Care Home: Dalewood View

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What the care home does well All of the people spoken with made positive comments, which included, `I am always made to feel welcome`. `I am looked after, the staff are good`. `They do everything you ask of them, and more`. `The home looks after residents well, with dignity and respect`. Each person had a care plan that set out their individual needs so that these could be met. Access to health care specialists was provided and health was monitored to keep people well. A varied diet was provided to maintain health and provide choice. Complaints and safeguarding procedures and practice upheld people`s safety. A maintenance and decoration programme was in place to maintain good standards of accommodation. Staff were appropriately recruited, trained and supervised so that a competent staff team was provided. A health and safety procedure was in practice so that a safe environment was maintained. What has improved since the last inspection? No requirements or recommendations were made at the last inspection. Ongoing redecoration and replacement had taken place so that a pleasant place to live was provided. Some specialist profile beds had been purchased for people needing them. The garden and patio area had been provided with sensory and sunshade equipment for people to enjoy. Care plans were more detailed so that full information was available to staff. Monthly audits on all aspects of care, environment and health and safety had been introduced so that these could be monitored effectively. What the care home could do better: Chipped crockery should be replaced so that people are provided with suitable equipment. A system to check the cleanliness of cutlery and its storage should be implemented to make sure they are always clean. Some repair work to damaged decoration should be undertaken to maintain good standards of accommodation. Recruitment records should detail the full dates of previous employment and evidence that gaps in employment have been explored so that safe practice is upheld. Safety checks on fire doors should be carried out at the frequency identified in written policies so that safe systems are maintained. Key inspection report Care homes for older people Name: Address: Dalewood View The Dale Woodseats Sheffield South Yorkshire S8 0PS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janis Robinson     Date: 1 7 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Dalewood View The Dale Woodseats Sheffield South Yorkshire S8 0PS 01142555060 01142555070 dalewood.view@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Healthcare (Focus) Limited Name of registered manager (if applicable) Mrs Nothando Moyo Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service user who may be accommodated is 60. The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 60 Date of last inspection Brief description of the care home Dalewood View is a purpose built nursing home situated in the Woodseats area of Sheffield close to shops and public transport. The home is accessed through a one way road system. 0 Over 65 60 Care Homes for Older People Page 4 of 27 Brief description of the care home The home provides 48 single rooms and 6 double rooms on two floors, with bathroom, dining and lounge areas on each floor. There is also a large activities room on the lower ground floor. The home overlooks woodlands to the rear of the property, and there is a patio area provided. To the front of the property there is a small garden area and a car park. Current fees range from £337 to £658 per week. Written information about the home is provided to people. Copies of the service user guide are available from the home. Care Homes for Older People Page 5 of 27 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: The quality rating for this service is two star. This means that people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection was carried out by Janis Robinson, regulatory inspector. A site visit took place between the hours of 9am and 3.30pm on the 17th of August 2009. The registered manager, Nothando Moya, was present during this visit. Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA), which detailed what the home was doing well, what had improved since the last inspection of 20th August 2007 and any plans for improvement in the next twelve Care Homes for Older People Page 6 of 27 months. Information from the AQAA is included in this report. On the day of the site visit staff were observed interacting with people that live at the home. A partial inspection of the premises was undertaken and records relating to care and the running of the home were checked. Two people who were able to share their views were spoken with about living at the home. Qualified staff, care staff, the cook and the administrator were spoken with about aspects of their jobs. During the site visit five staff completed questionnaires about their skills and experiences of working at the home. Two relatives were spoken with about their experiences of visiting the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Chipped crockery should be replaced so that people are provided with suitable equipment. A system to check the cleanliness of cutlery and its storage should be implemented to make sure they are always clean. Some repair work to damaged decoration should be undertaken to maintain good standards of accommodation. Recruitment records should detail the full dates of previous employment and evidence that gaps in employment have been explored so that safe practice is upheld. Care Homes for Older People Page 8 of 27 Safety checks on fire doors should be carried out at the frequency identified in written policies so that safe systems are maintained. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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. Written information about the home was available so that people could make informed decisions. Peoples needs were assessed prior to moving into the home to make sure these could be met. Evidence: A statement of purpose and service user guide were seen on display in the entrance area. The manager stated that each person, and their representative, was provided with their own copy of the service user guide so that they had access to important information. The documents contained details about all aspects of the home and had been reviewed so that they were up to date. The recent changes in management were recorded in the service user guide seen. The guide was available in alternative formats, including audio tape to assist people. The manager confirmed that she carried out detailed needs assessments with people and their representatives to make sure the home could meet all identified needs. The Care Homes for Older People Page 11 of 27 Evidence: manager visited people and their representatives in their own home, or in hospital, to gather relevant information. Copies of initial assessments were seen in three care plans checked. They contained detailed information about the person, their needs, preferences