CARE HOMES FOR OLDER PEOPLE
Somerleigh Court Somerleigh Road Dorchester Dorset DT1 1AQ Lead Inspector
Gloria Ashwell Unannounced Inspection 27th October 2005 11:45 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 Somerleigh Court DS0000062046.V261891.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. Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Somerleigh Court Address Somerleigh Road Dorchester Dorset DT1 1AQ 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) 01305 259 882 Bentleigh Care Ltd Ms Margaret Anthea Gee Andrews Care Home 40 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (25) of places Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. A maximum of 15 service users under the category of DE(E) to be accommodated on the top floor of the building. Two named persons (as known to the CSCI) between the ages of 6065 may be accommodated to receive care. 7th April 2005 Date of last inspection Brief Description of the Service: Somerleigh Court is a purpose built nursing care home, first registered during November 2004. It is located close to the centre of Dorchester, within walking distance of shops and other facilities including a GP practice. Service user accommodation is on the ground, first and second floors; each floor comprises a separate unit with a dedicated staff team, lounge/dining room, kitchenette and hygiene facilities. The second (top) floor is registered to accommodate a maximum of 15 elderly persons requiring nursing care for conditions associated with dementia; the ground and first floors are registered to accommodate up to 25 elderly persons requiring nursing care. The home is managed by Mrs Andrews who is an experienced registered nurse. At all times a registered nurse is on duty on each unit. All service users are accommodated in single bedrooms with en suite toilets and wash hand basins. Each unit has a range of equipment including assisted bathing facilities to aid safe movement of service users with impaired mobility. Visitor’s cars may be parked close to the home (a permit obtained from the home MUST be displayed). Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection took place during April 2005; since that inspection no complaints against the home have been received or investigated. The inspectors arrived (unannounced) at 11.45. She spoke to the registered manager, and toured the premises speaking with 10 residents and 3 members of staff. The inspector observed staff interaction with service users and the carrying out of routine tasks, departing at 14.45. Additional information used to inform the inspection process included formal notifications of events provided to the Commission by the registered provider. The previous inspection was the first assessment of this recently established home (opened during November 2004) and high levels of compliance with the National Minimum Standards were found. Standards assessed and found met during the previous inspection were not reassessed during this inspection. The duration of this inspection was 3 hours. What the service does well:
Discussion with residents indicated they are exceptionally satisfied with all aspects of the home. On the day of inspection the home was very clean, comfortably warm and well staffed. The standard of nursing and social care is very good; each resident has a documented plan of care and staff are familiar with each resident’s needs and circumstances. The home is well equipped, attractively decorated and suitably furnished. Staff are enthusiastic and kind, and receive training. The home is well managed. Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (All these Standards were assessed and found met at the last inspection) The home assesses prospective residents prior to admission, but with particular regard to those with dementia, should improve aspects of the process to ensure that persons with any other mental health condition are not admitted. EVIDENCE: In advance of admission the home assesses the needs and circumstances of each prospective resident. For those with dementia, who are to be accommodated on the top floor of the home, the assessment process should be improved to be robust, systematic and with measurable outcomes i.e. the assessment should identify if the proposed resident has other mental health needs, and thereby falls within a category of need which the home is not registered to provide. Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 9 (Standards 8, 10 & 11 were found met at the last inspection) The standard of care is very good and in accordance with a written plan of care. Residents receive prescribed medicines at the correct times and in correct amounts; those wishing to do so can manage their own medicines. EVIDENCE: All residents with whom the inspector spoke said they felt very well cared for and safe. Staff to whom the inspector spoke were aware of each residents health and social care needs. Risk assessments form the basis for care plans and daily ‘evaluation sheets’ describe the care of each resident. Residents wishing to do so can manage their own prescribed medicines, although most prefer this to be done by the nursing staff. Residents said that nurses give them the correct medicines, at the correct times. Medicine records were accurate and included all necessary details.
Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 10 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): (All these Standards were assessed and found met at the last inspection) EVIDENCE: Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 11 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): (All these Standards were assessed and found met at the last inspection) EVIDENCE: Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 12 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): (All these Standards were assessed and found met at the last inspection) EVIDENCE: Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 13 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): (All these Standards were assessed and found met at the last inspection) EVIDENCE: Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 14 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): 38 (Standards 31, 32, 33, 35, 36 & 37 were found met at the last inspection) The premises and equipment are generally maintained in a safe condition but the frequency of fire safety equipment checks/tests must be improved to ensure that it will operate effectively in the event of need. EVIDENCE: Somerleigh Court is a modern purpose built premises, newly equipped with good quality items; maintenance agreements have been established for the safety checking of the passenger lift, fire safety equipment and other significant installations. Examination of records of ‘in house’ tests/checks of fire alarms indicated that these were not reliably carried out at the required weekly frequency, and the monthly visual checks of fire extinguishers had not been recorded. It is required that all fire safety equipment is maintained in accordance with the standards laid down by Dorset Fire & Rescue Service.
Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 15 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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 38 Regulation OP3823(4 ) Requirement Fire safety equipment must be checked/tested for safety in accordance with the standards of the local Fire & Rescue Service, and accurate records must be kept of these works. Timescale for action 01/12/05 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 OP33 Good Practice Recommendations The process of pre-admission assessment of prospective residents with dementia should be improved. Somerleigh Court DS0000062046.V261891.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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