Inspection on 07/07/08 for Durnsford Lodge Residential Home

This inspection was carried out on 7th July 2008.

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 20/07/06

Durnsford Lodge Residential Home 27/01/06

Durnsford Lodge Residential Home 03/11/05

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Durnsford Lodge Residential Home 90 Somerset Place Stoke Plymouth Devon PL3 4BG Lead Inspector Kim Fowler Unannounced Inspection 7 July 2008 10:00 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.V367406.R01.S.doc Version 5.2 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.V367406.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Durnsford Lodge Residential Home Address 90 Somerset Place Stoke Plymouth Devon PL3 4BG 01752 562872 01752 562872 care@durnsfordlodge.co.uk 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 (0), Old age, not falling within any registration, with number other category (0) of places Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of either gender whose primary care needs on admission to the home are within the following categories Old age, not falling within any other category (Code OP) Dementia (Code DE) The maximum number of service users who can be accommodated is 28 20th July 2006 2. Date of last inspection 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 residents 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. 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 residents by way of ramps. Some bedrooms overlook it and other bedrooms have a view of Plymouth Sound and the coastline of Mount Batten and Jenny Cliff. Residents 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 is not registered to provide nursing care and it does not provide intermediate care. The fees at Durnsford Lodge are from £290 to £375. Extra costs include hairdressing and chiropody (information provided by the Registered Provider July 2006). Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good outcomes. The unannounced inspection took place over 1 day and started at 10:00am and finished at 3.40pm. The homes deputy manager and one of the business partners were available throughout the inspection. The Registered Manager is currently on holiday. The inspector made a tour of the building and spoke to most the people living at the home, and three visitors who were visiting at the time of the inspection. Documentation relating to the care planning process and the management of the home were examined. Any comments people made are in the relevant section of the report. What the service does well: What has improved since the last inspection? What they could do better: Pre-employment checks, including references undertaken prior to employment, would protect people living at the home and ensure as far as possible that only suitable staff are employed. Please contact the provider for advice of actions taken in response to this Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 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 Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2/3/6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering admission to the home can be confident that a full assessment will be completed before admission, to ensure the home can meet their individual needs. EVIDENCE: Files examined held individuals contracts and included the terms and conditions of occupancy. These contracts were supported by the placing authority’s contracts. All files examined contained a pre-admission assessment. Also in place were the placing authority’s detailed care plans. The Manager will visit any prospective new admission to gather information to completed the preadmission assessments. One person living in the home said that they had a visit to the home before they moved in. Durnsford Lodge does not offer intermediate care. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff and manager provide good personal and health care support to people who live at the home. They also ensure the promotion of privacy and dignity at all times. EVIDENCE: All files examined held an initial assessment and a full assessment, both giving clear information detailing care needs and showed comprehensive care plan. One file also contained a family history to enable staff to be fully aware of individual’s background and needs. Evidence was recorded which showed that care plans are updated regularly. These care plans give detailed instructions to all staff to ensure intimate personal care is being provided in a manner that meets with peoples approval. This is particularly important as some people living at the home have limited communication skills. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 10 All peoples assessment and daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. The manager stated that the risk assessments are reviewed regularly and updated as and when needed. Since the last full inspection a new care plan review form has been produced. They showed a comprehensive review being undertaken and included the person living at the home, staff and family member where possible. One review examined had been signed and dated by the person whom it related to. All people living at the home have access to all health care services and information was recorded onto a medical visit record sheet in each persons file that there was input from other professionals including GP’s, chiropodist and consultants based at the local hospital. One example was a file that showed a record of a person living at the home raising a medical concern and evidence was recorded that this was followed up in the medical review form to show the GP had visited as requested. A record was made into the daily record so all staff are made aware of the visit and any follow-up treatment required. A person living in the home with high care needs had information on their file which showed that this is updated regularly, and from discussion with the staff they are aware of this person’s high care needs and have sought advice when needed. Most people living in the home were spoken with and some were able to confirm that their