Inspection on 13/02/08 for The Dales

This inspection was carried out on 13th February 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Dales 28/01/09

The Dales 12/12/06

The Dales 21/01/06

The Dales 07/06/05

The Dales 21/02/05

The Dales 17/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Dales Main Street Ellenborough Maryport Cumbria CA15 7DX Lead Inspector Nancy Saich Unannounced Inspection 13th February 2008 9:00 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 The Dales DS0000022548.V355807.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. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Dales Address Main Street Ellenborough Maryport Cumbria CA15 7DX 01900 817977 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) Dales Care Homes Limited Mrs Joan Margaret Iredale Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability over 65 years of age (1) of places The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 40 older people (OP), 1 of whom may have a physical disability (PD(E)). 12th December 2006 Date of last inspection Brief Description of the Service: The Dales is an older property that has been extended and adapted to cater for up to 40 older people. It is situated in the centre of Ellenborough, a residential area of Maryport. It is near to all the amenities of the village and the town. The home is owned by the Iredale family, and the registered manager Mrs Joan Iredale has recently retired. Her son Graham Iredale is applying to be the manager. The accommodation for residents is on two floors served by a passenger lift. Most of the bedrooms are single occupancy but there are some double rooms available. The home has a number of large and small lounges and a small patio area outside. Charges range from £373 to £434 per week. Further information can be obtained from the home. The Dales DS0000022548.V355807.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 1 star. This means the people who use this service experience adequate quality outcomes. This was the main or ‘key’ inspection for the year. Some weeks before the visit we asked the residents’ representatives to give out surveys to people who live in the home. We received a number of these after the visit, and they gave us a positive picture of the home. We also asked the manager to complete a document called the Annual Quality Assurance Assessment (the AQAA). This asks them to describe what has happened in the home since we last inspected it. It also asks them to tell us about their plans for the future. This AQAA was returned promptly and in great detail. We also checked on all the other information we received during the past year. This included any report of accidents, complaints or concerns. We judged that any of these reported to us had been dealt with correctly. The lead inspector, Nancy Saich, visited the home, met with the people who live there, and with the staff and the management team. We shared a meal with residents, walked around the building and read files and documents that backed up what we saw and what people told us. What the service does well: The home has a good brochure and a new website that describes the care and services provided. People were satisfied and content with their lives and a number of them told us they felt that the home took into account their individual preferences and needs. Medical care and the management of medication are very good and people are supported in maintaining good health. Staff treat people with dignity and respect. Residents said that they felt that the staff treated them with the kindness, care and sensitivity. The people who live in the home told us that they enjoyed the entertainments and activities on offer. We judged that the life story project with local community groups is an example of good practice. They also told us that the food provided was a very high standard and we sampled the food provided on the day. Meals were relaxed and everyone enjoyed both the high-quality food and the opportunity to socialise. There are suitable arrangements in place for people to have complaints taken seriously, and for the safeguarding of vulnerable adults from abuse. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 6 Residents have clean and comfortable bedrooms and plenty of shared space that they can relax in. Several people said they liked the fact that there were a number of lounges to sit in and that their bedrooms were a good enough size to comfortably spend time in. The staff are aware of the things they need to do to prevent cross infection and they do their best to keep the home clean. Normally there are enough staff to give very good levels of care and services. Staff have National Vocational Qualifications in care, have received suitable training in the past and are keen to complete the new training they have planned. What has improved since the last inspection? What they could do better: We want the acting manager to make sure that they always receive an up-todate social work assessment of any new resident. This will make sure that home has as much information as possible about a new resident. The management team need to make sure that care plans are always up to date, detailed and available to staff and residents alike. Staff and management need to make sure that home is tidy and safe both inside and out. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 7 Any new member of staff must not work in the home until their name has been checked against the Protection of Vulnerable Adults List. This will ensure that residents are always protected from possible harm. The acting manager must apply for registration as soon as possible, and the company must arrange for a change to the name of the responsible individual. This needs to be done so that the registration reflects the changes that have taken place over the last year. 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. The summary of this inspection report can be made available in other formats on request. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 8 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 The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 9 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): 1, 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The way new people are admitted needs to be improved so that the right information is always in place and that the right care can be given from the start. EVIDENCE: The AQAA tells us that The Dales have a new website that gives plenty of information about the home. We were also given a new brochure for the home and saw their Statement of Purpose. Together these give plenty of information about life in The Dales. We met new residents who told us that they had been encouraged to visit before they decided to move in to the home. We also saw files that prove that management went out to see people before they came into the home and that the admission was planned with the resident in mind. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 10 We did find that the home had accepted new residents without all the necessary paperwork from Social Workers. This means that sometimes the full information is not available to the staff and some residents’ needs may not be known. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. Although residents were happy with the care provided, some of the paperwork needs to be upgraded to make sure that people receive consistent care. EVIDENCE: We looked at the working files that staff use and we found that some files did not have up-to-date written plans that help staff understand what each person needs. The acting manager did have newer plans for residents, but these hadn’t been printed out and were still on computer. This was done by the end of the day. We spoke to residents about the care plans and they said that staff discussed the plans with them, and they were happy with the content. We read a number of the older care plans and could see that staff did work on them to make sure that residents got the best possible care. However some plans needed more detail. We judged that the new format would help to The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 12 improve the way care is managed but the management team must make sure that staff have full access to all the information they need. We met two district nurses on the day and they said that staff were very good at calling then in if something was wrong. They also told us that the local GP visited the home on a regular basis. She was due to visit in the next two weeks to check that every one had the right kind of medication and that their health was as good as it could be. We looked at the medicines kept on behalf of residents and we found that these were stored correctly and managed properly. Daily notes showed that staff were aware of health care needs and took suitable action when someone was unwell or needed a change of medicine. We spent some time sitting with residents and watched how staff worked with them. Generally we saw friendly and sensitive interaction. Residents said that staff were: • • • “Brilliant”. “Helpful, kind and friendly”. “Good lasses -- nothing is too much trouble”. One person said: “ Things are setup here as if I really mattered as a person.” We judged that the family and the people who work for them really do treat residents with the dignity and respect they deserve. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 13 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 excellent. This judgement has been made using available evidence including a visit to this service. People told us that they had interesting things to do and plenty of choice about the way they lived their lives. EVIDENCE: The inspection started around nine oclock in the morning and only a few residents were up at the breakfast table. People told us that they got up when they wanted, went to bed as they wanted. We saw that some people enjoy the company of others in lounges or the dining room and the others preferred to spend time in their own bedrooms. All around the home there was evidence to show that people followed their own hobbies and interests. One person told us that she enjoyed handicrafts and liked to help the staff with some of the household chores. Some of the residents enjoy listening to music, reading and watching TV either in their rooms or in one of the many lounges around the home. We saw evidence that people were supported in following their own religious beliefs. People told us that there were regular services in the home and at certain times in the year special services were held to celebrate particular festivals. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 14 People told us that there was entertainment in the home at least once a month and they enjoyed these get-togethers. There had been regular craft sessions in the home every week but the tutor had recently retired. The management were trying to find a replacement as the residents had enjoyed making pottery and taking part in other crafts. The home has regular meetings where they encourage people from the community to come into the home to talk with the residents about local history. We saw photographs of local history exhibitions put on in the home. People told us that this year they were working on family history and that a number of local people were coming in for help with tracing their ancestors. They hope that in the future they can have a new exhibition about this. People in the home told us this made them feel they were valued members of the community. The visitors’ book shows a high volume of visitors every day. We saw a number of relatives and friends on the day who enjoy coming to the home. Visitors are encouraged to come as often as they wish and lots of people like to come mid-afternoon when they sit down in the dining room for afternoon tea. Every day this is a social occasion that residents and families look forward to. People told us that the food was extremely good and that there was “ plenty of it”. People can have three cooked meals a day plus afternoon tea and a light supper. Sometimes one meal runs into another as residents have enjoyed lingering at the table. We saw nicely prepared food and sampled excellent home baking. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 15 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 adequate. This judgement has been made using available evidence including a visit to this service. People stated that they felt safe and that any concerns or complaints were listened to and acted on straight away but a management error could have compromised residents’ safety. EVIDENCE: There had been one complaint received by Social Services and this had been investigated by the home. We asked residents if they had any complaints and everyone was satisfied with the care and services they received. They said that if anything were wrong they would go to a member of the family or one of the senior staff. People trust them to deal with any problems quickly and appropriately. We also asked people if there was anything worrying going on in the home. They said that there was nothing abusive about the care they received. Several people said that they would tell a family member if they suspected anyone was being unpleasant to any resident. The residents’ representatives knew how to contact outside agencies if they thought things were not being dealt with properly. We noted on the day that the staff team were very protective of residents and were carefully monitoring a new member of staff. Staff spoken to knew how to report abuse. The acting manager said that they had received training in this and that he was planning to arrange more. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 16 We were concerned that some of the checks on new staff had not been completed. Management realised that they had made an error and put it right straight away. We judged that residents had been properly protected but we asked the acting manager to make sure this does not happen again. This is discussed further under Staffing. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. Once all areas of the home are tidy and hazard free then people will live in a comfortable and safe home. EVIDENCE: We walked around the home, both inside and out. We could see that the management team had removed some unnecessary clutter since our last visit but that more was building up. We felt concerned that were some hazards outside the building that needed to be put right before the warm weather comes so that residents can use the space safely. We saw that residents’ bedrooms were nicely decorated, carpeted and furnished. Several rooms had new rise and fall beds for people with restricted mobility. The home also has other aids for people who find getting about The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 18 difficult. One of the bathrooms has been completely refurbished and now has a new bath that helps people to get in and to lie down safely and comfortably. The lounges and the dining room were clean and comfortable. We did think that the time is now right to consider some redecoration and upgrading of furniture in these areas. The management team said that this was part of their future planning. We asked the management team to make sure that they try to keep the building as tidy as possible. When we asked people who live in the home about this, they were unconcerned and said that they thought things were “tidy enough”. Individual bedrooms were clean and neat. Staff were fully aware of their responsibilities in keeping the home clean and odour free. One person told us: • “ My room is lovely, my clothes are clean and well pressed -- what more could I ask for? I am well looked after here, I get my hair done and staff help me to dress well -- it makes me feel good about myself.” The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 19 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. Management need to make sure they understand how to check new staff are suitable so that this very good staff team can continue to give good care to people in the home. EVIDENCE: We judged this outcome by talking to people who live in the home and to staff and visitors. We also looked at the last four weeks of rosters. We learnt that the home had been a little short staffed, but that the team had covered all the vacant hours. People told us that staff were very busy but still had time for them. The acting manager said that they were recruiting new staff. A number of staff in this home already have National Vocational Qualifications in care at levels two or three. New staff will be expected to register for the qualification. We looked at the files of the last three members of staff to be recruited. We discovered that although these staff members had attended for interview and that suitable references had been taken up, the checks on their background had not been completed properly. One person on the management team had misunderstood the guidance on this and these staff had been in the home. We judged that they had been closely supervised but we explained that they should not work with the residents until the first of the checks had been The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 20 completed. This was agreed on straightaway and the necessary steps taken to safeguard the residents further. The staff we spoke to had been trained to understand the need of residents. We observed them working in a competent and caring way. The management team explained that their training programme had been on hold due to vacancies in the team. The AQAA gave an outline of the planned training for this year and this includes training on safeguarding adults and on the new Mental Capacity Act. We judged that existing staff had been suitably trained and that the new training planned will help both new and more experienced staff. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. The company need to make sure that their registration reflects the good management systems that are being created in the home. EVIDENCE: The Register Manager, Mrs Joan Iredale has recently retired but continues to play a role in the home. She and her husband George Iredale are directors of the company but have now decided to allow their two sons and their daughter in law to manage the home on a day-to-day basis. Mr Graham Iredale is to be the new registered manager and his brother Stephen the responsible The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 22 individual. We want them to complete the registration process as soon as possible. The management team complete regular checks on how the home operates. They also send out surveys to people who live in The Dales and to their relatives. We saw evidence to show that they took into account the opinions of these people and made changes to the home that residents had asked for. They also hold residents meetings and it was obvious on the day that residents feel they can approach the management team with any issue. The home also has residents’ representatives who contribute to future planning. Suitable systems were seen that help residents to manage their own finances. Most people manage their own money or have relatives or solicitors who helped them out. Senior staff help people with small sums of cash and these are kept securely and accounted properly. We saw evidence around the home to show that the person responsible for maintenance tries to keep on top of the work that needs to be done. They are currently recruiting for an assistant so that these routine jobs may be done more quickly. We saw the documents that proved a routine health and safety matters were being carried out properly. These cover fire and food safety, maintenance of equipment and general checks on safety. These were in order. SCORING OF OUTCOMES The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 23 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 To of the HOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 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 2 X 3 X 3 X X 3 The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 30/03/08 2. OP29 19 3. OP31 7,8 It is required that up to date care plans are always available for staff and for the residents themselves. The company must make sure 30/03/08 that every new member of staff has suitable background checks prior to them coming into the home. A registration application 30/03/08 reflecting the changes to the way the home operates must be with the Commission for Social Care Inspection by the due date RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. The Dales Refer to Standard OP3 OP18 Good Practice Recommendations It is recommended that the management team always make sure that social workers send a completed assessment before a new resident is admitted. It is recommended that the new management team make DS0000022548.V355807.R01.S.doc Version 5.2 Page 25 3. OP19 sure they understand every aspect of safeguarding vulnerable adults. It is recommended that the Company dispose of unwanted items and tidy external areas of the home. The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 The Dales DS0000022548.V355807.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!