Care Home: Darlington Manor Residential Care Home

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. Service users say that staff treat them well and treat them with respect. The staff are working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users were very complimentary about the food, and there is a balanced diet, with service users choice included. (The latter, choices needs to be included on the menus). Complaints and concerns are taken seriously and are responded to properly. The home is kept clean and hygienic and free from odours. The home following this inspection, will now have enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is very experienced and is providing positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? Several areas have been decorated and refurbished since the last inspection visit. New carpets have been laid in the corridors, and some new lounge furniture has been purchased. The requirements from the last inspection report have been addressed. What the care home could do better: The decoration particularly in the elderly mentally infirm units is the same throughout all the communal areas: lounge, dining room and corridors. This does not help to orientate service users in their environment, and there is also a distinct lack of good signage which again may hamper service users orientation. Displaying Orientation boards providing information depicting: date/day, weather, the names of the staff on duty, appropriate signs on toilet doors, bathrooms, dining and lounge areas will enhance and promote the orientation for people with memory problems. The management team have agreed to contact Stirling university who can provide the service with appropriate information about environmental design, and colour schemes suitable for this client group. In order to keep records up to date, The fire log book checks and staff fire drills must be properly documented. To ensure that service users are made aware of the menu choice`s, the alternatives available must be included on the main menus. Key inspection report Care homes for older people Name: Address: Darlington Manor Residential Care Home Darlington Manor 70 Falmer Road Darlington Durham DL1 4AZ     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: Jim Lamb     Date: 2 9 0 6 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 26 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 26 Information about the care home Name of care home: Address: Darlington Manor Residential Care Home Darlington Manor 70 Falmer Road Darlington Durham DL1 4AZ 01325361166 01325487600 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Robert Pattinson t/a Manor Care Home Group care home 63 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Age on admission 55 years and over. The maximum number of service users who can be accommodated is: 63 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 63 Dementia - Code DE, maximum number of places: 63 Date of last inspection Brief description of the care home Darlington Manor provides residential accommodation for up to sixty-three older people including thirty-two people within the dementia care unit. The home is in a residential area of Darlington and is situated just outside of the town centre. The home is a two-storey building that overlooks Eastbourne Park. The home stands in its own Care Homes for Older People Page 4 of 26 63 0 Over 65 0 63 Brief description of the care home private gardens with an ornamental fountain in front of the front entrance porch. The gardens are very well kept. There is also adequate car parking available for visitors. Inside, the home has fifty-eight single bedrooms and five double bedrooms. Twenty-seven bedrooms have full en-suite facilities; the remaining bedrooms have private wash hand basins. The home has two passenger lifts, five lounge areas including a lounge for those that choose to smoke and two dining rooms. A bus stop and the railway station are within walking distance of the home. Darlington Manor aims to be part of the local community and works hard to get involved in lots of community activities. The home also has a variety of pets that live there. The home charges the following fees. General residential fees are 377.00 and Dementia care fees are 382.00 per week. These fees include food, accommodation laundry and staff on duty twentyfour hours a day. Additional charges are made for some entertainments, hairdressing and chiropody, newspapers and other personal items. Current charges and what they include should always be checked with the manager prior to admission to the home. The service users guide and inspection reports are available in the home. 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: 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 significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Older People Page 6 of 26 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager, the area manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, and checked what improvements had been made since the last visit. We told the manager/provider what we found. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? Several areas have been decorated and refurbished since the last inspection visit. New carpets have been laid in the corridors, and some new lounge furniture has been purchased. Care Homes for Older People Page 8 of 26 The requirements from the last inspection report have been addressed. 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 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 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 10 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. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: The service users guide, given to prospective service users and their family, provides good information about the facilities available at the home. Examination of care plans showed that prior to admission, an invitation is extended to each prospective service user and his/her family to visit the service so that they can look around the home, meet members of staff and the people already living there during this, and any subsequent visits, assessments are carried out to determine needs and to ascertain if they can be met at the home. If the prospective service user is unable to visit, a member of staff will where possible visit the person in his/her own home or hospital. Following admission there is a trial period during which time new Care Homes for Older People Page 11 of 26 Evidence: service users are able to decide if they wish to continue to live there. All service users are provided with a detailed contract that explains the homes terms and conditions and the fees to be charged.. The home does not offer intermediate care; therefore standard 6 does not apply. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: Monitoring of health is undertaken and health care needs addressed by communitybased professionals e.g. the persons own doctor, District Nursing Service, Occupational therapists, physio therapists and Chiropodists etc. Care plans are well maintained and up-to-date and contain information about the general health of the person and details of any specific medical condition or ailment. Risk assessments and risk management strategies have been developed in areas such as: mobility, risk of falls etc. Regular monitoring and reviews ensure changing needs are identified and appropriate action taken. Medicines held on behalf of service users are administered, according to the homes policies and procedures, by members of staff who have received appropriate training in the safe handling of medicines. Those people who have been assessed as being able to self-medicate are encouraged to look after their own medication. All medicines are Care Homes for Older People Page 13 of 26 Evidence: stored appropriately in a secure facility. Medication records are accurately maintained. The extractor fan in the medication storage room was not working and needs to be repaired, this will stop the room overheating. It was observed during the inspection that people living in the home are treated with respect and addressed courteously and appropriately. Needs and preferences about such things as diet, times of getting up and going to bed, personal care etc are carefully noted in care planning documentation so that members of staff are able to address care needs as the individual wishes and in a manner that preserves dignity. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: There is a relaxed, informal and friendly atmosphere in the home. Routines are flexible and allow the people living at the home to make decisions about everyday things such as when to rise and retire to bed. Care plans and conversation with service users showed how people are encouraged and supported to be as independent as possible, subject to their individual plan and risk assessments. Meals are served at set times although there is a great deal of flexibility to suit individual needs and wishes. Records of food served show a varied and balanced diet is provided with alternatives always being available should someone wish not to have the dish of the day. People living in the home said the food is very good, they said they were often consulted about menus. The main menus do not include the choice/options available, the management team said that they would review the menus and include the alternatives available. People living in the home are encouraged and supported to lead meaningful and Care Homes for Older People Page 15 of 26 Evidence: stimulating lives and are offered a range of activities: bingo. board games, film nights, handicrafts, gardening, trips out e.g. shopping and visits to local places of interests. The service users make good use of the superb landscaped gardens, there are a range of sitting areas that are frequently used during the summer months. Photographs of events and outing are displayed throughout the home. The views of people living in the home are sought on a daily basis through informal conversation and at regular service users meetings, during which people are consulted about the general running of the home, and suggestions for improvements are sought. Service users told the inspector they are happy living here and commented about the friendly and homely atmosphere. They made many very positive comments about the staff and said they were always cheerful and eager to please. Local clergy visit so that people living in the home can take part in an act of religious worship if they wish. Two visitors spoke to the inspector: each made very positive comments about the home and expressed satisfaction with the way that their relative was being cared for. They said they always received a warm welcome from members of staff, and a cup of tea and biscuits, whenever they visited. Care Homes for Older People Page 16 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 management is effective, and this results in the service users being protected from harm and abuse. Evidence: Policies and procedures are in place to protect people living in the home and to respond to any suspicion or allegation of abuse. All members of staff have received training in adult protection. The home has a suitable complaints procedure stating how complaints can be made, who will deal with them, the timescale for the process and what to do if not satisfied with the way in which the matter has been handled. Copies of the complaints procedure are available throughout the home and are contained in the service users guide. Records show there have been no complaints received since the last inspection. People living in the home said they were happy with their life at the home, but said should they be concerned about any aspect of their care they would know how to make a complaint. 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 provides a comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and well maintained. The grounds were highly attractive, tidy, safe, and accessible. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. During the last year, there has been some improvements made to the environment, there are new carpets in the corridors, several bedrooms have been refurbished and decorated, and some communal areas have been decorated. The decoration particularly in the elderly mentally infirm units is the same throughout all the communal areas: lounge, dining room and corridors. This does not help to orientate service users in their environment, and there is also a distinct lack of good signage which again may hamper service users orientation. Displaying Orientation boards providing information depicting: date/day, weather, the names of the staff on duty, appropriate signs on toilet doors, bathrooms, dining and lounge areas will enhance and promote the orientation for people with memory problems. The management team have agreed to contact Stirling university who can provide the Care Homes for Older People Page 18 of 26 Evidence: service with appropriate information about environmental design, and colour schemes suitable for this client group. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition, and 28 bedrooms have got en-suite facilities. Lighting was bright and domestic in design. All doors have privacy locks and room sizes meet the required standards. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users bedrooms have opening windows and restrictors are in place that have been approved by the Fire Brigade. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There was emergency lighting throughout the home. The kitchen was spotlessly clean and well organised. Water is stored at over 60C. Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was clean and mainly free from offensive odours. The laundry facilities are very well organised. The washing machines have the specified programme to meet disinfection standards. 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. There is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: Staff levels on the day of the inspection did not quite meet the agreed level for the number of service users. On the day of the inspection there were 52 service users. (28 residential and 24 EMI). In addition to the manager, the required numbers of staff were on duty across the day: Residential unit, 4 staff from 8am to 1pm, from 1pm to 4pm 3 staff increasing to 4 from 4pm to 9pm. EMI unit there are 4 carers between 8am and 9pm. The management team agreed to immediately increase the number of staff to 4 between 1pm and 4pm on the residential unit, this is essential to ensure that the needs of the of service users are fully met at all times. There are enough domestic, maintenance, and catering hours. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. Care Homes for Older People Page 20 of 26 Evidence: The homes training programme meets the National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. All statutory training was up to date and all of the staff team has completed NVQ level 2/3. Examination of personnel files evidenced that prior to a new member of staff commencing employment two suitable references are obtained and all necessary checks, including Criminal Records Bureau (CRB), are conducted. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The registered manager has the required qualifications and experience to run the home. There is a range of quality systems in the home. There is an annual survey of the views of the service users and their families. The findings are collated and an action plan drawn up to address any areas of concern. There are also regular meetings held with both the service user groups and with the staff group. These are minuted and action points listed. Both individual and central supervision records were studied. These records show an Care Homes for Older People Page 22 of 26 Evidence: appropriate bi-monthly pattern of supervision, with an annual work performance appraisal. All staff receive annual health and safety training. This is good practice. Checks of the fire log book showed that all the required checks and tests of equipment and systems do not take place at the proper intervals, this was discussed with the management team and the maintenance supervisor, it became apparent that all the necessary checks were being undertaken, but not recorded in the log book. It was agreed that all checks will be recorded in the fire log book. It was also agreed that more detailed fire training records for staff will be implemented. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. Servicing and maintenance records are comprehensive and well maintained. 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 1 15 The menus should be reviewed to include a choice of main meals, this will ensure that service users are aware of the options available. Professional advice should be sought for the environmental design, colour schemes, and signage needed to promote the orientation of service users with memory problems. To promote the health and welbeing of service users and staff, the weekly/monthly fire checks must be properly recorded in the fire log book. The fire drill records for staff must be more detailed. 2 22 3 38 Care Homes for Older People Page 25 of 26 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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