Inspection on 03/11/05 for Durnsford Lodge Residential Home

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Durnsford Lodge Residential Home 07/07/08

Durnsford Lodge Residential Home 20/07/06

Durnsford Lodge Residential Home 27/01/06

Durnsford Lodge Residential Home 07/09/04

Durnsford Lodge Residential Home 14/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Durnsford Lodge Residential Home 90 Somerset Place Stoke Plymouth Devon PL3 4BG Lead Inspector Megan Walker Unannounced Inspection 3rd November 2005 09:45 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 Durnsford Lodge Residential Home DS0000003476.V265189.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. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Durnsford Lodge Residential Home Address 90 Somerset Place Stoke Plymouth Devon PL3 4BG 01752 562872 01752 562872 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) Mr Ernest Boyter Bertie Mrs Iris Emily Bertie Mrs Carole Diane Scott Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28), of places Physical disability over 65 years of age (28) Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Uses from the age of 60 may be admitted to the Home. Date of last inspection 7th September 2004 Brief Description of the Service: Durnsford Lodge is situated in a residential area of Stoke close to local shops and other amenities and local transport links. The home provides accommodation and personal care for 28 Service Users over the age of 60 for reasons of old age, dementia and physical disability. There is 24hour staffing including night waking staff. The home is 2 large houses redesigned to become one home that has further been extended. The home provides 20 single and 4 double bedrooms, of which 5 and 1 respectively have en suite facilities. There are 2 lounge rooms. One of these is designated as a smoking room although it also provides access to a number of bedrooms. A large dining room has the other lounge leading off it. A passenger and stair lift provides access to all floors. The garden is well maintained and accessible for Service Users by way of ramps. Some bedrooms overlook it and other bedrooms have a view of Plymouth Sound and the coastline of Mount Batten and JennyCliff. Service Users are enabled to access any health and social care services they require. Parking is available at the front of the property and in the street. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday 3rd November 2005 between 10h00 and 16h30. The inspection included a tour of the premises. Time was spent talking with service users, staff, the Deputy Manager, Helen Vickery, and the Registered Manager, Carole Scott. Care records, staff files, and other records and documents were inspected. The inspector prior to the inspection received five Relatives/Visitors Comment Cards and five Service Users Comments Cards. During the inspection the Registered Manager was interviewing for day and night care staff posts. Also in the afternoon ten staff, including the Deputy Manager and the Registered Manager had an exam, held in the dining room and adjudicated by an external assessor. There has been an issue about theft of food from the larder. The Registered Manager has taken action to prevent this continuing. There were six requirements from the last inspection. Three of these requirements had not been fully actioned by this inspection, and two of these three were outstanding from the inspection before last. There are thirteen requirements and three “Good Practice” recommendations to be met following this inspection. What the service does well: The service users at Durnsford Lodge receive a good level of personal care. The staff have a fair understanding of the needs of the service users and in conversation about individual service users are clearly able to recognise changing needs. The staff have a good working relationship with social services and mental health services. The Registered Manager is proactive in making sure that all staff have foundation training in the care of older people and opportunities to take other Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 6 relevant courses to improve their knowledge and personal development in care work. Service users spoken to were happy living in the home and praised the care staff that work there. Contact with family, friends and the local community is encouraged. Relatives/Visitors Comments Cards received prior to the inspection praised the care given by staff to service users living in the home. The staff spoken to were confident with good levels of morale and teamwork. What has improved since the last inspection? Ten staff have taken a fourteen-week course for a Certificate in “Positive Dementia Care”. All these staff took the exam during the inspection and they all passed. The Registered Manager has reviewed and is changing the recording system for service users care plans and daily record sheets. This will enable staff to have an “at a glance” overview of each service user when they come on duty. It still requires more detail and needs to easily identify current care needs of individual service users. The Registered Manager has reviewed and changed the staff training record. Now each staff member has a training record including training completed and to be done, with dates, on their individual staff file. An assessment of the home and its facilities has been done by an Occupational Therapist. