Care Home: Dalvey House

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What the care home does well All the residents spoken with were very complimentary of the care they received and the friendly nature of management and care staff. Residents are only admitted to the home following a full assessment of their needs and having confirmed that the home can meet those needs. Staff at the home support resident`s rights to privacy in care routines and residents spoken with confirmed they are able to enjoy the privacy of their rooms when they choose without interruption. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made very welcome. Residents are helped to exercise choice and control over their lives as far as possible. The complaints procedure can reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff can easily follow. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. A robust quality assurance system is in place to ensure that the home is run in the best interests of the residents. What has improved since the last inspection? The home has a programme of ongoing maintenance. Several parts of the home have been repainted and re-carpeted. The windows to the front of the house have been repaired and repainted. The garden is well maintained and easily accessible. A new pergola has been put up to add extra shade for resident wishing to sit outside. Residents spoken with said they enjoyed going out into the garden when the weather permitted. The standard of recording relating to the administration of medication had improved and residents could be assured that medicines were given appropriately. The staff training programme ensured that staff had sufficient training to be able to carry out their duties to a good standard, thus meeting the needs of the residents. CARE HOMES FOR OLDER PEOPLE Dalvey House 35 Belle Vue Road Southbourne Bournemouth Dorset BH6 3DD Lead Inspector Amanda Porter Unannounced Inspection 09:30 16th June 2008 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 Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 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. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dalvey House Address 35 Belle Vue Road Southbourne Bournemouth Dorset BH6 3DD 01202 423050 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) Norlington Care Limited Joanne Louise Smart Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category (Code OP) The maximum number of service users who can be accommodated is 19 Date of last inspection Brief Description of the Service: Dalvey House is a care home that provides personal care and support for up to nineteen older people. It is a large detached house that has been adapted to provide residential care. The service user accommodation is situated on two floors with a passenger lift providing access to the first floor. All service users at Dalvey House have single rooms, eight of which benefit from en-suite facilities. There are separate lounge and dining areas and an easily assessable rear garden with level pathways. The house is situated on a bus route and is within half a kilometre of shops and other community amenities including the cliff tops at Southbourne. Car parking space is available at the front of the house. Mrs Tempany and her son Gary Tempany are the registered Directors of Norlington Care Limited. Gary Tempany is the responsible individual for the home and Joanne Smart is the registered manager. The fees for the home as provided to CSCI at the time of inspection range from £460 to £500. Additional charges include hairdressing, chiropody and newspapers. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_c hoos.aspx Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection took place on the 16th June 2008 over a period of approximately five hours. The purpose of the inspection was to review the requirements made at the last inspection and to assess all of the key standards. The Registered Manager, Mrs Joanne Smart, and her deputy were on hand to aid the inspection process. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home. • The annual quality assurance assessment completed by the home. • 5 questionnaires completed by residents, 4 by relatives and visitors, 5 by health professionals and 1 by a member of staff. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents, visitors and staff. During the course of the inspection residents, visitors and members of staff were spoken with and asked their views on the service provided at the home. Comments received in surveys and through discussion included: “Dalvey House has provided my relative with a new lease of life and I am thoroughly impressed with the care given.” “All the staff treat me with kindness and respect, take time to share a friendly word and make it feel as much like ‘home’ as possible” “The senior staff really give a personal service and feel like my friends.” “Whenever I visit Dalvey House, which is at various times, the staff are always friendly, nothing is too much trouble. The meals are excellent, and the entertainment also. It’s like home from home!” Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The home has a programme of ongoing maintenance. Several parts of the home have been repainted and re-carpeted. The windows to the front of the house have been repaired and repainted. The garden is well maintained and easily accessible. A new pergola has been put up to add extra shade for resident wishing to sit outside. Residents spoken with said they enjoyed going out into the garden when the weather permitted. The standard of recording relating to the administration of medication had improved and residents could be assured that medicines were given appropriately. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 7 The staff training programme ensured that staff had sufficient training to be able to carry out their duties to a good standard, thus meeting the needs of the residents. 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 summary of this inspection report can be made available in other formats on request. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 8 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 Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure enables prospective residents, and/or those acting on their behalf, to make informed decisions about admission to the home and ensures that only residents whose needs can be met by the home are offered places there. EVIDENCE: The care files for two residents were inspected. These showed that the home has a good procedure in place. Prior to anyone moving into the home a full assessment of needs was undertaken with the prospective resident. Generally sufficient information was obtained so that a care plan could be drawn up and made available to staff. The Registered Manager confirmed in writing to the prospective resident that their needs could be met by the home. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 10 Residents spoken with confirmed that they or a family member had visited to the home and were given sufficient information about the home before making a decision as to whether to stay. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Two care files were reviewed and both contained the relevant assessments and care plans needed so that staff had the information to be able to give a good standard of care. Documentation showed that residents and/or their chosen representative were involved in the drawing up and review of care plans. This was confirmed by those people spoken with during the course of the inspection. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 12 Care documentation did not include a thorough nutritional assessment, which would show at an early stage if the resident had any particular dietary needs. However people spoken with said that they were well fed and “nothing was too much trouble.” Nutritional needs appeared to be met. Staff spoken with confirmed that they did take particular notice of what and how much people ate and if someone’s appetite appeared reduced they would take action. Where the need for specialist equipment was identified it was provided. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, district nursing services and chiropodists. One GP said, “All aspects of care provided by Dalvey House are appropriate, from my experience as GP.” The home has a good medicines policy and procedure in place. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. People spoken with were happy with the care they or their relative received and confirmed that staff treated them with respect and were supportive and kind. Comments received included: “I would not have my relative in anyone else’s hands.” “I am very happy and well looked after.” “All the staff at Dalvey House are very helpful and efficient and caring.” Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, cultural and recreational activities meet the needs of the residents. EVIDENCE: Residents spoken with said they were happy with the lifestyle that living at the home afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. Recent organised activities included: • • • • • Bingo Trips out to local attractions Visits from local clergy Gentle exercise classes Musical entertainment. DS0000052636.V361476.R01.S.doc Version 5.2 Page 14 Dalvey House On the day of inspection several residents, relatives and members of staff went out for a pub lunch, which they thoroughly enjoyed. Residents confirmed that their visitors were always made welcome at the home and they could have visits in private. One visitor commented: “I am always made very welcome.” All residents spoken with confirmed they enjoyed the food provided. Records showed that residents’ likes and dislikes with regard to food were known and residents were aware that alternatives to the main menu were always available. Residents said: “The food is jolly good here.” “There is always a good choice.” “The food is excellent and always nicely served.” Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. EVIDENCE: The home has a clear complaints procedure available to everyone. Residents spoken with during the inspection said that if they had any concerns they would feel confident about talking to the Registered Manager knowing that she would listen to them. The home has a policy and procedure to respond to suspicion or evidence of abuse or neglect and staff have received training in this area. This was confirmed by staff spoken with during the course of the inspection. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment at Dalvey House is good providing residents with an attractive, homely and safe place to live. EVIDENCE: A tour of the premises and review of maintenance documentation showed the home is well maintained inside and out. There was evidence that equipment is serviced regularly. Residents have easy access to all communal areas. The well-tended garden is attractive and easily accessible. Since the last inspection a new pergola had been erected in the garden and the manager confirmed that new garden furniture was to be purchased to put in it. However there was adequate seating Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 17 for residents in other parts of the garden. Residents confirmed it was a very pleasant place to be when the weather was good. There is an ongoing maintenance and refurbishment programme. Several areas had been repainted, and recarpeted recently. Resident’s rooms were furnished appropriately. Bedrooms were personalised with a variety of mementos, pictures and small items of furniture. All areas of the home seen during the inspection were clean, bright and free from any unpleasant odours. Surveys completed indicated that the home was always kept clean. The laundry continues to be well managed and there were adequate supplies of clean linen available. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient care staff are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can give a good standard of care to the residents living at the home. EVIDENCE: At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at that time. During the inspection staff were on hand to meet the needs of the residents. Residents spoken with confirmed that staff were available when they needed them and they were not kept waiting. The home has an ongoing training programme, which includes NVQ level 2 and 3 in care and 50 of the care staff hold the minimum of a level 2 award in care. Four staff recruitment files were reviewed. The files were well ordered and contained all the information required by law. POVA first and enhanced Criminal Record Bureau checks had been obtained for all new staff. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 19 Training files demonstrated that staff were receiving induction training. Staff confirmed that they were encouraged to take up training opportunities provided. Recent training including: • Fire safety • Moving and handling • Dementia awareness • Food hygiene • Medication administration • Infection control • Coping with aggression • The mental capacity act. Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 15 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and the daily management and running of the home centres round the care of residents. Good management practice, systems in place, and records kept, confirm the health and safety of all in the home. EVIDENCE: Through discussion it was evident that residents, visitors and staff enjoy the way the home is run and find the Registered Manager is very approachable. Mrs Smart demonstrated throughout the inspection that she runs the home Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 21 effectively and is well supported by a competent staff. She ensured that adequate numbers of well-trained staff were available to meet the needs of the residents. She also ensured that robust recruitment procedures were adhered to. There is a quality assurance and quality monitoring system in place. The home takes steps to review its performance regularly and residents’ views are sought and suggestions put forward are acted upon. The Registered Manager and residents spoken with confirmed that residents either deal with their own finances or have a representative to do so. The home will hold a small amount of money for residents if they so wish. Records showed that staff had received recent training in fire safety and manual handling updates and staff confirmed this. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and appropriate action was taken as necessary. To improve levels of infection control it is recommended that the home provide paper liquid soap and hand towels in each resident’s room so that staff can wash their hands before leaving the room. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No 7 8 9 10 11 Score 3 X X X X X X 3 3 2 3 3 X STAFFING Standard No Score 27 3 28 3 29 3 30 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP8 Regulation 14(1) Requirement The Registered Person must ensure that nutritional screening is undertaken on admission and subsequently on a periodic basis, a record of nutrition must be maintained, including weight gain or loss. Timescale for action 17/09/08 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 OP38 Good Practice Recommendations Liquid soap and paper hand towels should be available in each resident’s room so that staff can wash their hands before leaving the area, thus minimising the risk of crossinfection. Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © 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 Dalvey House DS0000052636.V361476.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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