health care needs were met and one person said, “I have seen the District Nurse recently”. The deputy manager of the home talked through the medication procedure for the home. The home uses the blister pack system for administration. The deputy manager confirmed that the staff had attended medication training. It was evident from these discussions that deputy manager and other staff spoken with that they understood the medication procedure that included administration, storage and disposal of medication. Staff members were able to confirm they were due to attend a medication-training course with the local pharmacist. Any changes in medication were recorded, signed and dated onto the medication recording sheets. One staff file examined held a medication training course certificate. Most people living at the home were spoken with during this inspection and all confirmed that the staff respect their privacy and dignity at all times. Observed Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 11 during the inspection were staff knocking on peoples doors to promote privacy and shutting the bedroom door when attending to a person personal care needs. The homes AQAA returned states, “In the past twelve months, we have involved a wider range of health care professionals for advice and guidance”. One person living in the home said, “the staff always shut my door” and another stated, “They shut the bathroom door when I’m having a bath”. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Durnsford Lodge can be confident that the home offers good wholesome meals. The home welcomes and encourages families and friends to visit. EVIDENCE: People were observed moving freely around the home. Some people remained in their individual bedrooms and one person said, “I like to stay here but I will go downstairs when I feel like it”. Staff were seen interacting with people and discussing everyday topics and included assisting individuals when needed showing staff were aware of the needs of people living in the home. The home employs an activities co-ordinator to work with groups and individuals each afternoon. An activities programme was displayed in the home and this included a singer, bingo and a manicurist visit. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 13 The manicurist visiting during the inspection was spoken with and confirmed that she attended regularly and there was always a queue of people waiting to have their nails done. All family visits and contact is recorded into individual files, and daily records examined showed recent family visits for several people living in the home. All bedrooms visited contained personal possessions and items; one person living at the home said that the home encouraged them to bring in items from home. All people, who were able to, made positive comments about the food provided. One of the cooks was spoken with during the inspection about the menus and food on offer. The homes 4 weekly menus were displayed for all to see and showed a varied and nutritional diet. A record was also held to ensure that all people received a mixed diet of fruit and vegetables. It was evident from the food seen served at lunch time: liver casserole, potatoes and vegetables followed by home made crumble and custard, that the food was home cooked using fresh products. The meal was well presented and freshly prepared. The homes AQAA states, “Arrange more outside entertainment (Garden parties, coffee mornings, barbecues and indoor shopping trolley service)”. Observation during the inspection showed that the Shopping Trolley service was already running and was positivley received by all the people living in the home. The comments received from people living at the home about the food provided included, “good and I can have a choice”. One person said of the lunch observed being served, “The casserole was lovely”. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16/18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. EVIDENCE: The homes complaints procedure was displayed for all to access and the complaints file was available in the main office. This showed no complaints made to the home, and the Commission has not received any complaints. Most of the people living at the home were spoken with and some were aware of the homes complaints procedure and a few stated that they had never had any need to use it. Some of the staff members on duty were interviewed during this inspection. The discussion with these staff members confirmed that many had completed the Adult Protection training. This training was carried out by the local authority and it was clear from the information given to the inspector from some staff they had a clear knowledge and understanding of the Adult Protection process. This training is supported by a Safeguarding video - shown to staff regularly to ensure all staff are updated on their training. The homes Aqaa records that, “More staff to attend POVA training”. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19/26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Durnsford Lodge continues to maintain a clean and suitable environment for it’s stated purpose and the people who live at the home can be assured that they will live in an attractive and comfortable home that is regularly maintained. EVIDENCE: The home is safe and well maintained and suitable for its stated purpose. It is a very comfortable, warm and light home. Several people living at the home confirmed this is usual. The gardens and patio area are to the front of the house are well maintained and assessable for all. The home employs a maintenance person to carry out repairs. This included building a large extension for the new laundry room which house’s a new industrial washing machine and 2 tumble dryers. One person living in the home pointed out that they had a leak in their bedroom ceiling. However the maintenance person had already started to repair this. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 16 The home was very clean, hygienic and free from offensive odours. The process for the removal of clinical waste was discussed and was satisfactorily dealt with. Several of the staff confirmed they had completed an infection control course and that the home provided disposable aprons and gloves for their use. Since the last inspection the homes has purchased new chairs, beds and new carpets have been fitted. Scaffolding was still in place after a new roof had been fitted on the home. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27/28/29/30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff training is encouraged and this enables people who live at the home to receive the best possible service. Not all staff files contain all required pieces of information to help protect the people living at the home. EVIDENCE: The homes rotas and the staff confirmed that there is sufficient staff employed to care for the number of people currently living at the home. However some staff felt that at times due to holidays or sickness they could be short of staff. During the day of the inspection one staff member was sick and staff stated that it was harder worker with one staff member short. These care staff were supported by a domestic and a cook. Most of the staff on duty during the inspection were spoken with and each provided evidence that they either held an NVQ qualification or are working towards it. The deputy manager confirmed that staff either hold an NVQ certificate or have been signed up to start this training soon. One staff member spoken with said they already hold an NVQ level 2 and the home are supporting them to complete a NVQ level 3. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 18 Examination of staff files showed that most staff had the required preemployment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. However some staff files were examined and some did not contain the required pre-employment checks including references and CRB’s placing people living at the home at risk. One staff member file only held one reference and was written by a friend with no previous employer reference held on file and the CRB was completed 2 months after commencing employment. Another newly employed staff file did not contain any references, both were testimonials and one was dated 2002 and another dated 2007. On discussion with the Business partner it was agreed that any person who’s CRB came back with any recorded information should have these issues discussed, recorded and held on individual files and if needed be risk assessed to ensure the well being and protection of people living in the home. One staff member stated that their recruitment and selection process was fair and they had completed a CRB check. The homes AQAA states, “Our recruitment procedures are quite stringent and we look to employ persons who have long standing experience of caring and have a wide range of training in this area. All potential staff have to hold a clean CRB check and good references”. The staff-training files provided further evidence that regular training was carried out. All staff interview confirmed that they receive regular and updated training. This included First Aid, Manual Handling and Food Hygiene. Induction training is provided by Training Agency package and all staff receive the home Staff Hand book. Comments received from staff on the training offered by the home was, “The home support staff training” and “NVQ training offered”. One staff member said “good staff team, nice crowd”. Another said, “I love it here”! The people living at the home said of the staff, “Excellent”, “are lovely and caring” and another said, “ Staff come to room and bring me a cup of tea”. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31/33/35/38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners, manager and their staff team strive to provide a homely, stimulating environment that respects and protects people who live at the home. EVIDENCE: The Registered Manager was away during the inspection but the deputy manager and one of the partners in the business were able to assist throughout the inspection. One staff member interviewed said, “ Brilliant manager, and is supportive”. The deputy manager has a NVQ 4 in care and the Registered Managers Award. In the office all records are held securely. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 20 The deputy stated that the home has recently completed quality assurance forms but these were not read during this inspection. One person living at the home thought they had completed a form recently and said any issues they raised were acted upon. Staff supervision records showed that this was not carried out recently however all staff files showed that appraisals had recently been completed. The deputy and staff spoken with confirmed that staff meetings are held. Several service users money and accounts were checked and were accurate and well recorded. The records are secure, updated and the home monitors receipts and expenditure for the protection of all. Each individual file holds a record on who manages money for individuals. Sampling of records indicated equipment is serviced regularly and maintained in good order. Health and Safety is a priority in the home and records examined showed fire safety training and fire protection is in place and up to date. The accident records were accurate and files examined showed that information is recorded onto accident forms and also written into people’s daily records with appropriate action taken when needed. Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 21 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 22 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 OP29 Regulation 19(1)(b)( 4)(b)(5)(d )Schedule 2 Requirement The Registered Provider must obtain the required preemployment checks for all persons working in the home prior to the commencement of their employment. Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Durnsford Lodge Residential Home DS0000003476.V367406.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V367406.R01.S.doc Version 5.2 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. 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