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 7 What they could do better: The recording system is under review by the Registered Manager. Whilst it has improved since the last inspection, it still needs to easily identify current care needs of individual service users. Staff need to record details about any change they perceive in service users. Such information will assist reviews of Care Plans that must provide a record of changing needs. Reviews must also record the extent to which individual service users have contributed to the process. The home provides for more people with mental health needs than those who have dementia. Staff would benefit from mental health training to enhance their recent dementia care training. The Provider should consider which category of care the home is actually able to meet, and ensure that the home is registered accordingly. The maintenance of the home is poor: - Redecoration is needed in some of the bedrooms where plaster is cracking and wallpaper is bulging and/or peeling away from the wall. - Several carpets are stained and need to be replaced if they cannot be cleaned. - Several carpets are stretched and ill fitting causing potential trip hazards to service users, staff and visitors to the home. - The pipes in the laundry room must be lagged and boxed-in with service hatches to provide the plumber with easy access to all the valves. Some areas of the home had offensive smells and stale cigarette smoke. Air freshening devices must be installed to overcome this. In order to safeguard service users who prefer to have their bedroom doors open, automatic fire safety door closures should be fitted. The laundry room must not be used as an escape route. More stringent measures must be put in place to ensure that service users cannot access the laundry room at any time of the day or night. The window in the Manager’s office must have a window restrictor fitted to it to ensure the safety of all the service users living in the home. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 8 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. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 9 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 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 10 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): 2,3,4,5 Service users and their families are given useful information and made to feel welcome before and after they move in. A dedicated team of care staff provide the service users with a good standard of care. EVIDENCE: Inspection of the four most recently admitted service users’ files confirmed that each service user was assessed prior to moving into the home. One file had a personal history and background of the individual. Where relevant, good care plans had been provided by either social services or mental health services. The Deputy Manager and a staff member confirmed that anyone considering moving into the home could visit and spend the day joining in with meals and other activities. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 11 There was a discrepancy regarding contracts between the service users who are funded by the Local Authority and those who are self-funding. The service users files inspected had contracts only for Local Authority funding. None of the service user’s files inspected had a written statement of terms and conditions. Discussion with the Deputy Manager, Registered Manager and a Senior Carer, and inspection of staff files confirmed that staff are developing their skills and knowledge to care for the service users living at Durnsford Lodge. Observation during the inspection showed staff as caring and committed to meeting the needs of the service users living in the home. The home does not provide intermediate care. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 12 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): 7,8,10,11 Service users can feel confident that their health care needs will be met. EVIDENCE: The Registered Manager explained that she has recently changed the recording system so that each service user now has a daily record sheet as well as their individual Service User file. This is intended to provide staff with an “at a glance” history of any recent changes or needs of a service user. There is also a home’s diary for hospital appointments, dentist, optician visits, etc. Inspection of Service User’s individual files and the daily record sheets did not show clear details of any changes unless there had been a seriously significant event. In such circumstances this was recorded on the Service User’s file, and when appropriate in the Accident Book. There was also subsequent information for staff to follow for future care of the service user. This included risk assessments where necessary. There was a record of reviews of care plans although this was only a date and a staff signature. Service users seen on the day of the inspection appeared well cared for. The Registered Manager confirmed that staff encourage appropriate dressing if Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 13 necessary although this may be over a period of some time so that the service user is not upset nor in conflict with the staff. Discussions with staff indicated that they have a good understanding of the needs of the service users in their care. The Registered Manager and the Deputy Manager confirmed that they and other staff members provide support required