a safe, well-maintained, clean and homely environment which offers privacy and comfort, reflecting individual tastes so enabling service users to live in a ‘homely’ environment. EVIDENCE: The environment was not inspected during this visit as a full tour had been undertaken at the last inspection. It should be noted, though, that some redecoration has been carried out since the last visit and this had been tastefully completed. The communal areas are homely and comfortable and the environment is welcoming. Overall the environment was clean, tidy and attractive and was suitable for service users needs. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 16 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): 27, 28, 29 and 30 The service users benefit from being cared for by staff that have a good basic understanding of their needs, however their care may be compromised as staff have not received adequate training. EVIDENCE: The home provides care and support to thirteen service users, and is supported by a staff team of twelve, the majority of whom have been working in the home for a number of years. The owners are also in attendance and are familiar with service users needs. The home does not use agency staff. A high proportion of staff have either completed their NVQ level 2 or are in the process and approximately 50 of staff have also completed NVQ level 3. Records viewed evidenced that staff have a job description, terms and conditions and CRB checks. Application forms are completed and the owners carry out interviews – it was noted that although references are requested, and verbal references are obtained not all files contained two written references and a requirement is being made to ensure that this happens for new members of staff. There are still concerns, though, with regards to the mandatory training needs of staff and records viewed showed that there are some outstanding training needs in particular with regards to movement & handling, medication and adult protection training. A staff-training matrix is now being introduced and the owner stated that she would be addressing the training needs of staff and be Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 17 implementing a training programme. A requirement is being made that this is carried out as a matter of urgency. Any new members of staff undergo an induction programme within the home and are trained by the owner in the needs of the service users. Staff records have improved slightly since the previous inspection, and the owner continues to address this. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 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 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): 32, 36, 37 and 38 Service users benefit from an owner who is clearly committed to safeguarding and promoting individuals independence, rights and choices and is assisted by a stable staff team who offer a good quality of support to the service users. However an improvement in risk assessments would further protect the service users’ health and safety. EVIDENCE: Both owners are fully involved in the daily running of the home, and work closely with service users and staff. They are available to support staff and also work within the home and their aim of ensuring that this is a home for those people living there is reflected through the positive rapport which was observed between service users and staff. Staff supervision has improved since the last inspection, and this is now starting to occur on a more regular basis and on a more structured and formal basis. Team meetings are also held – although the outcomes of these are not Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 19 recorded and it would be god practice to record the outcomes of any staff meetings. Records for staff and service users files have improved since the last inspection, but there is still a need for more continuity in the formats – the owner is aware of this and is continuing to address this. The home is committed to ensuring that service users are well cared for and ensures that their needs are met. Overall the environment is well maintained and has all current safety checks in place. There is some cause for concern, though, with regards to appropriate risk assessments and staff training as previously stated in this report, and the owner is aware these must be addressed. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 3 2 2 Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 (4) (c) Requirement Risk Assessments for service users must be implemented and updated regularly, thereafter, in particular with regards to movement & handling and the risk of falls. The registered person must ensure that all staff be trained in adult protection protocols, and A person shall not employed to work at the care home unless all information as specified in schedule 2 of the Care Homes Regulations (2001) has been obtained in that two written references are in place for new members of staff. This should commence for all new members of staff as from date of inspection. All staff must be fully trained by an accredited trainer in mandatory training needs with a priority placed upon movement and handling. A training programme needs to be implemented for all outstanding training and the action plan forwarded to the commission DS0000029067.V262942.R01.S.doc Timescale for action 15/02/06 2 3 OP18 OP29 13 (6) 19 28/02/06 16/01/06 4 OP30 18 (1) (c) (i) 28/02/06 Durland House Version 5.0 Page 22 within the timescales stated. 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 Refer to Standard OP12 OP37 Good Practice Recommendations It is a good practice recommendation that the home records activities. It is strongly recommended that the home continue to improve their record keeping processes. Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Durland House DS0000029067.V262942.R01.S.doc Version 5.0 Page 24 - 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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