Inspection on 10/01/06 for The Dome Hotel

This inspection was carried out on 10th January 2006.

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 Dome Hotel 24/09/08

The Dome Hotel 28/09/06

The Dome Hotel 18/07/05

The Dome Hotel 10/11/04

The Dome Hotel 28/06/04

The Dome Hotel 26/01/04

Similar services:

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Newbeech House

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

CARE HOMES FOR OLDER PEOPLE The Dome Hotel Barton Court Avenue Barton-on-Sea New Milton Hampshire BH25 7EY Lead Inspector Tracey Box Unannounced Inspection 10th January 2006 10:30 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 Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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 Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Dome Hotel Address Barton Court Avenue Barton-on-Sea New Milton Hampshire BH25 7EY 01425 616164 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) Mrs G Lawrence Mrs G Lawrence Care Home 3 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (3) of places The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To accommodate only one named person in the LD category To accommodate only one named person in PD category Date of last inspection 18th July 2005 Brief Description of the Service: The Dome Hotel Rest Home is a registered care home providing accommodation and personal support for three older people, the home may only accommodate one person with learning disabilities. The home is privately owned and managed by Mrs Gillian Lawrence. The home is located in BartonOn-Sea, New Milton, situated close to the sea and within walking distance of local amenities. The home is situated on the first floor of a large building and provides a homely environment for three service users. The ground floor has been converted into privately owned self-contained flats, totally separate from the home, however, access to the home and flats are shared using the front door. Stairs lead to the first floor where the accommodation comprises of three single bedrooms, kitchen, lounge/diner, bathrooms, toilet and staff sleep in room/office. A conservatory on the ground floor provides further communal space. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours. Three people living at The Dome Hotel prefer to be referred to as residents, therefore will be referred as this throughout the report. The inspector looked at records and asked staff and residents for their views and experiences of living at working at the home. The home appeared clean, warm and comfortable. What the service does well: What has improved since the last inspection? What they could do better: The provider is required to ensure that all staff receive mandatory training to enable them to carry out their roles and responsibilities. THIS IS A REPEAT REQUIREMENT FROM 18/8/05. The provider must return all un-used and out of date medicines to the pharmacist and monitor stock levels monthly. The provider must revise the complaints procedure and devise a complaints log in order to monitor complaints effectively. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 6 Once staff have received the required mandatory training, the inspector recommended the home develop a staff training and development plan to monitor when training has taken place and when it is due. The manager is supporting a resident to open their own bank or post office account, this will enable the resident to have more control over their finances whilst promoting their independence. The provider must revise each service users contract to include the actual fee the home charges the resident, this is to be updated and agreed with each resident as the fee changes. The staff team would benefit from clear direction from the registered manager of how the home strive to meet regulated standards, the home have internet access which will enable them to keep up to date of issues surrounding health and social care. 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 Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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 Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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): These standards were assessed at the previous inspection. EVIDENCE: These standards were assessed at the previous inspection. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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): 8,9,10 (Standard 7 was assessed during the previous inspection.) Health care records showed that resident’s health care needs were documented adequately. Staff follow the homes policies and procedures for dealing with medicines, however appropriate training has not been provided. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: Individuals care plans are reviewed monthly and were signed by the manager. Records also showed details of resident’s visits to the doctor and chiropodist. One service user said “staff care for me as I wish, all I have to do is ask”. Staff administer two resident’s medication, staff told the inspector that both residents prefer this. One resident said “I want staff to store my medication for me because it’s safer”, this is reflected in each individual’s care plan. The inspector looked at the medication storage area, which was in a locked cupboard. The inspector saw that some medicines had been discontinued by the doctor, however still being stored at the home. The provider must return all un-used and out of date medicines to the pharmacist and monitor stock levels on a regular basis. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 10 Risk assessments must be completed to safeguard residents who self medicate, along with a letter from the resident’s Doctor to authorise. Staff said they had not received training regarding the safe administration of medicines, therefore the provider must arrange appropriate training for all staff who administer medicines. The inspector witnessed staff address individuals in their preferred manner, as stated in individuals care plans. Staff were observed knocking bedroom doors and waiting for a reply before entering. All residents commented on how polite, helpful and friendly the staff are at the home. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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. Service users feel the home matches their expectations and preferences, their social, cultural, religious and recreational needs are met. Contact with family/friends/representatives and local community is encouraged as the individual wishes. Practices in the home demonstrate that the home promotes individual choices and encourages residents to have control over their lives. Dietary needs of service users are well catered for with a balance and varied selection of food available that meets individual’s taste, dietary requirements and choices. EVIDENCE: One resident said “I get support to help me do what I want, staff encourage us to take part in activities, sometimes I do, staff are understanding if I don’t want to. My family visit and also take me out.” One resident said “I am usually busy doing something every day, this morning I went to church then had coffee with my friends, came home for lunch, later I will be going to the post office to open an account. I walk to most places as they are local, my friends live close by and are welcome to visit me here. I enjoy living here, this is my home and I wouldn’t want to leave.” “The manager and staff will do anything for me.” The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 12 A record of visitors to the home was seen, however it was apparent that not everyone was signing it on entering or leaving the home. Staff must remind visitors to sign the book. The home shop on a weekly basis for groceries, staff said they ask each resident what they would like to eat for the following week, this determines what foods are bought. The cupboards and freezer are stocked with alternatives should a resident change their mind, one resident said “I can eat what I fancy, staff encourage me with my diet to help me loose weight.” Fresh fruit and vegetables were available. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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): 16,18. The home has a comprehensive complaints procedure, however, the procedure for logging complaints requires revising. The home has a policy on abuse, however, the document requires reviewing. EVIDENCE: The inspector witnessed the homes complaints procedure, which gives clear guidelines of process, a copy of this procedure is held in the homes policy file and in each “residents” welcome pack. The inspector saw the complaints log, the provider is required to revise the complaints log to include more detail of the complaint, timescales, action taken and outcome, thus enabling the home to monitor its complaints more effectively. The residents and staff were aware of the procedure, but have not felt the need to do so, they were confident the home would take appropriate action should a complaint be made. The manager and staff said they had not received any complaints. The inspector read the policy on abuse, which was basic, it was recommended the home obtain a copy of the Department Of Health No Secrets Document to correspend with the homes abuse policy and Hampshire County Council procedure for the Protaction Of Vulnerable Adults, these documents together would provide a comprehensive abuse policy and procedure for staff to follow. Staff said they had not received training on abuse, however they are aware of the homes policy and what to do should a claim of abuse be made. The home had a whistle blowing policy. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 14 All staff records showed Criminal Records Bureau (CRB) enhanced checks had been made prior to staff commencing their work at the home. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 15 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. (Standard 26 was assessed during the previous inspection.) Residents live in a safe environment, which is well maintained. EVIDENCE: The manager showed the inspector around the home, which appeared well maintained. The manager explained the home does not have a maintenance file, staff record faults in the diary and arrange for a maintenance person (who is employed by the home) to fix the fault. Staff said this form of recording enables them to monitor progress easily. The inspector tested a call point which sounded an alarm to gain staff attention. Staff attended the call promptly. One resident said “I feel safe here, as well as being free to come and go as I please, staff are here for me if I need them”. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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): 28 (Standards 27,29 & 30 were assessed during the previous inspection.) Staff appear to be competent to do their jobs, however records do not show any formal training to support this. EVIDENCE: At the time of the inspection, appropriate numbers of experienced staff were on duty, however they had not receive adequate training to fully ensure the residents safety. Three staff files were sampled. The files contained photographs of the individual, along with other evidence of the individual’s identification. The inspector saw evidence of the CRB disclosure being completed. The files contained application forms which included previous experience of the individual. One senior staff said she had recently completed her National Vocational Qualification (NVQ) level 3 in care and was waiting for her portfolio to be verified. The inspector saw one first aid certificate which is valid until May 2006 for the manager and senior carer. No other certificates were available, staff confirmed they had not received any training to keep updated with mandatory training. The Provider should ensure all staff receive the appropriate mandatory training, once they have, it is recommended that the manager devise a staff training plan to enable the manager to track training needs. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 17 The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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): 31,33,38. (Standard 35 was assessed during the previous inspection.) The home has a registered manager who runs the home in the best interests of the service users. The systems for service users consultation are good, however there is limited evidence that indicates service users views underpin any review and development by the home. Residents health, safety and welfare are not fully protected. EVIDENCE: The registered manager is registered with The Commission for Social Care Inspection (CSCI) to run the home. The manager is aware that if she continues to manager the home, she will need to complete the requires qualifications for registered managers, the Registered Managers Award (RMA) and NVQ level 4 in care. The staff team would benefit form clear direction from the registered manager of how the home strive to meet regulated standards, and how to keep up dated on issues surrounding health and social care. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 19 The home operates a keyworker system, which means each resident has a named member of staff who has specific responsibilities for the resident. A member of staff said “ I often spend one to one time with the resident I am keyworker to, we may go out or spend time in the home, as the resident wishes.” The inspector asked how the manager ensures the home is run in the best interest of residents. The manager confirmed she gets feedback on the running of the home on a daily basis by talking to residents, families and staff , however no records of this were available. The manager will develop a formal way of showing this consultation occurs, and the outcome. Staff confirmed quality issues are discussed on a one to one basis at their supervision and within staff meetings. Staff said they had not received any training recently regarding health and safety issues. Therefore the provider must ensure all staff receive adequate training, including moving and handling, food hygiene, fire training and Control Of Substances Hazardous to Health. A first aid certificate was valid for the manager and one senior staff. Records of staff attending fire drill practice were available, however it showed that one night staff member had not received adequate fire drill training to ensure the residents safety should an evacuation be required at night. Staff confirmed their awareness of health and safety procedures, and were aware if the homes policy and procedures, and where to find them. The home has risk assessments in place for the building and safe working practices for staff. Certificates showing the maintenance of services within the home were available and found to be in order. Radiators were covered and had thermostatic controls. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 21 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 OP16 Regulation 22, Sch3 (11) 13.4,5,6. 18(a,C(i) Requirement The provider must revise the complaints procedure and devise a complaints log in order to monitor complaints effectively. The provider must ensure all staff receive all mandatory training. THIS IS A REPEAT REQUIREMENT FROM 18/08/05 Timescale for action 10/02/06 2. OP38OP28 OP18 10/02/06 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 2 Refer to Standard OP09 OP38OP28 OP18 Good Practice Recommendations The provider must return all un used and out of date medicines to the pharmacist and monitor stock levels monthly. Once staff have received the required mandatory training, the inspector recommended the home develop a staff training and development plan to monitor when training has taken place and when it is due. The Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Dome Hotel DS0000011609.V277213.R01.S.doc Version 5.1 Page 23 - 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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