and as preferred by individual service users. One service user spoken to confirmed that whenever he has to attend hospital or other health-related appointments a carer will go with him. Inspection of Service Users’ files and the home’s diary confirmed that there is a record of all appointments with doctors, opticians, dentists, and other specialist services. Staff stated that they have a good working relationship with health providers. In discussion about illness and death the Registered Manager explained how recently the hospital had liaised with the home’s care staff regarding a service user who was an inpatient because he had no family or next of kin. There has been one death of a service user since the last inspection. All the service users spoken to stated that they were well cared for and that staff were kind and caring. One service user commented “the staff do their best even when there is nothing they can do”. All the Service Users Comments Cards stated that services users feel that they are well cared for, that staff treat them well and that their privacy is respected. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 14 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): 12,13,14,15 All the service users are able to make informed choices about their lifestyles within the home. Service users maintain contact with their family/friends/representatives and the local community. A staple diet is available to all service users. EVIDENCE: Both the Deputy Manager and the Registered Manager confirmed that risks are explained to individual service users so that service users can make an informed choice about their lifestyle. This information was confirmed during the tour of the premises and meeting service users. Good interaction between staff and service users was observed. Where risks are perceived risk assessments had been completed. Services users are helped to make choices about what they want to do and staff support individual decisions. The Registered Manager stated that there have been occasions when staff have used gentle persuasion, for example, day trips during the summer months. The Registered Manager also stated that this would only happen if it would be for the benefit of the individual service user, Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 15 and in the event of adamant refusal, that wish would be respected. One service user was observed doing a jigsaw puzzle in her room and she confirmed that this was her preference during the afternoons. A number of service users were observed having an afternoon rest or sitting in their rooms watching television or reading. Staff spoken to confirmed that service users could choose to go to their rooms or to sit in any of the communal rooms. There is a programme of activities within the home including bingo however the Occupational Therapist’s report recommended that this should be formalised to ensure these activities happen. In conversation with service users it was confirmed that family and friends could visit when they choose, and that service users go out, some regularly, to meet up with their families and friends. Observation confirmed that service users could receive their visitors in private or in the communal rooms. Observation confirmed that staff knock on bedroom doors before entering. All the Service Users’ Comments Cards confirmed that they do not wish to be more involved in decision making within the home. The Deputy Manager confirmed that the home does not hold regular Residents Meetings because there is little or no interest or participation by the service users at such meetings. A full time cook is employed for midday meals Monday to Friday, and a parttime cook for Saturdays and Sundays. The care staff prepare breakfast and tea. A staff member confirmed that different dietary needs are catered for both service users and staff, and that meals are served in the dining room unless a service user is poorly, in which case food is taken to them in their rooms. One service user spoken to confirmed that service users are encouraged to go to the dining room for meals and “staff prefer you to go to the dining room”. All the service users spoken to had varied views about the quality of the food. No one confirmed that there was a choice at midday except when liver was on the menu. Also none of the service users spoken to about the food thought that they could have something other than what was on the menu. The Registered Manager stated that all the service users to her knowledge enjoyed the midday meal served on the day of the inspection and that no one had ever requested an alternative. Inspection of the Resident’s Menu for the three weeks prior to and including the week of the inspection showed occasional choice for some meals such as liver or faggots. This is not however always clear whether the “alternative choice “ is for lunch or tea. There is never a choice for sweet at midday or more traditional meals such as cottage pie or “roast” dinners. The menus all state “Residents to inform staff if they wish an alternative choice”. Discussion with staff implied that at teatime service users do have more choice than is recorded on the menu sheets. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 16 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 17 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): 16,17,18 Service users are protected from abuse, neglect and self-harm. Their legal rights are protected. EVIDENCE: Inspection of Service Users’ Files and the Accident Book confirmed that staff are responsive and take appropriate actions to prevent abuse and self-harm. The files showed recordings of involvement and joint working with the Community Mental Health Team to prevent further self-harm. Discussion with the Registered Manager confirmed that she is competent in dealing with alleged abuse and taking necessary measures to ensure the protection of service users being cared for in the home. There has been one Adult Protection investigation since the last inspection. This is still pending an outcome due to the nature of the investigation. There have been no complaints received either by the home or the Commission since the last inspection. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 18 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): 19,20,21,22,23,24,25,26 Service users do not live in a safe, well-maintained environment. EVIDENCE: There were areas of potential risk of service users, staff or visitors tripping on poorly fitting carpets. Several carpets in bedrooms and in communal areas were badly stained and made the home look dirty and neglected. Some bedrooms and a corridor have been fitted with vinyl flooring. On the day of the inspection this was sticky to walk on. Some bedrooms and other areas of the home had offensive smells. The decoration was variable in different parts of the home. Some service users prefer to keep their bedroom doors open but can only do so by blocking it open with a commode or other large object. This is a fire safety hazard and puts everyone in the building at risk. A manual hoist inspected had an out of date safety certificate. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 19 A tour of the building confirmed that service users are encouraged to bring in personal items with them when they move into the home. One Service User File inspected had an inventory of personal belongings. The home employs a Maintenance Man who carries out regular and ad hoc repairs. Some of the bedrooms inspected had cracking plaster and bulging wallpaper. One room had a wet patch under the window, spreading under the wardrobe. The carpet on one staircase was stained particularly the top steps and on the half-landing. The carpet in one bedroom was badly stained and rucked causing it to look unsightly and posing a trip hazard to both the service user and to staff. The carpet had stretched and was rucked in the hall, some of the bedrooms and the Manager’s Office. One bedroom did not have a plug for the wash hand basin. Some bedrooms that do not have en-suite facilities had commodes prominently placed within them. One bedroom had the commode in front of a window overlooking the street. In the same room the wash hand basin is also visible from the street. There were no net curtains for privacy. Bars of soap were provided in all the communal bathrooms/toilets, and a tub of cream was found in one communal bathroom. Most of the toilets had no toilet roll holder. Some of the bedrooms smelt strongly of urine. Areas in the home near the “Smokers Lounge” had a strong residual smell of cigarettes. The pipes in the laundry were exposed. Inspection of Service Users Files and in discussion with staff it was confirmed that service users have gained access to the laundry although it is in a “staff only” part of the home. The window in the Manager’s Office does not have a window restrictor. It is on the first floor. This room is easily accessible by service users. There were periods during the inspection when the room and the window were left open and unattended. The Registered Manager confirmed that the Registered Provider is planning to start a refurbishment and redecoration programme in the near future. Service users will temporarily move in to vacant bedrooms whilst works are carried out in their own rooms. The Registered Manger confirmed that she was aware of the stair carpets and will ensure that they are cleaned with a carpet cleaner. She also confirmed that she would check all the carpets and look into getting them properly fitted. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 20 The Registered Manger confirmed that toilet roll holders would be fitted in all the toilets needing one. The Deputy Manager explained why there is no plug in one service user’s wash hand basin. Since the inspection the Registered Manager has confirmed that there is a risk assessment to support this action. The Deputy manager explained that some service users like to have a commode in their bedroom for use at night-time. There was no record of this on care plans. The Registered Manager agreed that a different sort of air freshener would be fitted in bedrooms and other areas of the home to ensure that it smells clean and pleasant. Discussion with staff confirmed that there are only two service users currently resident in the home that smoke and that staff no longer use the “Smokers Lounge”. Instead they stand outside at the back of the home, outside the laundry room. The home has a smoking policy for service users, however, the Registered Provider may wish to consider revising this if the number of smokers continues to be a minority. In the interests of the majority who do not smoke, suitable air-freshening devices should be fixed in the “Smoker’s Lounge”, and in surrounding areas where the smell of cigarette tobacco is prevalent. The previous requirement to box-in