Inspection on 02/08/05 for Durland House

This inspection was carried out on 2nd August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Durland House 20/06/07

Durland House 15/12/05

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 Unannounced 02 August 2005 12:00 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. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Durland House Address 160 High Street Rainham Gillingham Kent ME8 8AT 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) CRH Care Home 13 Mrs Margaret Agnes Hartley Category(ies) of Old age (13) registration, with number of places Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. admission of resident below 64 2. Three service users with dementia whose dates of birth are as follows:31.12.1915, 31.12.1915 and 02.02.1923. Date of last inspection 10 January 2005 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. It is home to 13 older people, 3 of whom are registered for dementia. The home is not registered to provide care for any other service users suffering from dementia. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by 2 inspectors who were in the home between 12.00 and 3.30 pm. Both owners, one of who is also the manager, supported the inspectors during the visit. Time was spent touring the home, and talking to residents. Documentation and records were also viewed including care plans and staff files. During the visit it was recognised that requirements from the previous inspection had either been met or partially met. What the service does well: What has improved since the last inspection? What they could do better: Record keeping in the home needs to be improved, especially relating to staff files. This would enable the manager to ensure that staff receive all appropriate training and supervision. Care plans would also benefit from having more detail included. Medication also needs to be monitored more closely to ensure that all records are fully completed. The home is still looking for additional staff so as to improve the opportunities for outings for residents. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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 H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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 Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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) 1 The homes Statement of Purpose and Service User Guide provide prospective residents with the majority of information they need to make an informed choice about moving into the home. EVIDENCE: The home has a fairly comprehensive Statement of Purpose and Service Users Guide in place that provides prospective residents with information about the home, however they need to be updated to reflect the number of residents registered within the home for dementia. Fire procedures are also omitted from this version and need to be included. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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 and 9 Residents would benefit from care plans showing more detail in order to meet all individual needs. Health needs are met and residents’ benefit from having full access to all professional health care services as required. Residents would benefit from medication records being improved. EVIDENCE: Records and care plans for residents were viewed. Care plans included needs assessments and daily living requirements. Care plans had recently been reviewed and the manager was currently updating all risk assessments. The manager was working towards improving the care plans so that contain more detail and was using professional guidance to help her in this area. Daily notes were comprehensive and well documented. Since the last inspection the ‘handover’ book for staff shift changes has also been improved by which staff can ensure that continuity of care is promoted. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 10 The home makes arrangements for any health related professionals to visit such as chiropodist or optician. All residents have their own G.P. and are supported in going to appointments. Medication records are still in need of improving to ensure that signatures are always in place and all appropriate records are fully completed. All medicines and any controlled drugs are stored appropriately. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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) 12, 13, 14 and 15 Residents’ benefit from a daily living routine which is flexible to suit their needs and preferences, but organised activities and outings do not promote a variety of choice. Residents are supported to maintain contact with family and friends, which ensures they continue to receive emotional support. The resident’s benefit from the appetising meals and a balanced diet offered by the home. EVIDENCE: Several residents were spoken to during the inspection and generally were all very complimentary of the home and the staff. Comments included • • • • • “I love it here and it has done me good” “It’s very nice living here” “The staff are very very good” “The food is lovely and cooked nicely” “The carers are lovely and I am spoilt” There were some less positive comments made with regards to activities and outings including “I sometimes get bored”. On discussions with the manager it Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 12 was identified that there are some activities including bingo and entertainers visited the home on occasions, including the local school choir at Christmas. An activities programme was seen to be on display. The manager had also been unable to replace the activities co-ordinator, although she is still attempting to find support in this area. The home organises birthday parties for individuals and staff support residents in visiting local shops or going out for a walk. The manager stated that they had tried to organise outings but residents often changed their minds at the last minute. Some residents visited local clubs on a regular basis and visits to their families are promoted. Residents, who wished, are supported in attending local churches and ministers also visit residents within the home on a regular basis. Family and friends are encouraged to visit and one family member spoken to highly recommended the care and support given within the home, and stated that he was always made to feel very welcome. Meals were observed being served and residents had the choice of eating their meal at the main dining table, in the lounge or in their rooms if they preferred. The menu showed a choice being offered and specialist diets were catered for. All residents spoken to said they were enjoying their meal. Since the last inspection the home now records meals and food eaten, so enabling them to monitor and support individual diets and well being. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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 The home has a clear complaints procedure so residents and relatives are aware of how to complain. EVIDENCE: There is a written complaints procedure in place that includes timescales and the address of the Commission of Social Care. There have been no complaints since the last inspection. The complaints procedure is also in place in the Statement of Purpose and Service Users Guide. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Residents’ benefit from living in a homely, pleasant and nicely decorated environment, which is clean and hygienic. EVIDENCE: At the time of inspection the home was in the process of being redecorated. This was being tastefully done and was in keeping with the home. Overall there were good standards of cleanliness and no odours were detected anywhere in the house. The residents have two communal lounges and a separate dining area. One of the lounges was quieter and smaller. All communal areas were pleasant, light and airy with a homely feel. Because of the layout of the home there were some small steps between different areas, but residents were observed moving around the home freely and where necessary were assisted by staff. All rooms except one had en-suite facilities and this room is situated directly opposite bathroom facilities. All rooms were nicely decorated and new Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 15 furniture had been purchased for some of the rooms. Shared rooms have screening available between beds to protect resident’s privacy. The main bathroom had recently been refitted with a new suite and tiles. Some of the rooms had their own telephone extensions and the manager stated that they would fit additional sockets if anybody requested this facility. None of the rooms had locks, although there was a lockable storage facility in all wardrobes. It was recommended at time of inspection that locks with an override could be fitted to bedroom doors. There were call bell systems and smoke alarms in all rooms and emergency lighting on main fire routes. There was bath hoist in the main bathroom and there are handrails around the home. There is also a stair lift to all floors. It was observed that some of the radiators were not covered and the manager would need to do a risk assessment for health and safety relating to these radiators. The laundry area was clean and spacious with 2 washers and 2 dryers. There was also a large storage area for linen. There is a bathroom and toilet off the side of the laundry but the Manager stated that only the toilet is in use. The home also evidenced complete up to date records for all relevant health and safety checks that had been carried out including Environmental Health, Fire Certificate, water supply and gas safety record. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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 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 and 30. Residents benefit from long term staff members who provide continuity of care. However the care of residents could be compromised where staff are not fully up to date with all mandatory training. EVIDENCE: The home has 13 members of staff who have all been working within the home for a number of years. There is a proportion of staff that work nights and 2 members of staff provide some additional hours for domestic duties. The owners are also in attendance and familiar with all individual resident’s needs. The owners are actively supporting staff with NVQ training. A record of TOPPS induction was seen in some of the files. There was some concern noted about other areas of training, where staff may not be fully up to date with all mandatory training needs, as these could not be evidenced in all staff files. The manager was aware that staff records needed improving, as they had no continuity and it was difficult to evidence recruitment policies and practices and any relevant training which had been undertaken. Staff contracts and CRB checks were in place. Discussions were held with regards to the management and organisation of staff files and the manager was advised that they would need reviewing and it would be good practice to put into place a training matrix so that she can monitor and keep up to date with staff needs. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 17 The inspectors observed staff members treating all residents with courtesy and respect during the inspection and interacting well. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 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) 36 and 37 The manager needs to continue to enhance staff skills through supervision so as to further safeguard all residents and also to ensure that records are fully maintained. EVIDENCE: There were no records of regular supervision for staff and the manager stated that this tended to be held on an informal basis at staff ‘handover’, and that she did not record these on a formal basis. It was advised that a more structured approach to supervision be introduced. This would benefit both staff and residents. Discussions were held with regards to the management and organisation of staff files as they were quite disorganised and had no continuity. The manager is aware that they need to be improved and is continuing to work on them. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 19 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 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 2 2 x Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? Yes. Although any outstanding requirements have been partially met to some degree. 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 OP 12 Regulation 16 (2) (m) Requirement The home should consult with service users about their social interests in that outings and activities for residents are promoted and facilited. Persons working at the care home are appropriately supervised so that all staff receive regular formal supervision which is recorded. Timescale for action 31st October 05 2. OP 36 18 (2) (a) 31st October 05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP 7 Good Practice Recommendations It is recommended that care plans continue to be improved so that the plan sets out in detail the action which needs to be taken by staff to ensure that all aspects of the health, personal and social care needs are met, and that risk assessments are in place especially in relation to falls. Records of medication received and administered should be monitored on a closer basis. Doors to service users room should be fitted with locks suited to service users capabilities and be accessible to H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 21 2. 3. OP 9 OP 24 Durland House 4. OP 25 5. OP 37 staff for emergencies or there should be clear records stating reasons for locks not being fitted to individual rooms. Any radiators which are not guarded or have a guaranteed low surface temperature should be risk assessed and appropriate measures taken in accordance with the risk assessment. Staff records need to be reviewed so that they are up to date and kept in good order and maintained, thereafter. Durland House H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Oast, Hermitage Court Hemritage Lane Maidstone Kent 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 H56-H06 S29067 Durland House V237564 020805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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