CARE HOMES FOR OLDER PEOPLE
The Dome Hotel Barton Court Avenue Barton-on-Sea New Milton BH25 7EY Lead Inspector
Tracey Box Unannounced 18.07.05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Dome Hotel Address Barton Court Avenue, Barton-on-Sea, New Milton, BH25 7EY 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) 01425 616164 Mrs G Lawrence Mrs G Lawrence CRH 3 Category(ies) of OP - 3; LD(E) - 1 registration, with number of places The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. To accommodate only one named person in the LD category. 2. To accommodate only one named person in the PD category. Date of last inspection 10.11.04 Brief Description of the Service: The Dome Hotel Rest Home is a registerd care home providing accommodation and personal support for three older people, the home may only accommodate one older person with learning disabilities. The home is privately owned and managed by Mrs Gillian Lawrence. The home is located in Barton-On-Sea, New Milton, situated close to the sea and within walking distance of local ammeneties. The service has reduced its numbers over the years as needs arose, the size of the home has reduced also to provide a small homely home on the first floor, half of the origional large building. The ground floor has been converted into privately owned self comtained flats, totally from the home, however, access to the home and flats are shared using the fromt door. Stairs lead to the first fllor where the accommodation compridses of three single bedrooms, kitchen, lounge/diner, bathrooms, toilet and staff sleep in room/office. A conservatory on the ground floor provides further communial space. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours, the inspector was supported by the manager, Gillian Lawrence. The inspector had the opportunity to speak with one visitor who said “One day I hope to live here”. The people living at The Dome Hotel prefer to be referred to as residents, therefore will be referred to as this throughout the report. The inspector spent time with two residents as they looked at their care plans and witnessed good interacting between residents and staff. The inspector looked at records and asked staff, residents and visitors for their views and experiences. The manager showed the inspector the layout within and surrounding the home, which appeared clean and comfortable. The inspector was impressed by the quality of the food being prepared and cooked for lunch, fresh ingredients were used to make the main part of the meal, however tinned vegetables were used, the manager stated this is not usual practice, they had not bought any due to my arrival, the inspector saw the fridge was stocked with fresh foods and fruit was available. What the service does well:
The service appeared very “Homely”, individual bedrooms were personalised. The manager said “We provide whatever the residents want”. Residents and visitor spoken with said the staff were friendly and provided them with the care and support they require. One resident said “the home being owned and managed by the same person is a real benefit to me as it creates a family environment, I feel very cared for”. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. One resident wanted to keep fish for pets, the manager took the resident to choose everything required and gave it as an early Christmas present. Staff re arrange duties to accommodate supporting residents on social events. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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 Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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) These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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. Residents health, personal and social needs are set out in individual’s care plans, however the recording of the plan review has yet to be established. EVIDENCE: The home has recently revised the way it stores and records information in the individuals care plan, there was no record to show that the plans had been reviewed with the individual on a monthly basis (or sooner if required.) Two residents explored their care plan with the inspector, the residents agreed with the contents and confirmed the staff care for them in the way they wish. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 Residents live in a safe environment, the majority of which is well maintained. The home is clean and pleasant. The home would benefit from ensuring staff receive training with hygiene issues. EVIDENCE: Decoration to the outside of the home would considerably improve one’s first impressions. The home appeared clean. The inspector saw records of residents room cleaning and bed changing. The inspector witnessed good food hygiene practices within the kitchen, however, decentred food was not adequately labelled to be stored in the freezer. The manager explained the environmental health officer does not visit as the home is small. The inspector requires the manager to ensure training is arranged for all staff covering hygienic practices. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 13 The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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) 27,29,30 The number and skill mix meet the needs of the residents. The procedure for recruiting staff ensures the protection and support for the residents. Staff training must be improved to ensure staff are competent to do their jobs. EVIDENCE: The home benefits from the manager, who is also the responsible individual who works closely with staff and residents. The home has not needed to recruit for four years. The manager explained the process should they need to, the inspector saw the homes written procedure. One member of staff on duty has worked with the residents for some years and commented on how “ I think this benefits the residents as we have knowledge of one another and it provides continuity of care”. The home benefits from volunteers, the inspector witnessed evidence of their Criminal Records Bureau enhanced disclosure. Records of staff training were not available, certificates showed all staff had received fire training by Hampshire fire brigade and staff had up to date first aid training, however, there was no records available to show staffs’ competences in all other mandatory training. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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) 35,38 Residents financial interests are safeguarded. Residents health, safety and welfare are not fully protected. EVIDENCE: The manager supports one service user with their finances, the inspector saw records of residents monies which agreed with the amount of cash the resident was holding. The inspector saw certificates for a recent fire inspection and electrical certificate. Risk assessments for the building , staff and visitors safety were available and seen by the inspector, who suggested a risk assessment be completed for the staffs sleep in room. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 16 The inspector requires the manager to arrange for all staff to receive manual handling training. The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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. 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x 3 x x 2 The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 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 OP 7 Regulation 15 2 (b) Requirement The provider is requires to review care plans each month with the residents involvement and maintain records. THIS REQUIREMENT REMAINS OUTSTANDING FROM 1/12/04 All parts of the care home are kept reasonably decorated The provider must ensure staff are trainind and competent to do their jobs Timescale for action 18/8/05 2. 3. OP 19 OP 30 23 2 (d) 18/9/05 18/8/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Dome Hotel H54 S11609 The Dome Hotel V238819 180705.doc Version 1.40 Page 19 Commission for Social Care Inspection 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
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