and choices so that these could be respected. Information gathered at assessment was used to write a care plan so that staff had access to all information. The three care plans checked all contained information that corresponded with the needs identified in the assessment document. In the AQAA, the manager stated that assessments from other professionals, such as social workers, Primary Care Trusts (PCTs) and medical reports were always obtained when available so that full information was considered. Care Homes for Older People Page 12 of 27 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. Peoples health and personal care needs were met. Evidence: Three care plans were checked. They included information on all aspects of personal, social and health care needs. The plans included details on the staff actions required to make sure assessed needs were met. Specific information on peoples individual wishes and abilities was recorded so that staff could respect these. The plans checked had been reviewed on a monthly basis to make sure they were up to date. The care plans seen showed that moving and handling and falls risk assessments had been undertaken to keep people as safe as possible. Skin risk assessments were undertaken and equipment to aid tissue viability was available to meet peoples needs. Regular weight checks took place as part of monitoring peoples health. The care plans contained detail of all health care contacts, appointments and treatments. Records showed that people had access to a full range of health care professionals to meet their needs. People said, Care Homes for Older People Page 13 of 27 Evidence: I can see the doctor if I need to, staff arrange it for you. I see my specialist at the hospital, staff will come with me. We have a dentist and chiropodist come. Staff were observed respecting privacy by knocking on doors before entering. The interactions seen between staff and people living at the home appeared respectful and patient. Staff were seen talking to people, explaining what they were doing and sharing laughter. The staff spoken with said that they had access to peoples care plans so that they were kept up to date. People made positive comments about their care, which included, They are good, take good care of us. Lovely. Nothing is ever refused. I am well looked after. A policy on medication was in place, which was seen. Medication was stored securely and administered by qualified nursing staff. Staff were observed administering medication. They stayed with the person until they had taken their medication, and patiently encouraged some people. Medication Administration Records (MAR) were signed after the person had taken their tablets. Three MAR were checked. They had been fully completed and the drugs recorded corresponded with the drugs held. The three care plans checked all contained details of peoples wishes regarding death and funeral arrangements so that these could be respected. Care Homes for Older People Page 14 of 27 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. People were provided with choice so that they had some control over their lives. A balanced diet was provided to maintain peoples health. Evidence: People said that they were able to get up and go to bed when they chose, and were seen to walk freely around the home if they were able. Some people chose to spend time alone in their room, and this was respected. An activities worker was employed and a programme of activities was provided to people. The activities timetable was on display. This showed that a variety of activities took place, such as quizzes, exercise and crafts. A large activity room was provided on the lower ground floor to facilitate activities. The AQAA stated that plans were in place to improve the activity room with the development of sensory, craft and exercise areas. The activity taking place on the morning of this inspection was well attended and people appeared to enjoy their time. People said, I really enjoy the activities, they are a lifeline. I dont want to join in any activities. I am a private person and enjoy my own Care Homes for Older People Page 15 of 27 Evidence: company, staff respect this. A working mens club was next door to the home. Some people visited the club on a weekly basis for a social outing. All of the people spoken with said that visitors were able to come at any time. one visitor said, I am always made to feel welcome, I have no concerns over my relatives care. The menu was on display in the dining rooms and in the entrance area. However, the menus seen in the ground floor dining room did not accurately reflect what was being served that day, which could add to peoples confusion. A varied diet was provided and choices were offered. People said, The food is fine, Ive put weight on since I moved in. The food is acceptable. Plenty of it. The cook on duty confirmed that people had a choice of food and he was aware of peoples personal preferences. Special diets were catered for so that individual needs could be met. There were plentiful supplies of food in the kitchen, and staff confirmed that they had access to food at all times in case any person requested this. The lunchtime meal was partially observed. Staff sat with people that required assistance with eating, talking to them and helping respectfully. The sideboard in the ground floor dining room had some crockery that was worn and chipped. This needed replacing so that people were provided with suitable equipment. The cutlery drawer , and cutlery was dirty. This was brought to the managers attention and cleaned during the inspection visit. Care Homes for Older People Page 16 of 27 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. The complaints and adult safeguarding practices protected people. Evidence: A copy of the complaints procedure was on display in the entrance area so that it was accessible to all visitors to the home. The manager stated that copies of the complaints procedure were also given to people living at the home as part of the service user guide. The complaints procedure was seen to include our contact details should anyone need these. The record of complaints was checked, these detailed the action taken and outcome of the complaint so that they could be monitored. All of the people spoken with said they knew how to make a complaint and were confident that the staff would listen to them. An adult safeguarding policy was in place and seen. The training records checked showed that all staff were provided with training in safeguarding so that they knew what to do if they suspected abuse or an allegation was made. The staff spoken with could describe the indicators of abuse and were aware of the action to take in response to concerns. The people spoken with said that they felt safe at the home. Care Homes for Older People Page 17 of 27 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. The home was generally well maintained so that people were provided with a pleasant place to live. Evidence: An inspection of parts of the environment was undertaken. This included