the pipes in the laundry had apparently been adhered to and the Maintenance Man had built a sliding case around them that could be unscrewed to provide access to the valves. At the time of the inspection this casing was no longer in place nor evident because apparently the plumber had objected to it. The Registered Manager stated that there is currently a dilemma over whose legislation is to be followed. Further discussion showed that both the requirements of the Commission and those relating to health and safety can be met by lagging the pipes (also a cost-saving measure), and by boxing-in the pipes and providing easily accessible service hatches to the valves. The Registered Manger confirmed that new procedures are now in place to ensure that service users cannot get into the laundry room. These procedures however are limited to quieter periods of the day. Since the inspection the Registered Manager has confirmed that there is a risk assessment to support this action. An Occupational Therapist has assessed the home since the last inspection. However there was no evidence that any of the recommendations had been actioned. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 21 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 22 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): 27,28,29,30 There are good recruitment procedures. Necessary checks and references are performed to safeguard service users. Staff are competent in doing their jobs. EVIDENCE: Inspection of staff files showed that there is a thorough system for checking staff before they start in the home. Two references were on each staff file inspected. Criminal Records Bureau checks had been made on all staff except one. The Registered Manager confirmed that this has been applied for and that the staff member concerned has no one-to-one contact with service users. There was one staff file without a photograph of that person. The Registered Manager confirmed that all the required checks would be made for anyone considered suitable to be appointed as a consequence of the interviews held on the morning of the inspection. Records inspected confirmed that staff are working towards ensuring that at least 50 of care staff have NVQ training. All staff undergo the home’s own induction procedure. This provides staff with an understanding of the work they are employed to do. The Registered Manager has now completed the NVQ Level 4 Award in Care and Management, and the Registered Manager’s Award. 10 staff have completed a distance-learning course in Dementia Care and took their exam on the day of the inspection. The Registered Manager is pro-active in encouraging relevant training and has started individual staff training records. The next block training for staff is planned for the early part Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 23 of next year. Records inspected show that all staff have regular fire training and fire drills. In September senior carers, the Deputy and Registered Managers completed a Fire Safety Awareness course. Other records inspected show evidence of staff training in Continence Care; Care of Diabetic Clients; Safety Compliance; Manual Handling. There was no evidence of Infection Control training. Discussion with staff and observation during a tour of the home, for example, bars of soap and communal hand towels in communal toilets and bathrooms, and in the staff toilets, showed that staff might not be fully aware of the risks of infection and how it can be prevented. One staff member stated that mental health training would be beneficial because more service users living in the home had mental health needs and did not have dementia. Observation and conversations with service users confirmed this to be the case. Inspection of Service User files, and discussion with staff about the needs of service users also confirmed that more service users have mental health needs than require care for dementia. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 24 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): 31,32,33,37,38 Mrs Carole Scott manages Durnsford Lodge well and competently. She provides clear leadership promoting confidence and good morale amongst all staff members. EVIDENCE: Records inspected showed that there are regular checks in relation to fire. All portable electrical equipment is due for its annual test this month. There has been a programmed Environmental Health Officer’s visit since the last inspection. All the recommendations have been actioned. The home is joined up to the “Community Pharmacy Advice To Homes” Scheme provided by Plymouth Primary Care Trust. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 25 There is sufficient staff on duty to care for the needs of the service users although one staff member stated that she no longer has time to chat with service users as in the past. One service user stated that night staff return clean laundry to service users rooms during the early hours of the morning because they have to start getting people up at 05h00. Discussion with night staff confirmed this to be true because there are some service users who choose to get up at this time. One service user spoken to stated that she likes to get up at 06h00 because it is something she has done most of her life. She also stated that she could have a cup of tea in the dining room at 07h00, before breakfast at 08h30. All staff spoken to confirmed that they felt Carole Scott to be an approachable manager and with whom they felt able to discuss any issues of worry or concern. Observation during the inspection before and after the Dementia Care exam showed Carole Scott to be encouraging and appraising of her staff team. All evidence in the home including staff comments, discussion with service users, feedback from Relatives/Visitors Comments Cards and records indicate that the home is well managed and that there is a commitment by the Registered Manager in running the home in the interests of the service users. Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 26 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 1 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 2 2 3 2 2 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x 3 3 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 27 Are there any outstanding requirements from the last inspection? YES 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 OP2 Regulation 17 Requirement Service users who are selffunding must have a written contract on their Service User file. The Registered Provider confirmed in writing on 15/12/05 that this requirement has been met. Service users must have a written statement of terms and conditions on their Service User file. The Registered Provider confirmed in writing on 15/12/05 that this requirement has been met. The home must maintain a permanent record of service users care plan reviews and the extent to which service users contribute to the process. The home must ensure that all service user care plans readily identify the service users current care needs. This requirement is outstanding from the previous two inspections. The home must provide mental DS0000003476.V265189.R01.S.doc Timescale for action 31/12/05 2 OP2 17 31/12/05 3 OP7 15 31/12/05 4 OP4 4 28/02/06 Page 28 Durnsford Lodge Residential Home Version 5.0 5 OP15 Reg17 (2) Sch4 (13) 6 OP19 23(2b,d) 16(2c) 23(d) 13(4a,c) 16(2c) 7 OP19 8 OP19OP26 16(k) 9 OP19 13(3) health training for staff so that service users with those needs know that they will be properly cared for by appropriately trained staff. The Registered Provider must apply to the Commission for the additional category MD(E) if the home is to continue providing care for service users with mental health needs. This requirement is outstanding from the previous inspection. Records of food provided for service users must show more detail particularly when an alternative has been offered. Service users must be offered a choice of food as well as an alternative. The Registered Provider must supply the Commission with a programme of planned redecoration and refurbishment. All carpets identified to the Registered Manager during the inspection must be cleaned or replaced. All carpets must be free of rucks or other trip hazards or replaced. This requirement is outstanding from the previous inspection. The home must be kept free of offensive smells The Registered Provider confirmed in writing on 15/12/05 that this requirement has been met. All bars of soap, tubs of cream and towels for communal use in communal bathrooms and toilets must be removed to prevent infection or the spread of infection The Registered Provider confirmed in writing on DS0000003476.V265189.R01.S.doc 31/12/05 31/12/05 31/01/06 30/11/05 03/11/05 Durnsford Lodge Residential Home Version 5.0 Page 29 10 OP19 12(1a) 13(4c) 11 OP21OP24 12(4a) 16(2c) 12 OP23 12(1a) 12(3) 13(4c) 13 OP26 13 15/12/05 that this requirement has been met. A window restrictor must be fitted in to the window in the Manager’s Office. The Registered Provider confirmed in writing on 15/12/05 that this requirement has been met. Commodes must be placed in more discreetly in bedrooms and net curtains or a screen must be provided where wash hand basins and commodes are next to windows in order to ensure and maintain the privacy and dignity of the service user at all times. The Registered Provider confirmed in writing on 15/12/05 that net curtains will be provided to meet this requirement. The Registered Provider must ensure that appropriate fire safety door closures are fitted to rooms where service users prefer their bedroom door to be kept open. All exposed pipe work in the laundry room must be lagged and boxed-in with useable service hatches providing easy access to all valves. This requirement is outstanding from the previous two inspections. The Registered Provider confirmed in writing on 15/12/05 that this requirement has almost been met. 31/12/05 30/11/05 28/02/06 31/01/06 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 30 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 OP14 Good Practice Recommendations The Registered Manager and staff should ensure that other parties, e.g. Mental Health Services, are fully consulted and involved in assisting service users to make choices about what they want to do. The Registered Provider should consider revising the home’s smoking policy to suit the health needs of the majority of the service users who do not smoke. The Registered Provider should consider installation of a sluice facility to help control the spread of infection. 2 3 OP19OP26 OP26 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 31 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Durnsford Lodge Residential Home DS0000003476.V265189.R01.S.doc Version 5.0 Page 32 - 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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