Inspection on 19/04/05 for The Dales Care Home

This inspection was carried out on 19th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The Dales Care Home 22/08/07

The Dales Care Home 13/06/06

The Dales Care Home 14/11/05

The Dales Care Home 19/10/04

The Dales Care Home 27/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Dales, The Care Home Fisher Close Repton Derbyshire DE65 6GS Lead Inspector Jo Wright Unannounced 19 April 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. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Dales Care Home Address Fisher Close Repton Derbyshire DE65 6GS 01283 238200 01283 238203 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) Derbyshire County Council Yvonne Cara McComish Care Home 22 Category(ies) of Older People registration, with number of places Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th October 2004 Brief Description of the Service: The Dales cares for 22 older people, in a purpose built, single storey building. The home is set in its own grounds, and service users have access to a number of garden areas. It is located in a residential area in the village of Repton, close to local amenities. All 22 bedrooms are single occupancy. The building is laid out in wings, each with its own lounge and dining space. Toilet and bathroom facilties are on each wing. Service users are able to move around the whole building. A resource centre is attached to the home. Service users living in the home are able to make use of the facilities provided at the resource centre. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection by two inspectors that took place over 5 and a half hours. A partial tour of the building took place, looking at communal areas, toilets and bathrooms, the kitchen, garden area and a small number of service users bedrooms. Care files and associated records, and medication were looked at. Time was spent talking with 13 out of the 21 service users, and 5 members of staff on duty, as well as the Registered Manager. What the service does well: What has improved since the last inspection? What they could do better: The storage of cleaning fluids must be improved to maintain service user safety. Cleaning fluids must be stored securely, so that service user safety is Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 6 maintained. Specific instructions on fire doors (keep locked) must be followed, unless the Registered Manager can demonstrate that the Fire Officer has advised otherwise. Staff must store medication appropriately and securely, and must stop using medication prescribed for one person for other people. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 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 Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 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) 3 Considerable progress has been made in the assessment of service users needs and the continuous recording after admission since the last inspection dated October 2004. Service users needs were assessed and the records supported that their needs could be met. EVIDENCE: Two service users files were examined and the appropriate assessments had been completed. The records were detailed and informative. Additional information had been provided by other agencies involved in the service users care. Service users spoke to confirmed that they had been involved in the assessment process, and this was demonstrated through the records. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 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, 9 and 10. Improvement had been made to ensure the health, personal and social care needs of service users were identified and met. Service users health care needs were assessed and planned for, although the risk assessments were not always reviewed and updated, and therefore could not be fully met. The policies and procedures carried out by staff around administration and storage of medication did not fully protect service users. EVIDENCE: Detailed care plans were in place for service users, which enabled staff to deliver appropriate care. Staff were not consistently reviewing and updating care plans monthly. Although some improvement was seen, this issue was noted at the time of the last three inspections, when a requirement was made for care plans to be kept under review. Not all risk assessments were fully completed, or appropriate action taken when needed, for example: tissue viability trigger tool scores had indicated certain actions were necessary to monitor the service users health needs, and these had not been actioned. This was seen at the time of the last inspection, when a requirement was made to ensure that risk assessments were reviewed on a regular basis or in line with current guidelines. Service users spoken to Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 10 confirmed they had been involved in the development and review of care plans. The practice of using medication prescribed to named individuals for communal use was observed. The prescribing instructions for one service user’s medication had not been followed, and staff had not been aware of the discrepancy. Not all medication was stored appropriately or securely. The issue of privacy and dignity was addressed throughout the care plans, and service users felt their privacy and dignity was respected. We observed staff lock bathroom doors whilst assisting service users with personal care needs. Locks were fitted to all bedrooms doors, although service users spoken to indicated they felt no need to lock their doors. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 11 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 and 15 The social activities available to service users had considerably improved. Service users links with family, friends and the community were generally well maintained. A varied range of meals and alternative meals were provided. Special diets were provided for. EVIDENCE: A dedicated social activities worker has now been employed, the result of which is a wider range of leisure and social activities. A number of service users were spoken to and all apart from one service user, who had made a choice not to participate in activities provided, stated that the activities now offered were appropriate and enjoyed. Social activities were observed taking place during the inspection. A wide range of meals was provided, with at least two alternatives if required. The food observed was according to menus, and well presented. The majority of service users spoken to spoke highly of the food provided. However, two service users said ‘that the meals were not to their liking’. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 12 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) None of these standards were assessed during this inspection. EVIDENCE: Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 13 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, 21, 23, 24 and 25 The environment was both safe and comfortable, and maintained a good standard. Improvements had been made to the bathrooms. Bedrooms reflected individual preferences and contained personal belongings. EVIDENCE: Service users rooms were warm, well lit and ventilated. The furniture provided was according to the service users own choice. There were sufficient toilets and bathrooms, located in appropriate areas. Two bathrooms had been upgraded and refurbished, to more fully meet the needs of less able service users, and service users using wheelchairs. The communal areas provided were comfortably furnished. The gardens were accessible to wheelchair users and appropriate seating provided. Considerable work had taken place to provide a large, level patio area with raised flowerbed, to enable service users to more fully enjoy the outdoor facilities. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 14 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 The deployment of staffing hours did not demonstrate that service users needs could always be met. EVIDENCE: One of the members of staff spoken to indicated concern about a period of between 30 minutes and one and a half hours when only one member of care staff was available. This was addressed with the Registered Manager, who confirmed that this was accurate information. Service users spoken with spoke highly of the level of care provided by staff. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 15 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, 36 38 The Registered Manager was experienced, and appeared competent and caring. The Registered Manager provided clear leadership and had good management skills. Staff supervision was provided on a regular basis. The health, safety and welfare of service users were generally promoted, although there were a number of health and safety breaches noted. EVIDENCE: The Registered Manager was able to demonstrate her competence throughout the inspection by her knowledge of the service users, the home, the policies and procedures, and the strengths and shortfalls of the service provision. Both staff and service users spoken with felt that Registered Manager was accessible and approachable. Service users said that Registered Manager listened to them and acted on what she was told. Staff said they felt confident that the Registered Manager would always act appropriately when concerns/problems arose, and that the Registered Manager was supportive and enabling. Regular Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 16 staff supervision periods were given. Service users/relatives meetings were held on a regular basis, and well published within the home. A service users survey had been carried out, and the results were displayed prominently on all the notice boards. Service users and relatives were given choices and their views taken into consideration. A number of health and safety issues were identified during the inspection, and brought to the attention of the Registered Manager. Cleaning fluids were not stored appropriately, and a number of fire doors marked ‘to be kept locked’ were not locked. The Registered Manager responded positively and agreed to contact the Fire Officer for further advice. Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x 3 x 2 Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 18 Yes 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 7 Regulation 15 Requirement The Registered Person must ensure that all care plans are kept under review and evaluated at least once a month, as recommended in National Minimum Standard 7 (Previous timescale of 31 July 2004 not met) The Registered Person must ensure that general risk assessments are reviewed on a regular basis and/or in with current guidelines (Previous timescale of 31 December 2004 not met). Medication must only be administered to the service user for whom it is prescribed and labelled. Prescribed medication must be administered as directed on the label. The administration instructions written on the Medication Administration Record must be correct. If there is any confusion the prescription must be clarified with the prescriber. Medication must be stored appropriately and securely at all times. The deployment of care staff Timescale for action 30 September 2005 2. 8 13 30 September 2005 3. 9 13 & 17 Schedule 3 13 & 17 Scheudle 3 31 July 2005 31 July 2005 4. 9 5. 6. 9 27 13 18 31 July 2005 30 Page 19 Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 7. 8. 38 38 13 23 must be reviewed to ensure that sufficient numbers of staff are on duty at all times to meet the needs of the service users. All cleaning products must be stored securely when not in use. The Registered Manager must ensure that adequate fire precuations are maintained at all times. September 2005 31 July 2005 31 July 2005 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 Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection Derbyshire Area Office South Point, Cardinal Square Nottingham Road, DERBY DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dales, The Care Home C52-C02 S36259 TheDales V221781 190405 Stage 4.doc Version 1.20 Page 21 - 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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