communal and individual rooms on all floors. The majority of the home was well maintained so that people had a pleasant place to live. A maintenance person was employed and a rolling programme of redecoration was in place to maintain standards. Since the last inspection ongoing improvements had been undertaken. These included the purchase of some profile beds for people requiring specialist beds, installation of keypads throughout the home, and redecoration of the activity room. All of the bedrooms seen were individually personalised, which showed that people had some control over their personal space. The home was clean and free from odours. However, some parts of the home showed signs of wear and tear. The ground floor dining room and lounge had marked decoration. The dining room sideboard was old and worn. A shower room seen had a few chipped tiles and marked shower tray. A bathroom seen had marked flooring. Two Care Homes for Older People Page 18 of 27 Evidence: bedroom carpets seen had marked flooring. The manager was aware of these issues and had identified some repair work as part of the redecoration programme to improve the facilities provided to people. People said they were happy with the accommodation provided. Comments included, Its very nice. I have everything I need. I have my photographs around me and it feels like home. Care Homes for Older People Page 19 of 27 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 recruitment and training policies and practice protected people. Evidence: The homes rota seen indicated that numbers of staff were being maintained so that peoples needs could be met. People spoken with said that enough staff were provided. In their surveys, when asked if there were enough staff to meet the individual needs of all the people using the service, three staff said usually, and two said always. A programme of National Vocational Qualifications (NVQ) was in place, to ensure a competent staff team was provided to people. Of the twenty six care staff, twenty two had completed NVQ level 2 in care. Two carers had achieved NVQ level 3 in care, and three were undertaking the award. Three staff files were checked. These contained all of the required information to show that thorough checks had been carried out. The files had evidence that a Criminal Records Bureau (CRB) check had been completed. They also included written references, proof of identity and employment history. However, one file did not include the dates of previous employment, and a further file had two gaps in employment history that had not been explained so that safe practice was upheld. In their surveys, all five staff said that their employer carried out CRB checks and Care Homes for Older People Page 20 of 27 Evidence: obtained references before they started work. Individual staff training records and a training matrix were checked. These showed that staff were provided with induction and mandatory training at relevant intervals to improve and maintain their knowledge. A computer system was in place that identified when staff required refresher training so that this could be provided at relevant intervals. In their surveys all five staff said that they were given training relevant to their role. A further training matrix seen showed that staff were provided with additional training which was relevant to their role, so that they had appropriate skills and knowledge. This included Dementia Care, Challenging Behavior and Care Planning. One staff commented, The home organises regular training for the staff and we have head of department meetings every month to discuss things. Care Homes for Older People Page 21 of 27 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 was well managed so that peoples safety and well being was promoted. Evidence: The registered manager had worked at the home for eight years, and was deputy manager for over three years. She commenced as manager in October 2008. The manager is a qualified nurse and had commenced the registered managers award. The home appeared well organised and people spoken with said the manager was approachable and supportive. The manager had started a weekly evening surgery so that people could meet with her if they wished. A poster was on display in the entrance hall which informed people of the surgery so that they were aware of this. Records of peoples finances were seen. Each transaction was recorded and receipts were kept. People received interest on their account. A quality assurance system was in operation to obtain and respond to peoples views. The results of surveys were published and displayed in the entrance hall so that this Care Homes for Older People Page 22 of 27 Evidence: information was available to all visitors to the home. Three staff records were checked. All evidenced that regular supervision meetings took place so that staff were appropriately supported and appraised. The AQAA detailed that appropriate policies and procedures were in place to inform good practice. However, some polices had not been reviewed since 2005 to make sure they were up to date. A health and safety system was in operation so that peoples safety was upheld. Systems were checked and serviced. Fire extinguishers and moving and handling equipment all had up to date service certificates. The fire book seen showed that regular fire drills took place and equipment was checked regularly to ensure it was in working order. A system to check fire doors on a weekly basis was identified as part of the homes health and safety procedure. Whilst all other equipment had been checked at timescales set out in the procedure, fire doors had not been checked since May 2009. The staff training records seen showed that staff were provided with a programme of mandatory training to ensure they had the right skills to do their jobs. Care Homes for Older People Page 23 of 27 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 27 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 1 15 16 All crockery must be in good 30/10/2009 condition so that people are provided with suitable equipment. 2 15 16 All cutlery must be kept clean so that people are provided with suitable equipment. 30/10/2009 3 19 23 All parts of the home must 30/11/2009 be well maintained. Rooms with damaged decoration and marked flooring must be repaired or replaced so that good standards are maintained throughout the home. 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 1 29 Gaps in employment history should be explained so that Page 25 of 27 Care Homes for Older People 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 full and safe practice is upheld. 2 3 4 29 37 38 Full dates of previous employment should be obtained so that full and safe practice is upheld. Policies and procedures should be reviewed to make sure they contain relevant and up to date information. Fire doors should be checked at the frequency set out in the written procedure to make sure all checks are carried out at relevant intervals. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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