Inspection on 02/12/05 for The Dene Lodge

This inspection was carried out on 2nd December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Dene Lodge 06/10/09

The Dene Lodge 08/04/09

The Dene Lodge 17/08/07

The Dene Lodge 05/07/06

The Dene Lodge 19/01/05

The Dene Lodge 01/07/04

The Dene Lodge 24/02/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Dene Lodge Bircham Road Alcombe Minehead Somerset TA24 6BQ Lead Inspector P Edwards Jackson Unannounced Inspection 2nd December 2005 09:00 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 Dene Lodge DS0000016025.V267138.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 Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Dene Lodge Address Bircham Road Alcombe Minehead Somerset TA24 6BQ 01643 703584 01643 708550 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) Hazelgate Ltd MRS PATRICIA ELIZABETH PALMER Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: The Dene Lodge is a care home proving care and support for up to 18 people over the age of 65 years, with a wide range of support needs. The home is located at Alcombe on the outskirts of Minehead. It is close to local shops and services and public transport links. The service users accommodation is arranged on three floors with the communal areas located on the ground floor. The home has a through floor passenger lift and a range of adaptations have been made to the home to ensure it is accessible for those who live there. The home is set back from the road and has attractive garden areas. Pat Palmer who is supported by a small staff team manages the home. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out during a morning, by one inspector. The deputy manager was in charge of the home; two care staff supported her. Two cleaners were also working in the home. A tour of the premises took place and the majority of people living in the home were seen during the inspection. Several of them were able to comment on the service provided. A sample of records, were examined during the inspection. The previous announced inspection took place 14th June 2005 when the majority of standards were assessed. At the time of the current inspection the majority of standards were assessed. But the reader is advised to read this report in conjunction with the previous report to gain a comprehensive picture of the home. What the service does well: What has improved since the last inspection? The deputy reported that the manager has recently completed the ‘managers award’. The deputy is currently completing the ‘Assessors award’. The deputy commented that the staff team have improved their understanding regarding the privacy needs of the people living here. The Care plans have been developed but it was acknowledged the task is not yet completed. The deputy is committed to ensuring this happens. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 6 Smoke detectors have been replaced throughout the home and automatic door closures have been fitted following a visit by the Fire officer. 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 Dene Lodge DS0000016025.V267138.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 Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3; 4; 5 As previously found (June 2005) the home is adequately staffed by wellmotivated and competent staff. Service users are confident that the staff team are able to meet their needs. EVIDENCE: Discussions took place with the deputy manager, residents in the home and visiting relatives. Information gained from the sample of care and support plans seen clearly indicated that assessments of needs take place and are kept under review. It was clear that specific care and support needs are taken into account when placements in the home are arranged. There was also evidence of discussion with residents prior to admission regarding their decision to move to the home, and that their families had been fully involved in those discussions. The Dene Lodge DS0000016025.V267138.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; 10; 11. As previously found (June 2005), The healthcare needs of resident service users are adequately met. The care plans have improved – but further improvement is needed regarding evidence of user involvement. EVIDENCE: A sample of care and support plans were seen and discussions took place with the deputy and a number of residents. Information in the care and support plans clearly set out how needs were met and illnesses and treatment was recorded. Some of those living in the home have a range of medical conditions including Diabetes, Parkinson’s disease and diseases associated with ageing. The home enjoys a good level of support from the multi-disciplinary health care professionals. Specialist links have also been made and used to the advantage of those living in the home, e.g. the Parkinson’s disease specialist nurse. The current care and support planning system is being reviewed and revised by the deputy and further improvements will be made. The new format will The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 10 incorporate service user (or where appropriate family or advocate) involvement. Staff were observed respecting service users privacy during this inspection but the deputy was aware that ongoing reminders were needed to ensure staff did not become complacent. A number of residents have their own telephones in their rooms, which enables them to keep in contact with friends and family independently and in private. Medication records were viewed and further advice provided to the deputy regarding the issue raised at the previous inspection. A recommendation was also made regarding a list of sample signatures of each staff member responsible for administering medication – as discussed with the deputy. It was clear from both observations and conversations with the deputy that the home strives to cater for those whose condition deteriorates The Dene Lodge DS0000016025.V267138.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. The home has menu’s which provide a well balanced diet with choices. Special diets are catered for. Residents service users are able to choose to join in organised activities or occupy themselves. Visitors are made welcome. EVIDENCE: Contact with friends and family is encouraged and supported by the home. The deputy was also sensitive to the support needs of visiting family members whose resident relatives were deteriorating. One person was going out for the day with visiting family and another resident received her regular visit from her family during the inspection. The home has a dedicated activities coordinator who takes the lead for organising a range of activities on a daily basis – she was off sick at the time of the inspection. It was clear that residents wishes are respected, as one person commented – external support staff had suggested a visiting volunteer, which she had declined. Each resident service user wears a ‘personal call bell’, which enables them to summon support independently wherever they are within the home. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 12 Those spoken with during the inspection were able to comment on their interests. Their individual bedrooms contained evidence of personalisation according to their needs and interests and tastes. Residents are asked on a daily basis what they would like to eat and choices are provided as a matter of course. Visiting relatives were able to comment on the meals offered in the home that the choice was good and they knew that their resident relatives preferences were catered for. The preparation and serving of lunch was observed. The deputy who was standing in for the regular chef cooked the meal. The meal was well presented and the atmosphere in the dining room was a relaxed and social occasion. Amongst the sample of care and support plans, nutritional needs were also recorded on a daily basis for one resident. The Dene Lodge DS0000016025.V267138.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 and 17 As previously found the home has systems in place to minimise the risk of abuse and enable staff and service users to raise concerns outside the home. EVIDENCE: The deputy commented that a visit from Age Concern was planned to ensure staff are aware of the support they can provide to those living in the home, including access to independent advocacy if needed. Visiting relatives were clear that they would speak out if they were unhappy about their relatives care within the home. They were also aware that other professionals visited the home on a regular basis, e.g. nurses and social workers – thus broadening the level of monitoring. The sample of care and support plans seen evidenced regular reviews by health and social care professionals. As previously found (June 2005) the complaints procedure was on display. The Dene Lodge DS0000016025.V267138.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; 20; 21; 22; 23; 24; 25; 26 The home is clean and well maintained with a good range of specialist equipment to aid mobility and independence. The home provides a comfortable and safe environment. As previously found (June 2005) ‘the bathing and showering facilities are inadequate’ EVIDENCE: A tour of the premises took place – grab rails are strategically placed throughout the home. The through-floor lift enables access to all parts of the home. Some residents were observed using walking aids and were supervised by staff according to individual needs. The majority of bedrooms were seen; they were clean and comfortably furnished according to individual needs and tastes. Toilets and en-suite’s had a good supply of disposable towels and liquid soap, which helps prevent the spread of infection. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 15 As noted at the previous inspection, ‘there is one communal bathroom which contains the homes only assisted bath and a level access shower. Although all rooms have en-suite facilities, these are considered inappropriate to the needs of service users and all baths have been disabled. Therefore all service users, from all floors use the communal facilities on the first floor’. A discussion with the deputy confirmed that the providers were aware of the need for action and that building works planned for the home would incorporate addressing this concern. The requirement remains and a further action plan will be required. The Dene Lodge DS0000016025.V267138.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 As previously noted (June 2005), the home is adequately staffed by a wellmotivated and competent staff team. Resident service users are confident that the staff team are able to meet their needs. EVIDENCE: At the time of the inspection there were two members of care staff, plus the deputy who provided hands on care and support. Two cleaning staff were also working in the home. There were clearly posted notices of staff rota’s several weeks in advance. Information regarding on call senior staff contact details were also clearly available. The deputy manager confirmed that she was currently undertaking the NVQ Assessors Award and the manager had recently completed the managers award. As previously found (June 2005) comments received from resident service users were very positive regarding the staff who support them. Visiting family members were equally complimentary about the staff. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 17 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; 36; 37; 38 As previously noted (June 2005), The home is effectively managed and systems are in place to monitor the quality of the service provided. Reasonable steps are taken to ensure the health and safety of those who live and work in the home. EVIDENCE: The manager has recently completed the Registered manager’s award. She is supported by, her deputy who was in charge of the home during the inspection. The deputy was observed providing clear leadership and supervision to staff during the course of the inspection. One of the resident service users spoken with was able to comment on the management of the home having been at the home through two changes of ownership and managers. She was happy with the current support and felt well cared for. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 18 Records relating to service users and staff were appropriately stored to ensure confidentiality was maintained. Discussion with the deputy clearly indicated that the needs of the people living in the home are prioritised. There was also evidence that regular staff supervision sessions occur. A visit by the Fire Officer had occurred since the previous inspection by CSCI. Requirements made by the fire officer have been implemented including the fitting of automatic door closures (which were seen during this inspection). The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 3 3 1 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? yes 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 OP21 Regulation 23 (2)j Requirement The manager must review the bathing and showering facilities, including en-suites, to ensure there are adequate facilities to meet the needs of service users and promote privacy and dignity (this requirement has been carried over from the previous two inspections, 19/1/05 and 14/6/05) Timescale for action 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. 1 Refer to Standard OP9 Good Practice Recommendations A list of sample signatures of all staff having responsibility for the administration be drawn up and kept with the medication records. The Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Dene Lodge DS0000016025.V267138.R01.S.doc Version 5.0 Page 22 - 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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