CARE HOMES FOR OLDER PEOPLE
The Dales Main Street Ellenborough Maryport Cumbria CA15 7DX Lead Inspector
Elaine Brayton Announced 07 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 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 Joan Margaret Iredale Care Home 40 Category(ies) of OP - Old Age registration, with number PD(E) - Physical Disability, over 65 of places The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Registered for 40 older people (OP), 1 of whom may have a physical disability (PD(E)). Date of last inspection 21 February 2005 Brief Description of the Service: The Dales is situated in the centre of Ellenborough, a residential area of Maryport. The home is within easy distance of the amenities of the village and of Maryport itself. The home is owned by the Iredale family. Mrs Joan Iredale is the registered manager. The other family members are involved in all aspects of the operation of the home. The home provides accommodation and care for up to forty older people. The accommodation is provided on two floors, and most rooms are accessible by the passenger lift, but a small number of rooms are accessible only by a staircase. The communal areas in the home include six lounges, three conservatories and a dining room. There were bathrooms and a shower room equipped to assist people with a disability. All of the bedrooms had en-suite toilet facilities. There was a seating area outside that service users could use in fine weather. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection of the home and took place over one day. Before the inspection residents and their relatives had an opportunity to complete a small questionnaire about their opinions of the home, and this information was taken into account when writing this report. During the inspection time was spent talking with the Manager and other directors of the home and care staff. Time was spent with service users individually and in groups. Most parts of the home were looked at, and records relating to the day to day running of the home and the care of residents were read. What the service does well: What has improved since the last inspection? What they could do better:
The Home must improve the systems they have to check the quality of the services they provide, and this must be based on the views of the residents. Training must be provided for all staff about the protection of vulnerable adults The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 6 so that they have an awareness of the issues around this subject and improved knowledge about what to do in the event of an incident in the home. 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 Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 The Statement of Purpose was informative, and provided people with details of the services and facilities the home provides so that an informed decision can be made about admission to the home. EVIDENCE: The Statement of Purpose is available in the home to anyone who wishes to read it, and provides people with important information about the home. An assessment of need is carried out before a person is admitted to the home to ensure the persons needs can be met by the staff group. Prospective residents are encouraged to visit the home to look around before making a decision to move in, and some people spoken to had visited with their relative before coming to live in the home, and had appreciated being able to do this. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The care planning systems ensured that the resident’s health and social care needs were met in a way that respected the privacy and dignity of people. EVIDENCE: The care planning system had improved since the last inspection, and the care plans looked at contained detailed information about the health and social care needs of the resident and how these needs were to be met. The care plans were regularly reviewed and included moving and handling and risk assessments. Resident’s general health is monitored, and details of healthcare issues and appointments are recorded. Residents said that they were treated with respect and their dignity was upheld. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Residents make their own decisions about their day to day life, and choose whether or not to participate in activities available in the home and maintain links with family and friends. The meals in the home are good and provide choice and variety to meet people’s preferences and dietary needs. EVIDENCE: Residents said that they had plenty of opportunities to take part in activities in the home, and during the inspection a pottery class was taking place. This is a regular event and residents get a lot of pleasure from it. Residents said that they make their own decisions about their day to day life, where they spend their day, what time they get up and when they go to bed. Visitors spoken to said they could visit whenever they wanted, they were always made to feel welcome and were offered refreshments. Meals are taken in the dining room or in the person’s own room, there is a choice of menu at each mealtime, and the meal times are very flexible. Residents said they enjoyed the food provided, it was always tasty and plenty of it. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 standard(s) 16,17,18 The home has a good complaints system, with evidence that complaints are taken very seriously. However, the adult protection systems need strengthening, to ensure residents are protected from abuse. EVIDENCE: Residents and their families are provided with a copy of the complaints procedure on admission to the home. Included in this are the names of people independent from the home, who can act as advocates for residents making a complaint if they wish. Residents are satisfied that if they make a complaint it is taken seriously and dealt with appropriately. The information and guidance for staff about the protection of vulnerable adults needs to be improved, and staff training must be arranged for all staff to provide maximum protection for residents. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 standard(s) 19,20,23,24,26 Residents are provided with safe and comfortable communal and private living accommodation, which meets individual needs. There is a safe and accessible garden with seating areas for the use of residents. EVIDENCE: The communal rooms in the home are spacious and provide comfortable seating areas for residents. There are five lounges that are used by residents as well as two conservatories and a dining room. There is a pleasant garden area, which has comfortable seating and sunshades, which is popular in warm weather, and resident, said they enjoyed sitting outside when it was warm. Resident’s personal rooms are furnished according to the wishes of the occupant, and many people had brought their own furniture and other possessions with them to make their room more homely. All of the bedrooms have en-suite toilet facilities. The home was clean and hygienic on the day of the inspection. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staff recruitment is robust, and ensures that sufficient numbers of staff are available with the necessary skills to meet the needs of service users. EVIDENCE: On the day of the inspection there were five care staff on duty during the day as well as staff to do the cooking, cleaning and assisting at meal times. Each night there are two members of waking night staff on duty. Residents said that staff attended to them promptly when required, and they thought there was enough staff on duty. Staff records contain information to show that checks are carried out before staff are employed, and the training that is undertaken to ensure people have the skills required to care for people appropriately. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38 There was clear guidance and direction to staff so that residents received consistent, quality care. However, the systems to seek the views of residents need to be improved to ensure the home operates in the best interests of the people who live there. EVIDENCE: The Manager, together with the Directors, are very much involved in the day to day running of the home, and speak to residents and visitors on a daily basis. Support and guidance is provided to the staff group, and staff said that the manager or directors were always available for them to speak to. The manager does some things to check the quality of the care and services provided to residents, but must improve the systems to ensure residents have opportunities to comment on all aspects of how the home operates. The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 2 3 2 3 3 3 3 3 The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 16 Are there any outstanding requirements from the last inspection? 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 op18 Regulation 13 Requirement All staff must receive training about the protection of vulnerable adults, including the procedure to follow in the event of an adult protection incident. The qualuity assurance systems must be based on seeking the views of residents. Timescale for action 31/08/05 2. op33 24 31/08/05 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 Good Practice Recommendations The Dales F58 F10 s22548 the dales v220773 070605 ai stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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