Care Home: Darwin House

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What the care home does well Darwin House was clean and fresh smelling. Staff were knowledgeable about people`s individual needs and personalities. We observed good interaction between staff and people living at the home. Staff took each opportunity to maintain people`s 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? We checked the previous requirements made at the last key inspection and found that these had been complied with. People had detailed assessments to maintain their health, safety and welfare. Care plans reflected people`s personal needs and areas of risk. They informed staff how to meet peoples needs and keep people safe. Systems for raising concerns and safeguarding people had been reinforced with additional training for staff provided; this ensures people feel secure and are protected from risk of harm. What the care home could do better: Ensure people`s social needs are met by extending the range of activities available. Continue to develop the record keeping systems so that information is more readily accessed. Ensure all staff have individual supervision and appraisals to maintain good practice and keep people safe. Key inspection report Care homes for older people Name: Address: Darwin House Darwin Lane Sheffield South Yorkshire S10 5RG     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: Ian Hall     Date: 2 6 0 1 2 0 1 0 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 25 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 25 Information about the care home Name of care home: Address: Darwin House Darwin Lane Sheffield South Yorkshire S10 5RG 01142301414 01142306017 whitakerhilary@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Darwin House Limited care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Darwin house is a residential care home providing personal care for up to 25 older people. It is situated in a residential area of Sheffield. The facilities were on three floors accessed by a lift. Seventeen single and five double rooms were available. Each of the bedrooms were provided with en-suite toilet facilities, five rooms had en-suite showers. A variety of communal lounge space, as well as a communal library room and dining room were provided. A central laundry and kitchen served the home. Sufficient bathing facilities were available. The home had pleasant landscaped gardens with seating for service users. The home had a car park. A copy of the previous inspection report was on display and available for anyone visiting or using the home. Information about how to raise any issues of concern or make a complaint was on display in the entrance hall. The manager confirmed that the range of fees from 1st April 2009 were £550 - £700 per week. Additional charges included newspapers, hairdressing and private chiropody. Care Homes for Older People Page 4 of 25 Over 65 25 0 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 stars. That means that people who use the service experience good quality outcomes. The key inspection was undertaken following the previous key inspection 9th September 2009 when the service was rated as delivering poor quality outcomes for people. Sue Turner (regulation inspector) and Ian Hall (regulation inspector) carried out this unannounced visit to the service over one day, the total time spent on site was 9 hours. In the report we make reference to us and we. When we do this we are referring to the inspector and the Care Quality Commission. Care Homes for Older People Page 5 of 25 We used a variety of information as well as findings from the visit to assess the quality of service offered to people who live in this home. The annual quality assurance assessment (AQAA) report had been received prior to the site visit. This report detailed what the home was doing well, what had improved since the last inspection and plans for improving the service in the next 12 months. We made reference to the improvement plan requested following the key inspection within which the homes management detailed the actions they had taken in response to the requirements made at that time. We also spent some time observing a lunch time meal being served to people who lived at the home to see how staff at the home supported them. It gave us some insight into how staff interacted with people and also an indication of peoples wellbeing. We also spoke to 9 staff and visitors to the home. We received 4 stakeholder surveys, comments from these are featured within the report. We have used comments from the people who use the service, relatives and staff comments as well as our site visit, to base our judgments about the quality of the service. Some comments and feedback from these stakeholders have been included within the report. On the day of the site visit we undertook a partial tour of the premises, inspected a sample of care records and checked records relating to the running of the home. The inspectors checked all key standards and the standards relating to the requirements outstanding from the homes last key 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 risk of significant harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 25 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 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 7 of 25 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 8 of 25 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 was available that provided details of the standard of care and services available at Darwin House. This included useful 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 such things as daily living, personal care, health care, social interests and areas of risk when appropriate. Whenever the need for specialist caring equipment had been identified this had been obtained prior to the person moving into the home. Care Homes for Older People Page 9 of 25 Evidence: The assessment formed the basis of the initial care plan. People said they had been able to discuss their wishes and the type of help they needed before they made the decision to move into Darwin House. Whenever possible people had been encouraged to visit and spend time at the home so they could meet members of staff and other people living at the home. This was confirmed by written entries in the case files. Copies of contracts and assessments were available and kept in the case file Care Homes for Older People Page 10 of 25 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. Personal and healthcare needs were met in a dignified manner. Evidence: Three peoples care records were examined. Peoples care needs had been assessed. A range of recognised assessment documents 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. Relatives said they were kept informed and involved whenever possible. Care plans detailed peoples religious and cultural needs and the gender of staff that they wanted to support them with their personal care. Pen portraits of the person, their lives and interests provided staff with background information to improve the care and service provided. Daily entries were made of care provided. This enabled staff to review peoples health and wellbeing and change plans of care as necessary. The care recording documentation was being Care Homes for Older People Page 11 of 25 Evidence: changed to improve access to information. There were records of visits by the GP, community nurse, dentist, opticians and chiropodist. All people were registered with a family doctor; there were good relationships with the doctors and district nurses. There were wheelchairs, aids and equipment provided to meet peoples moving and handling needs. We examined the homes medication policy, medication records (MAR charts) and the storage and handling arrangements for medicines. We observed medicines being given to people. Pots were used to hand out medication to the person and water was offered to help them take their medication. Time was spent with each person and encouragement given to help them with their medicines. People living at the home said that Staff were caring and helpful and that Nothing was too much trouble. People said that the 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 12 of 25 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 