Care Home: Darnall View

Similar services:

• Elmleigh Convent
• Eastfield Farm Residential Home Limited
• Fairview
• Cottingham Hall
• Cranmer Scheme
• Fairburn Mews
• Claremont House

What the care home does well People considered that the level of care was good and there were many positive comments about the staff support and the level of care. "Enables all in their care to live a pain free, happy as possible life. could ask more", "Very happy with care" and "They`ve got time for everyone" The home was clean, well maintained and there were no offensive odours. No person What has improved since the last inspection? The area outside the main lounge/dining room had been developed to provide a safe and secure garden area with patio, raised flowerbeds, seating and a grassed area. People could choose to use this facility whenever they wished. CARE HOMES FOR OLDER PEOPLE Darnall View 37 Halsall Avenue Darnall Sheffield South Yorkshire S9 4JA Lead Inspector Christine Rolt Key Unannounced Inspection 19th August 2008 09:45 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 Darnall View DS0000002954.V370292.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. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Darnall View Address 37 Halsall Avenue Darnall Sheffield South Yorkshire S9 4JA 0114 243 3323 F/P 0114 243 3323 none None Fisherbell Limited 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) Manager post vacant Care Home 23 Category(ies) of Dementia - over 65 years of age (23) registration, with number of places Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may admit persons between the age of 60 and 65 years of age. 28th August 2007 Date of last inspection Brief Description of the Service: Darnall View provides care for twenty-three older persons with dementia. The home is purpose built and is situated on a residential estate in the Darnall area of the city. There is ample car parking to the side of the home. Accommodation is on two floors with a passenger lift to provide access. All bedrooms have en suite lavatories. There is a lounge/dining room on the ground floor and a visitors’ lounge on the first floor. From the lounge/dining room there is access to an enclosed garden and patio area. The fees were £392.00 per week. Additional charges were made for hairdressing, chiropody, toiletries, newspapers and reflexology. One of the owners supplied this information during the site visit on 19th August 2008. The owners make people aware of the service in the service user guide, advertising and when enquiries are made. The role of the Commission is included in the service user guide. Darnall View DS0000002954.V370292.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 stars. This means that the people who use this service experience good quality outcomes. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9.45 am to 5.00 pm. One of the owners completed an Annual Quality Assurance Assessment before the site visit. This document gave her the opportunity to say what the home did well, what had improved and what they were working on to improve the service. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with two of the owners. The majority of people living at the home were seen throughout the day and several were chatted to. The care provided for three people was checked against their records to determine if their individual needs were being met. Ten questionnaires were sent to the home and seven were returned. Several visitors were asked for their opinions and one visitor completed a questionnaire. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living at the home, visitors, the staff and the owners for their assistance and co-operation. What the service does well: What has improved since the last inspection? Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 6 The area outside the main lounge/dining room had been developed to provide a safe and secure garden area with patio, raised flowerbeds, seating and a grassed area. People could choose to use this facility whenever they wished. 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. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 7 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 Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 8 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 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using this service had full assessments of their needs EVIDENCE: People said that they received sufficient information about the home. Comments about this were, “We were given a tour of the home, saw all the facilities and spoke to both the managers and some of the staff” and “We visited three times and Darnall View gave us good co-operation and information”. People said that this home was chosen because “it was recommended”, “good reputation”, “light and airy and convenient”. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 9 Assessments were carried out and copies of the local authority assessments and the home’s own assessments were available on the three files that were checked. These provided detailed information of each person’s needs and wishes. This home does not provide intermediate care. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 10 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 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were treated with respect. Medication recording procedures were almost met. Care and health needs were met and recordings of person centred care were almost met. EVIDENCE: People living in the home looked well cared for, clean and appropriately dressed. Staff were observed treating people with respect and kindness, and interactions were good. People living in the home and their relatives said they were satisfied with the home; they received the care and support they needed and were treated with respect and dignity. Three care plans were checked in detail. They provided good details of the person’s needs and wishes and information of how the needs were to be met. However, the daily records did not include information of how each person Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 11 spent their day. This was discussed during the site visit. Files contained good information of health needs and how these were being met. Comments were, “The district nurse visits frequently. Doctors are called if necessary and ….an ambulance is called if deemed necessary” and “The care staff appear to be alert to any physical and mental changes that occur and call the appropriate medical professional to deal with these”. There was information to verify that people living in the home and their families were involved in care planning to provide as much information as possible about the person and their life. Comments about people’s care were, “He’s always clean and tidy and shaved”, “They keep us fully informed and are attentive and sensitive to needs”, “The manager or senior staff are always happy to discuss any aspects of care with us”, “Good communication”, “The staff of the care home are helpful, caring and supportive”, “I feel quite sure that every member of staff provides excellent care” and “There are occasions when all the care staff are busy, but usually there is someone to deal with my needs”. Files contained risk assessments with details of the identified and associated risks and the action taken to minimise the risks. People’s property was listed but without sufficient details to enable identity e.g. size, brand, model number of televisions, radios, etc. Accidents were recorded and monitoring charts were used. Monthly analyses were used to determine the frequency and any patterns to time or place of accidents. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 12 The medication procedure was observed and the correct procedure was being followed. The trolley was clean and each person had his or her own prescribed medications. A sample of medication was checked. There were no gaps in the medication administration record (MAR) charts. Medication, both in the monitored dose system (MDS) and loose medication tallied with the records but one medication was not recorded as being received even though it was being used. The owner said that this had not been received with other medication and she had had to chase it up. It arrived late and it was an oversight that it was not recorded as received. Medication that was carried forward onto the new MAR sheet was not totalled with new supplies. The owner was advised to do this to show the total quantity of the medication available for the person, thus making the stocktaking process easier and preventing confusion. One of the owners carried out weekly medication audits and these were seen during the site visit. This is good practice. A sample signature sheet was available to identify each member of staff. This is good practice. Handwritten entries were countersigned to ensure that the correct information was recorded. This is good practice. Darnall View DS0000002954.V370292.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 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were generally satisfied with their lifestyles in the home. EVIDENCE: People’s opinions about activities were mixed. Some person considered that there were activities whilst others thought that more could be done to keep people motivated. Comments about activities were, “A number of outings have been arranged to take clients on short trips out …anyone can join in the activities of the home i.e. Dominoes, bingo, colouring, ball games, gardening.” “I don’t participate” “Would like to go out more” “The activities at the home are lacking. Some of the residents are able to play games such as dominoes, which are available on a daily basis, but apart from Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 14 this there does not appear to be much else to do. One outing to a museum was arranged and enjoyed by the residents who went.” “This area could be improved” “A reflexologist visits the home to treat residents who request this.” There was a programme of activities displayed but this was not conspicuous. The owners were advised to provide a larger activity board that people could see and understand. The home did not have an activity coordinator, but according to the owners, were continuing to advertise for one. In the meantime a member of ancillary staff was employed on a part time basis as an activity co-ordinator and care staff were also involved in social activities. On the day of the site visit, staff were observed sitting and chatting to people individually and also involved in table games with groups of people. One person was interested in gardening and had worked on the raised flowerbeds outside the lounge. Daily records in people’s care plans did not contain information of how each person spent their day (see section Health and Personal Care). Care plans contained information of people’s choices and preferences. Daily records also showed that these choices and preferences were respected, e.g. people got up and went to bed when they wanted. People who were capable had keys to their bedrooms. A person living in the home confirmed this. Visitors were made welcome and visited throughout the day of this site visit. Some people were still having breakfast at the start of this site visit. People looked relaxed and there was no rush. The same relaxed atmosphere was observed at lunchtime. The owner said that staff spoke to each person and asked for their choice from the meals available. The cook said that she was aware of each person’s likes and dislikes. However, there was no menu on display for people to check the meals on offer. To ensure that people are given as much information as possible to enable them to understand the meal options available, various methods and formats for doing so were discussed. These included a large menu board with written and pictorial information of the meals on offer. On the day of the site visit, the lunchtime meal was toad in the hole, broccoli, carrots and mashed potatoes and gravy. The alternative meal was cheese salad. The dessert was bread and butter pudding with custard and alternatives were available. The majority of comments about the meals were positive. “My mother always enjoys her meals”, “Very good meals” and Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 15 “The meals are good, home cooked food. The menu is quite varied” One person thought that improvements could be made, “…the choices we were told about don’t seem to happen and the food sometimes seems unattractive and perhaps unappetising.” Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 16 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 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People felt they were listened to and protected. EVIDENCE: The owner said that the complaints procedure was included in the service user guide, which each person in the home had. Copies were also made available to people’s relatives. People said that they knew how to complain and were confident that the service would respond appropriately. “Any problems are dealt with quickly and efficiently”, “I always speak directly to the managers if possible or senior staff. I have to say I have had very little to complain about” “…manager is very approachable” “I feel safe in the home” and “The managers at the home ask the residents if they are happy most days.” Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 17 All staff had undertaken adult safeguarding training. More in depth training had been booked for all senior and long term staff and the owner was able to provide dates for this training. There were no allegations of abuse. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 18 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 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People lived in a clean pleasant and safe environment. EVIDENCE: The home was clean and tidy and there were no offensive odours. were clean and of good quality. Carpets “One of the first things you notice about the home is how pleasant it smells. The rooms always appear to be clean”, and “Very clean, no smells and a pleasure to visit, light warm and airy”. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 19 Bathrooms and lavatories were clean, tidy and fit for purpose. However, these rooms were functional and were not domestic in character. The need to provide a more homely atmosphere was discussed with the owner. Bedrooms were attractive with good quality furniture and fittings and had been personalised by their occupants. Towels that were being put into bedrooms were ragged around the edges. The owner said that new flannels and towels had been ordered. Flannels had been delivered, which were seen during the site visit and the owner said the delivery of towels was imminent. Aids and adaptations were fitted throughout the home to maintain people’s independence. Liquid soap and paper towels were available in lavatories to prevent cross contamination. The corridors were similar to each other and provided few visual clues for people with dementia. There were very few signs or aids to orientation throughout the home. The environment could be made user-friendly which would help people’s orientation around the home and to time and place. Ways that this could be achieved were discussed with the owners. Since the last inspection, the area outside the main lounge had been made secure and was accessible to people living in the home. A garden had been developed with the provision of a patio area with seating and raised flowerbeds, and a grassed area. The development of the grassed area was discussed with the owner Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 20 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 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A well trained staff team cared for the people in this home. EVIDENCE: There were sufficient staff on duty at the time of this site visit. All new employees undertook induction training and copies of the booklets were seen on staff files. The Annual Quality Assurance Assessment (AQAA) stated that the induction programme met the National Minimum Standards. The AQAA also provided information that 60 of staff had achieved a minimum of NVQ Level 2 in care and that this would rise to 73 when other staff completed this course. The owner was able to supply information of training undertaken since the last inspection to enhance staff members’ skills. This training included falls awareness, oral hygiene and Chronic Obstructive Pulmonary Disease (COPD) to raise staff awareness of asthma and other health issues that cause breathing difficulties. The owner said that future training included Part 2 Dementia Care training and pressure care/tissue viability training. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 21 The recruitment files for three members of staff were checked. All contained the relevant checks, including Criminal Records Bureau disclosures, and information to show that the system was robust. People spoke positively about the staff. “The staff are always friendly and helpful and always reassure any worries we may have” “The staff are very professional and caring and take the time to speak to relatives when they visit”, “Either the manager or senior staff are available at all times…” and “I feel quite sure that every member of staff provides excellent care” Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 22 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, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home had no registered manager. People’s welfare was promoted and the home was run in their best interest. EVIDENCE: The home had no registered manager. Two of the owners were continuing to oversee the home and spoke of their plans for the future. The CSCI had not been formally notified of this but this notification was received shortly after the site visit. One of the owners who had achieved the NVQ Level 4 in care and the Registered Managers Award intended to become the registered manager. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 23 The home had a quality assurance system that included audits of systems and records within the home. Residents’ meetings were held and people’s views were also sought via questionnaires. Money held on behalf of people who lived at the home was stored safely. Individual records were kept of all transactions. A sample of these were checked during the site visit and money tallied with the records. Receipts were available for transactions made on behalf of people living in the home. Advice was given on numbering receipts and recording this in a column on the individual accounts. This would ensure ease of reference during auditing of accounts. One of the owners supplied information of mandatory health and safety training (i.e. moving and handling, basic food hygiene, emergency first aid, infection control and fire awareness) that had been undertaken since the last inspection. Training was ongoing and updated at regular intervals, which is good practice. Advice was given on implementing a staff training matrix that would provide ‘at a glance’ information of the members of staff who needed training. Records and certificates were available to verify that service and maintenance checks were carried out and a sample of these was checked during the site visit. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 24 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 Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 2 3 Refer to Standard OP7 OP7 OP9 Good Practice Recommendations The daily records should include information of what each person has been doing throughout the day to ensure that all their needs and wishes are being met. People’s inventories should provide sufficient details of items to enable identity. Medication carried forward should be added to medication received to provide a total of any particular medication available for the person it has been prescribed for. This will prevent confusion and make stocktaking easier. To ensure that people are aware of the activities on offer, the programme should be more conspicuous and in formats that people living in the home can understand easily. The provision of a large menu board with written and pictorial information would help people to be more aware of the meals on offer. 4 OP12 5 OP15 Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 26 6 7 8 9 OP19 OP19 OP35 OP38 Efforts should be made to make bathrooms and lavatories more homely and domestic in character for the benefit of people living in the home. Aids to orientation around the home and to time and place should be seriously considered to help people maintain their independence as far as possible. Receipts should be numbered and recorded on the person’s individual accounts to ensure ease of reference during auditing of accounts. The use of a training matrix would provide ease of reference of staff training needs. Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Darnall View DS0000002954.V370292.R01.S.doc Version 5.2 Page 28 - 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!