Care Home: Danescourt

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What the care home does well Danescourt was clean and fresh smelling. We observed good interaction between staff and people who live at the home. Staff took every opportunity to maintain peoples independence and enable them to exercise choice. People were helped to make use of local amenities. The manager encourages staff to train and extend their knowledge and skills. What has improved since the last inspection? People said they were happy with the areas of the home that had been redecorated and refurbished. The home has been refurbished and equipped with a modern kitchen. What the care home could do better: Continue to upgrade and refurbish the home in accordance with the business plan. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Danescourt 1 Rectory Gardens Doncaster DN1 2JU     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: Ian Hall     Date: 0 7 1 1 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 © (2009) 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: Danescourt 1 Rectory Gardens Doncaster DN1 2JU 01302328455 F/P01302328455 NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Doncaster and South Humber Healthcare NHS Trust Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Danescourt provides care for people who have previously spent many years living in large institutional hospitals. The home is registered to provide personal care and accommodation for up to eight elderly persons within the category of learning disability. The home is a large detached house that is situated at the junction of Rectory Gardens and Thorne Road. It has a prominent position overlooking Town Fields and is 2 miles from Doncaster town centre. The home was formerly a private family residence that has been extended and adapted. There is a choice of two lounges and a dining room that overlook the well maintained gardens. A passenger lift provides access to the first floor bedrooms. The home is set within well-stocked and maintained gardens. There is a private and secluded area at the rear of the property that is regularly used for barbecues and activities. Pathways within the grounds are level to enable easy access. There are limited car-parking spaces available at the home; a bus route is nearby. The weekly fees are 326 pounds; thehome charges extra for holidays and toiletries. Care Homes for Older People Page 4 of 26 8 Over 65 8 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at risk of significant harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The unannounced site visit was undertaken as part of of the inspection started at 08.30 and concluded at 14.30 on the 7th November 2008. The inspection was conducted by Care Homes for Older People Page 6 of 26 the link inspector Mr I Hall. The site visit included a tour of the building, reading records, discussions with staff and people who use the service and observation of the meals provided. We also met the with the manager and other members of staff. In addition the inspection took account of information received about the service since the last key inspection 6th November 2007. This included records of telephone conversations with staff, events notified to CSCI and records of management visits to the home. Prior to the site visit the home carried out a self assessment of the service. This is called the annual quality assurance assessment (AQAA). People spoken with were happy to assist with the inspection. Comments were positive when describing the care and motivation of the staff, these included : I like living here, I feel safe, the staff are very good to me. At the end of the site visit verbal feedback was given to the manager. 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. The service provides people with detailed information to enable them to choose whether the home is the one for them. Detailed assessments ensure that peoples needs could be met prior to offering them a place. Evidence: An information pack is available that provides details of the standard of care and services provided. This includes information about staff, their qualifications, visiting the home, choosing meals, the laundry service and how to raise concerns. We checked three case files. Each contained a detailed needs assessment; this included things such as daily living, personal care, health care, social interests and areas of risk when appropriate. Whenever the need for specialist care equipment had been identified this had been obtained prior to the person moving into the home. Care Homes for Older People Page 10 of 26 Evidence: The assessment formed the basis of the initial care plan. People said they had been able to talk about the type of help they needed before they had decided to live at Danescourt. Whenever possible people had been encouraged to visit and spend time at the home. This was confirmed by written entries in the case files. Copies of contracts, social work referrals and assessments were available and kept in the case file. 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. Clear information is provided to guide staff meeting peoples needs. Staff ensure that people are able to access health services as they need them. Staff attitude and approach to care is based upon respect for the person, this helps safeguard and promote peoples rights and dignity. Staff work to the homes policies for the administration of medication, this promotes the wellbeing of people who live at the home. Evidence: We examined three peoples care records. Peoples care needs had been assessed. A range of recognized assessment tools had been used to measure peoples needs. These included mobility, mental ability, state of nutrition, and areas of risk such as falls. These provided a baseline for staff to measure peoples progress or increasing level of need. this enables staff to plan the help and support people need. There were care plans to tell staff how to meet these needs. These had been reviewed regularly. Most people we spoke to knew about their care plan. Care plans detailed peoples Care Homes for Older People Page 12 of 26 Evidence: cultural, religious needs and the gender of staff they wanted to support them with their personal care. Pen portraits of the person, their lives and interests provide staff with background information to improve the care and service provided. This enables staff to review peoples health and wellbeing and amend plans of care as needed. There were records of visits by the GP, community nurse, optician and chiropodist. All people were registered with a family doctor; there were good relationships with the doctors and district nurses. Aids and equipment had been provided to meet peoples moving and handling needs. We saw that toilet and bathing areas had been provided with aids and adaptations so people could use them independently and safely. We examined the homes medication policy, medication administration record (MAR) charts and the storage and handling arrangements for medicines. We observed medications being given after meals. Pots were used to hand medication to the person and water was offered to help with the taking of medicines. Time was spent with each person and encouragement given to help people take their medication. People living at the home said that staff were caring and always helped them, and that nothing was too much trouble. People said that staff promoted their privacy and dignity. We saw staff knocking upon bedroom doors and waiting to be invited to enter. We observed interactions between staff and people living at the home. These were warm relationships with each person showing respect for the other. 