Inspection on 24/09/08 for The Dome Hotel

This inspection was carried out on 24th September 2008.

CSCI found this care home to be providing an Good service.

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 Dome Hotel 28/09/06

The Dome Hotel 10/01/06

The Dome Hotel 18/07/05

The Dome Hotel 10/11/04

The Dome Hotel 28/06/04

The Dome Hotel 26/01/04

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Hillview Farm

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REACH Upton Court Road

The Cotswold Home

Fairways

Newbeech House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Dome Hotel Barton Court Avenue Barton-on-Sea New Milton Hampshire BH25 7EY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Laurie Stride     Date: 2 4 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Dome Hotel Barton Court Avenue Barton-on-Sea New Milton Hampshire BH25 7EY 01425616164 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs G Lawrence care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: No service users to be admitted under the age of 60 To accommodate only one named person date of birth 27/8/1946, in PD category Date of last inspection Brief description of the care home The Dome Hotel Rest Home is located in Barton-On-Sea, New Milton, situated close to the sea and within walking distance of local amenities. It is privately owned and managed by Mrs G Lawrence. The premises are situated on the first floor of a larger property (also owned by Mr and Mrs Lawrence) providing a homely environment and personal support for three older people, one of who has a learning disability. The ground floor has been converted into privately owned self-contained flats, totally separate from the home. Access to the home and flats are shared using the front door. Stairs lead to the first floor where a secondary front door leads to residents accommodation that comprises of three single bedrooms; kitchen, lounge/diner, bathrooms, toilet and staff sleep in room/office. A conservatory on the ground floor Care Homes for Older People Page 4 of 26 Over 65 0 3 1 0 Brief description of the care home provides further communal space. The home is located in Barton-On-Sea, New Milton, situated close to the sea and within walking distance of local amenities. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit took place as part of a key inspection of this service. The visit lasted approximately five hours during which we (the commission) spoke with one of the three people who use the service, the registered manager who is also the owner, and two members of staff. During our visit we also looked at samples of the homes records and undertook a brief tour of the communal areas of the premises and one of the bedrooms. Further evidence used in this report was obtained from the homes annual quality assurance assessment (AQAA), an annual service review we conducted on 23/04/08 and the previous inspection report for 28/09/06. The current range of fees is between 400 and 550 pounds sterling per week. This information was obtained at the time of the inspection visit. Members of the public may Care Homes for Older People Page 6 of 26 wish to contact the care home for up-to-date information about fees. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to use the service receive information about the home to help them make a choice and have their needs assessed to ensure that the service is suitable for them. Evidence: The previous inspection report identified that the home had an effective admissions procedure. During this visit we saw the records in relation to one individual who had moved in since the last inspection. It was clear that the individual had made a choice to live in the home and the move had been arranged in liaison with the persons solicitor and doctor. Staff members have the skills to meet the individuals assessed needs as documented in the care plan. We also saw that the home continues to review the needs assessment on a regular basis. Each person receives a copy of the homes Service User Guide and has a contract Care Homes for Older People Page 10 of 26 Evidence: detailing the terms and conditions of residence. The home does not provide intermediate care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. Medication administration practices protect the people who use the service. Evidence: The previous inspection report showed that the service did well at involving people in planning the care and support they receive. The homes annual quality assurrance assessment (AQAA) stated that all records are kept up-to-date. For this inspection visit we saw the three individuals care plans, which are written in plain language, are easy to understand and consider all aspects of the persons life, including health, personal and social care needs. Risk assessments are also included in the plans where appropriate. We saw that the home keeps records of monthly reviews of care plans, which includes discussion with the individual whenever possible. Each person has a key worker and daily records are kept showing the activities and support undertaken. Through looking at the records and discussion with two senior support staff, it was evident that they had a good understanding of individuals emotional and physical Care Homes for Older People Page 12 of 26 Evidence: health needs and the agreed ways of supporting them. We saw records showing when appointments with healthcare professionals took place and the outcome of these. We spoke with one of the people who use the service, who confirmed that she was able to access health care services independently and had no concerns in this respect. Staff members provide support to people to access services if required. The AQAA told us that the home makes people who use the service aware of their rights to privacy, dignity, choice, rights, independence and fulfilment. We observed that staff members interact with people who use the service in a manner that respects their privacy and dignity and promotes their independence. One of the people who live in the home manages their own medication and we were shown correspondence from the doctor confirming this arrangement. Records of medication given/taken are kept and those we saw were up-to-date and there were no gaps. We saw that the storage of medication is currently suitable and advised the manager of recent changes to the regulations for the storage of controlled drugs. The home does not currently hold any controlled drugs and the manager and a senior staff member said they would make arrangements to have the correct storage facility. Staff members receive training in the administration of medication. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports people to pursue their chosen activities and leisure interests and enjoy a full and stimulating lifestyle. The dietary needs and preferences of people who use the service are well catered for. Evidence: The homes annual quality assurrance assessment (AQAA) stated that daily life and social activities are planned around the wishes of people living at the home. During our visit we observed that people can do what they want to do and at their own pace. For example one person chose to stay in their room using their computer, while another moved between their bedroom and the communal areas as they wished. Two of the people living in the home continue to access the community independently, although staff members will support them if asked to do so and providing there is suitable staff cover at the time of asking. Staff members encourage individuals to pursue their interests and to maintain their social networks. One individual attends church and lunch clubs and another drives a car to see friends. There is a homely atmosphere and visitors are made welcome and may stay for a meal. For example, people from the warden assisted flats on the ground floor visit Care Homes for Older People Page 14 of 26 Evidence: their neighbours in the home and join in the homes Christmas parties. People who live in the home are also invited to attend the proprietors family functions. A member of staff told us how they went out for a birthday meal with one of the people who live in the home. Routines are flexible around individuals choices, for example one person prefers to make their own breakfast and another likes an early breakfast on Sunday before church. People can help themselves to fruit, snacks and drinks in the kitchen. Records are kept of individuals food preferences. Members of staff told us that food is delivered to the home and everyone is asked what they would like ordered. We saw that the menu offered varied and appetising meals and observed one person request and receive an alternative meal at lunchtime. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that any concerns they have will be taken seriously and acted upon. The homes policies and procedures, backed up by staff training, protect people who live in the home from abuse. Evidence: Service user surveys, which we received back for the annual service review (ASR) we carried out in April 2008, indicated that people know who to complain to if they are not happy with their care. This was also confirmed at the last inspection visit. The homes annual quality assurrance assessment (AQAA) told us that people who use the service, relatives and visitors are made aware of the complaints policy and procedure, which is also on display in the hall. During our visit we spoke with one of the people who live in the home, who told us that they are happy there and have no concerns. The manager said there have been no complaints since our last visit and there is a complaints log if necessary. We have received no complaints about the home in the time since the last inspection. The home has policies and procedures in place in relation to the protection of vulnerable adults. We advised the manager to obtain the updated local authority safeguarding adults policy. We saw records showing that staff members had received training in these matters and those we spoke to demonstrated a clear understanding of their role and responsibilities within the procedures. We also saw records Care Homes for Older People Page 16 of 26 Evidence: demonstrating that the home operates a thorough staff recruitment procedure, which helps to protect people who use the service. The manager told us that people who live in the home are encouraged to take responsibility for their own financial affairs and to use their money as they wish. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from having a clean, pleasant and comfortable environment to live in, which meets their individual needs. Evidence: The previous inspection report identified that the home is accessible, clean and wellmaintained. The manager is aware that as individual needs change consideration may need to be given to the installation of a stair lift on the access stairs. The home has a maintenance person, who had recently repaired a balcony and fitted shelves in an individuals bedroom. Work is also scheduled to re-decorate inside and refurb parts of the exterior of the building. The home overlooks the sea and is near to the local shops. The communal area is comfortably furnished and each person has their own bedroom and washing facilities. We were invited to see one persons bedroom, which they told us they are happy with and have everything they need. The annual quality assurrance assessment (AQAA) stated that people living in the home have any specialist equipment they require, for example one person has a walking frame and a handrail is fitted in the bathroom. The laundry room is suitably equipped and the home has infection control policies and procedures, which staff members and people who use the service are encouraged to Care Homes for Older People Page 18 of 26 Evidence: adhere to. Hot water is available throughout the day. On the day of our visit the home was fresh and clean and there were no visible hazards. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained to enable them to meet the needs of people who live there. The homes thorough staff recruitment procedures ensure people are protected. Evidence: We saw that the homes staffing rota is arranged in a flexible way to make sure that staff members are available to support individuals with their chosen routines and activities. There is at least one member of staff on the premises at any time. The manager and two senior staff all live locally and have known and worked with the people who live in the home for many years. Staff members we spoke with had a good knowledge and understanding of the different needs and personalities of the people who use the service. The annual quality assurrance assessment (AQAA) stated that everyone who has worked in the home has undergone pre-employment checks. During our visit we looked at the personnel records for two staff members. Each file contained the necessary information, including evidence of Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks, application forms and two written references. This demonstrates that people who use the service are protected. We looked at a sample of two staff members training records and saw evidence that Care Homes for Older People Page 20 of 26 Evidence: training is given on subjects such as moving and handling, fire safety, first aid, health and safety, dementia care and medication administration. Two senior staff confirmed they are completing National Vocational Qualifications (NVQ) at level 4 in care and the Registered Manager Award. The AQAA stated that all staff have or are obtaining NVQ at level 3 or above, or hold a nursing care qualification. Through talking with the manager and staff on duty it was clear that good communication exists among the staff team. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and management practices promote the wellbeing and best interests of the people who use the service. Evidence: The previous inspection report identified that the home is well run and the AQAA told us that all staff are competent to manage the home on a daily basis. The registered person has managed the home for twenty-three years and there is a regular staff team providing continuity of care. The manager updates her skills by attending training with the staff team. Staff members we spoke with told us that the manager is approachable and supportive. We saw that the quality of the service is monitored through, for example, a service user questionnaire, house meetings and staff meetings. We also saw that matters raised through the questionnaire or meetings are addressed. For example, one person who lives in the home requested a new piece of furniture and this was obtained. The Care Homes for Older People Page 22 of 26 Evidence: manager and senior staff are in daily contact with people in the home, who are encouraged to express any concerns they may have. We observed an open and friendly atmosphere in the home. As mentioned previously, the home does not look after individuals money. People who live in the home are encouraged to take responsibility for their own financial affairs. During our visit we saw evidence that safe working practices are promoted. Fire safety drills and equipment tests are recorded and staff members receive training in health and safety matters. People who use the service are reminded about the fire safety procedures at house meetings. Up-to-date gas safety and electrical installation and appliance certificates were on file. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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