stimulate people. Visits from relatives and friends were encouraged so people kept 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 case 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. We discussed the managers plans to extend the range of activities currently provided and the value of appointing a dedicated activities co ordinator. No one currently leaves the home unless accompanied by a member of their family or staff. People said they were able to go to bed or rise as they chose. A multi denominational service was held regularly for people who wish to follow their religious faith. Peoples comments included, The foods very good here, Mum says the meals are Care Homes for Older People Page 13 of 25 Evidence: very good and thats all that matters. We saw the cook preparing and baking cakes and buns. She said these were freshly made each day. People said they enjoyed them with their cups of tea and there was always plenty to eat. A list of birthdays had been provided for the cook who said she prepared teas for peoples birthdays. The meals provided were appealing and smelled appetising. People said they enjoy their meals. They can choose other meals if they dont like the meal provided. People were seen and heard to make choices. Staff were seen to help and encourage people with their drinks and meals. Mealtimes were unhurried with extra portions provided as required. Peoples personal likes and dislikes were documented and known by staff. Special diets were available as needed. Drinks and snacks were available through both the day and night times. Care Homes for Older People Page 14 of 25 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. Concerns and complaints received were dealt with promptly and changes made to improve the quality of peoples lives. Staff had been trained in the recognition and reporting of abuse and relevant checks were made prior to them starting work, this reduced the risk of harm to vulnerable people. Evidence: Visiting relatives and some people living at the home were able to describe how they would raise concerns with staff. They said that any matters they raise however trivial were dealt with promptly by staff and they were satisfied with the outcome. The complaints procedure was available for people living at the home, their relatives and staff. Their comments included, The one minor complaint I had was dealt with very well, My mums lived here for a year now and Ive never had any complaints. There hadnt been any adult safeguarding referrals made since the last key inspection. One complaint had been brought to the managers attention, this had been investigated and recorded within the homes policy and procedure. The manager told us that people who had no advocate or next of kin would be provided with access to advocacy services provided by Age Concern. Care Homes for Older People Page 15 of 25 Evidence: Staff had been provided with training in adult safeguarding procedures to ensure people were safe, and to inform staff what to do if an allegation was made. Our discussions with staff confirmed that they felt confident and able to respond to concerns or complaints effectively. Care Homes for Older People Page 16 of 25 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 well maintained, ensuring that people live in pleasant and safe surroundings. The bedrooms were clean and reflected personal choice. Evidence: We saw that the home was clean and smelt fresh. Soft furnishings, pictures and ornaments had been used to provide a homely domestic setting. Bedrooms had been provided with matching soft furnishings and bedding. A range of colours had been used to individualise the appearance of bedrooms. Families had assisted with personalisation of bedrooms with favourite items and memorabilia. Bedrooms were lockable with keys available for those who wished to exercise the choice to lock their own door. Peoples comments included, Im very happy with the cleanliness and Its very clean and homely here. Staff confirmed that they were provided with protective clothing if they needed it, and that equipment was in working order, being serviced as required. Appropriate seating was provided in the enclosed garden for people wishing to sit Care Homes for Older People Page 17 of 25 Evidence: outside whenever the weather permitted. Care Homes for Older People Page 18 of 25 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. People were cared for by sufficient staff who weere competent and safely recruited. This helps protect people from harm. Evidence: We met with nine 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 they were supported by the manager and encouraged to train and update their skills. Staff training in moving and handling was being conducted on the day of inspection. Two new members of staff we interviewed were able to provide evidence both written and verbal of their induction training and developing knowledge of the care needs of people at Darwin House. They confirmed they had to provide two satisfactory references and a Criminal Records Bureau check before commencing employment. Personnel files sampled confirmed that the home follows the company staff recruitment procedures. We discussed the mangers plans to restructure the files to improve access to information. Records of staff supervision and their training needs were examined; the manager discussed her plans to increase the frequency of supervisions. We saw the staff Care Homes for Older People Page 19 of 25 Evidence: training and development plan. Training courses completed and planned were seen. These included health and safety, moving and handling, fire prevention and dementia care. Most staff had achieved National Vocational Qualifications, the remaining staff were working to achieve the award. This ensures that staff were trained to meet peoples care needs safely. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was organized and managed in the best interests of the people who live there. Evidence: We saw there was always a senior member of staff on duty at the home with advice and support readily available. Responsibilities for the day to day operation of Darwin House were shared between senior members of the team. People said, I feel the home is well run, We have meetings so we can comment about how the home is run, I think thats very positive. Staff said the manager was approachable, very professional and they felt confident in her. The manager had a job description that defines her role and responsibilities and staff were aware of her role. Staff supervision and appraisal was being undertaken; this processs had been Care Homes for Older People Page 21 of 25 Evidence: allocated to a senior member of the care team. The manager confirmed that all the staff team would have completed their supervisions within the next two weeks. 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. Questionnaires were used annually to seek the views of people and relatives. Regular meetings were 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 is run. People felt their views and opinions were taken into account by staff. The manager handles money on behalf of some people, account sheets with receipts were kept. A second person witnessed each transaction. Policies and procedures met the required standards. Records were mainly up to date, the manger was in the process of reorganizing how some records could be better organized with information readily available. 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. Staff had received mandatory training and updates for health and safety, moving and handling and fire safety to enable them to meet peoples care needs safely. Care Homes for Older People Page 22 of 25 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 23 of 25 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 2 12 30 A staff member with dedicated time should be recruited so that the programme of outings and activities is enhanced More complete records of staff criminal record bureau checks should be maintained so renewal dates are clear. Care Homes for Older People Page 24 of 25 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. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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