Inspection on 03/12/05 for The Dell

This inspection was carried out on 3rd December 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 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 Dell 11/03/09

The Dell 29/09/07

The Dell 17/01/07

The Dell 16/02/06

The Dell 03/02/05

The Dell 28/07/04

The Dell 09/03/04

Similar services:

Claremont House

Chesham House

Oak Ridge

Argyll House

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

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

CARE HOMES FOR OLDER PEOPLE The Dell The Dell Nelson Way Beccles Suffolk NR34 9PH Lead Inspector Alan Clare Unannounced Inspection 3rd December 2005 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 The Dell DS0000037196.V271338.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. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Dell Address The Dell Nelson Way Beccles Suffolk NR34 9PH 01502 712683 01502 712683 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) Suffolk County Council Mrs June Ann Gill Care Home 38 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (27) of places The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2005 Brief Description of the Service: The Dell is a purpose built home owned and managed by Suffolk County Council. Situated on the outskirts of the market town of Beccles in a residential area with shops and other facilities nearby. The home has access to a tail lift mini bus. The home has a landscaped garden with car parking and an attached day centre, which is run separately but available to residents of the home. The home is set out on two floors and divided in to four houses, Balmoral, Windsor, Homelea and Gloucester house. Each house other than Balmoral, which also has it’s own laundry, has bedroom, sitting and dinning rooms, a kitchen, bathroom and toilet facilities. There is a central main kitchen and laundry servicing the home and day centre. The Dell is registered to provide care to 38 older people, of which the 11 places in Balmoral House are offered to people with a diagnosis of dementia. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a Saturday and started at 10.00am just as a Coffee Morning was about to begin. Time was spent with the registered manager June Gill and two team leaders Jill Powely and Jo Knight. A tour of the premises was made with particular time spent within the Balmoral and Homelea houses. A number of resident’s records were examined as well as Medication Administration Records and utility certificates. The inspector took time to sit and take coffee and talk with residents in two houses. During the morning one resident was welcomed home from hospital. Two relatives who were visiting the home were spoken with separately. What the service does well: The Dell has a bright and friendly atmosphere in which attention has been paid to providing residents with a more homely experience by the placing of ornaments, pictures and plants throughout the building. The interior of the building is bright and decoration is well maintained. There was a pleasant fragrance throughout the home. Some of the windows provide impressive views of the locality from within the home. Throughout the visit residents commented on how they were “ well looked after ” and how “good” the food was. Residents described staff as being “ very kind and helpful“, “ they help you with any problem” and in all houses residents knew the staff on duty by their first name. One member of staff spoken to talked about the “personal pride” taken by staff when working in their allocated houses and informed the inspector that staff of the home understood that “ it is the residents home first and foremost”. Staff relationships with residents were seen as being kindly and caring. The home has detailed care plans, which include resident’s preferences and records of the activities that residents have participated in. During the morning, a number of residents chose to visit the coffee morning and join in the raffle. The Dell DS0000037196.V271338.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. The Dell DS0000037196.V271338.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 The Dell DS0000037196.V271338.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): 1,2,3,4,5. Residents can expect to have their health and personal needs identified before moving into the home and that a written contract / statement of terms will be prepared. Residents cannot expect that the contract between themselves and the county council will be fully completed, signed and dated by the home. EVIDENCE: A sample of resident’s records examined by the inspector provided detailed information relating to the resident’s health needs and preferences. All documentation was completed other than a number of resident’s contracts with the county council, which had not been signed by the home. The Dell DS0000037196.V271338.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): 7,8,9 and 10 Residents and relatives can expect that resident’s health and personal care are identified and met. Risk assessments are documented and acted up on. Residents residing in Balmoral House special care setting cannot expect that specialist communication formats and orientation aids will be available to assist their understanding. Residents can expect that their health care needs be met. Residents can expect that medicines pre-packaged by the home’s pharmacist are correctly recorded and stored. However, they cannot be assured that medicinal ointments in use will be stored appropriately and recorded as is required. Residents can be assured that they are treated with respect and their right to privacy respected. Residents and their relatives can expect that they will be cared for in a sensitive and respectful way at the time of ill health and of their death. EVIDENCE: The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 10 The recommendations