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. Suitable activities were provided at the home to keep people stimulated. Visits from relatives and friends were encouraged so people keep in touch with people who were important to them. There was a good catering service, which met peoples nutritional needs and food preference. People who live at the home were encouraged to eat a healthy and varied diet. Evidence: Three care files and care plans were checked. These show that people were involved in a range of social activities. People were reading, listening to music and watching television. No one currently leaves the home unless accompanied by members of their family or staff. Staff organize activities that stimulate people and encourage social interaction. Peoples comments included the food is good here, and they help me whenever i want them to. Care Homes for Older People Page 14 of 26 Evidence: We saw staff baking cakes and buns, staff say they were freshly made each day. people said they enjoyed them with their cups of tea and that there was always plenty to eat. A list of birth dates had been provided with special teas provided for people on their birthday. The meals provided were appealing and smelled appetizing. People said they enjoyed their meals. Alternative choices were available for people who didnt like the meal provided. People were seen and heard to make choices at dinnertime. Staff were seen to help and encourage people with their meals and drinks. Mealtimes were unhurried with extra portions provided as needed. Peoples likes and dislikes were documented and known to staff. Special diets were available as needed. Staff said they sought the dietitians advice when needed. Drinks and snacks were available through both day and night times. 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. The complaints procedure enables people to raise concerns. Concerns and complaints received were dealt with promptly and changes made to improve peoples lives. Staff had been trained in the recognition and reporting of abuse. Relevant checks had been made prior to them starting work, this reduced the risk of harm to vulnerable people. Evidence: People living at the home were able to describe how they would raise any concerns they had with staff. They said that anything they were worried about was dealt with promptly by the staff. The complaints procedure was available for people living at the home. People said they were very happy living at Danescourt. Two people had brought their concerns to the managers attention, two elements of their concerns were founded, actions had been taken to remedy the deficits. They had been investigated and recorded within the homes policy and procedure. People who had no advocate have been provided with access to advocacy services provided by Age Concern. Care Homes for Older People Page 16 of 26 Evidence: Staff had been provided with training in adult safeguarding procedures to ensure that people were safe, and to inform staff what to do if an allegation was made. The inspectors discussions with staff confirmed that they felt confident and able to respond to concerns or complaints confidently. 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. The home was clean, tidy and generally well maintained ensuring that people live in pleasant and safe surroundings. The bedrooms were clean and reflected personal choice. redecoration and refurbishment of the home has improved the environment. Evidence: We saw the home was clean and smelled fresh. Soft furnishings pictures and ornaments had been used to provide a homely domestic setting. The bedrooms we entered were all quite individually furnished and decorated. Each reflected the interests and personality of the occupant. Many favorite items and treasured possessions were displayed. Bedrooms were lockable with keys available for those who wished to exercise the choice to lock their own door. There is level access throughout each floor of the home with handrails provided to assist people to maintain their mobility and independence. The kitchen had been refurbished and equipped to a high standard in consultation with the environmental health inspection officer. Care Homes for Older People Page 18 of 26 Evidence: Toilet and bathing areas were equipped with grab rails and safety aids. These are needed to enable people with physical disabilities to maintain their independence. Appropriate seating has been provided in the enclosed garden area for people wishing to sit outside whenever the weather permitted. Staff confirmed that they were provided with protective clothing if they needed it and that equipment was in working order, being serviced as required. Low surface temperature radiators had been provided to reduce the risk of people being burnt. 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. Staffing levels were maintained to meet peoples care and social needs. Staff had received training to meet peoples general and specifies needs. Appropriate support and guidance was provided to new staff, enabling them to safely care for people who live at the home. Staff files included the required information. The home operated a recruitment policy that promoted peoples protection. Evidence: We met with eight members of staff including the manager during the course of the inspection. We saw staff working with people and noted that there was an atmosphere of mutual respect; their conversations were relaxed and friendly. The staff group were well motivated and enthusiastic about their work. They confirmed that they were supported by the manager and encouraged to train and update their skills. Personnel files sampled confirmed that the home follows health authority staff recruitment procedures. Care Homes for Older People Page 20 of 26 Evidence: Records of staff supervision and training needs were examined. We saw the staff training and development plan. Training courses completed and planned were seen. These included health and safety, moving and handling and first aid. Many staff had achieved National Vocational Qualifications; the remaining staff were working to achieve the award. Skills for prevention of infection and fire safety were updated each year. This ensures staff were trained to meet peoples care needs safely. 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. Staff said the manager was supportive and approachable and there was a system of professional supervision. People were involved in making decisions about their care and exercise control over most issues that affected their lives. Systems were in place to protect peoples financial interests. Checks had been made on the major systems in the home such as fire and gas installations to ensure the home was safe for people. Evidence: We saw there was always a senior member of staff on duty at the home. Responsibilities for day to day operation were shared between senior members of the team. Care Homes for Older People Page 22 of 26 Evidence: Staff said the manager was very professional, approachable and they had confidence in her. Staff had received management supervision at regular intervals; this is needed to develop staff and monitor care practices. A senior manager visits the home to monitor care and standards at the home. A written report of their findings was available at the home. Management use a quality assurance system to measure standards of care and service provided. Regular meetings are held for staff and people who live at the home. These give people living at the home a voice and chance to say how the home should be run. People felt that their views and opinions were listened to by staff. The manager handles money on behalf of some people, account sheets with receipts were kept. A second person witnessed each transaction. No fire exits were obstructed and hazardous substances were securely stored. Statutory servicing and checks of equipment were complete. Risk assessments had been completed to maintain a safe environment. 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 © (2009) 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!