for four lifting and moving risk assessments were tracked and seen to have been actioned. Two Medicine Administration Records (MAR) for pre packed medicines on each house were completed correctly. Medicinal ointments were seen to be kept loose in resident’s bedrooms and applied by staff undertaking personal care. MAR records for these items were not recoded and completed by staff trained in the homes medicine policy. During the tour of the home, seven residents were seen relaxing or going about private activities in their rooms. Staff were courteous and polite when approaching them. One resident told the inspector “ … appreciated being able to get away to watch a favourite television programme” another stated that … always waited in her room at the times her daughter was to visit. A relative said, “… Her mother’s room was so cosy it was a pleasure to visit”. Balmoral House special care setting does not have any aids to orientation or items of information or menu’s in alternative appropriate formats, which would assist residents understanding. A board listing the names of staff was present in the dinning area, however, without additional detail such as photographs it’s effectiveness in assisting residents to recognise which staff are on duty is questionable. The care plan of a recently deceased resident was examined and recordings were noted by the inspector to be informative about the sensitive and detailed care and attention the resident received together with the courtesy and respect shown to relatives. The door to the deceased resident’s room was locked waiting the time when the family felt able to collect their relative’s belongings. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,15 Residents can expect that activities will be offered on a group or individual basis subject to availability of staff time outside of completing practical tasks. Resident’s relatives can expect that they will be welcomed and invited to be involved in activities in each house. Residents can expect to be able to move around the home and use the privacy of their rooms as when they wish to do so. Residents can expect that well cooked and presented meals will be served in pleasing surroundings and that there is flexibility of times to meet individual requirements. EVIDENCE: In each house that the inspector visited there was evidence of different activities taking place or having taken place recently, these included painting, music with staff sing along, board game with relatives, out to coffee morning, and a group watching television. However, the inspector noted that with the exception of Balmoral House, staff were seen to be spending time in the kitchen areas completing household tasks such as tidying up and washing up rather than activity with residents. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 12 A selection of care plans documented that over the past month residents have on occasions been involved in arranged activities. On the day of the visit a number of relatives were present in the home. Two relatives confirmed that they were “always made to feel welcome and had never experienced problems when visiting.” One relative stated that with the “good care and attention” she knew … received, she didn’t “feel guilty about her being in a home”. “ It’s nice that … was able to stay local”. One resident described how “ being it’s (the home) so near to my daughter, I can go home to her at very short notice”. “ Staff just help me get ready when the family phone”. Residents had earlier chosen from the daily menu. Lunch, which appeared well cooked and appetising, was conveyed to the houses on heated trolleys and served to residents in places where they had chosen to sit around tables in their houses. Staff went about assisting in a personable manner and there was no sense of residents being rushed to finish their meal. Those who chose to be were served in the sitting areas. Two meals were kept for people who would eat later. Residents of Balmoral House would benefit from the menu and information being available in formats appropriate to meeting their specialist needs communication needs. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 13 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): 16. Residents and relatives can expect that staff will respect their right to make complaints. EVIDENCE: During the visit a relative informed the inspector that members of a resident’s family had been made aware by managers of the home’s complaints procedure. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 14 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): 19,21,22,23,24,25,26 The residents and relatives can expect that the home provides a safe, comfortable very clean environment and where necessary the home takes steps to address particular needs and provide equipment. The home does not always take proper care and attention in finding suitable storage places for additional equipment. EVIDENCE: One outstanding repair was identified in a resident’s shower room in Balmoral House where there was a water leak from the ceiling. All lavatories in en suite bathrooms in Balmoral House are low in height. The home has consulted with the Occupational Therapist service which is providing individual assessments to residents as to suitability of the lavatories for individual residents and where necessary providing grab rails and raised toilet seats to ensure safe use. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 15 Risk assessments were tracked and it was seen that recommendations for the provision of additional equipment were met. The lifting hoist, floor standing fan and wheelchair belonging to one resident where being stored in a small room described by staff as a” quiet sitting room”. All rooms visited where decorated with resident’s own possessions and a comfortable armchair. Three residents were pleased to invite the inspector to visit their rooms. The home is clean and pleasant with the exception of one room where an odour of urine was noted by the inspector and a visiting relative. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 16 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): 27,28,30 Residents can expect that the home aim to meet their needs by the numbers and skill mix of staff. Residents cannot be assured that when other residents require additional time and attention that there will not be times when they are left unsupervised. Residents of Balmoral House can expect that staff receive an introductory training in caring for people with dementia. However, they cannot be assured that newly appointed staff receive specialist training prior to commencing employment or that a record of staff attendance at courses is maintained by the home. EVIDENCE: Risk assessments were seen to be in place and acted upon. During the visit the inspector noted that staffing on each house, other than Balmoral, consisted of one member of staff who was supported by one other whose time is shared working around the home. There where two members of staff available within the Balmoral House throughout the visit. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 17 During the visit the inspector noted that residents and staff were not generally engaged in one to one activity and on occasions residents were left unsupervised whilst the one allocated staff went about completing tasks, which took them away from the residents. In order to welcome and settle a resident returning from hospital, staff where required to leave other residents unsupervised for periods of time. The registered manager informed the inspector that she has recently requested that team leaders draw up and maintain a record of staff training. This information was not available for the purpose of the inspection. Recently appointed staff are having to wait until next year to receive specialist training in dementia care. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 18 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): 31,32,33,38 The residents can expect to live in a home which is well managed and which provides for their safety, care and well being. Whilst they can be assured that the ethos and leaderships encourages staff to consider The Dell “ to be their (the residents) home” and “ should be their home from home” they cannot expect that the management approach will always be able to meet with the best interests of the residents. EVIDENCE: Members of the management team spoken to, acknowledged the inspectors concern that staffing arrangements could not ensure resident’s safety at all times and placed limitations on opportunities for staff and resident intervention. The inspector was informed that this matter had been raised with senior managers previously and but on the day of the visit the management of the home were unable to confirm how these concerns were to be addressed. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 19 Despite previous requirements that prescribed medicinal creams require being stored administered and signed for as medicines, no action has been taken to address this. MAR sheets continue to be unsigned after creams are administered. The contract between the county council and the resident is not always signed by the home. The registered manager informed the inspector that she has previously requested that team leaders draw up and maintain a record of individual staff training. However at the time of the visit no such records were available for inspection. The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 20 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 3 2 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x 3 3 3 3 2 3 STAFFING Standard No Score 27 2 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 x x x 2 2 The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Arrangements for recording and storage of prescribed creams. 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 2 3 4 Standard 2 8 9 12 Regulation 5 (c) 12 (4) (b) 13 (2) 16 (n) Requirement Contracts must be fully completed and signed by the home. Provide aids to communication in formats appropriate to specialist needs of residents. Ensure that custody and handling of prescribed creams complies with M.A.R. regulation. Allow for time during which staff are able to offer activities unhindered by routine practical tasks. Provide menus in format that enhances residents with special needs to make informed choices. Ensure that storage of equipment does infringe on recreational space. Provide sufficient staff cover across each house that prevents periods of time when residents are left unsupervised. Provide introductory training to staff prior to their working with residents with special needs. The decision relating to staffing ratios must be progressed DS0000037196.V271338.R01.S.doc Timescale for action 31/01/06 31/01/06 03/12/05 31/01/06 5 6 7 14 25 27 & 28 12 (2) 23 (m) (i) 18 (1) (a) 31/01/06 31/01/06 03/12/05 28/02/06 8 9 30 31,32,33 18 (c) (i) 10 (1) The Dell Version 5.0 Page 22 10 37 & 38 3 (a) (b) through line management arrangements. All residents’ contracts must be signed on behalf of the home. The Registered Manager must inform CSCI in writing how requirement 3 is to be met. The Registered Manager must ensure that her requests to staff in order to meet requirement 10 are complied with. The home must arrange and maintain a record of staff training, which is available for inspection. 03/12/05 31/01/06 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 The Dell DS0000037196.V271338.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 The Dell DS0000037196.V271338.R01.S.doc Version 5.0 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. 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. 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