Care Home: Deansfield

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What the care home does well People who were spoken with during the inspection were very complementary regarding the service provided, level of care and the staffing and management arrangements. Care planning is clear and effective and the care is delivered by appropriately skilled staff who are attentive to people`s needs. The manager has a good day-to-day rapport with people and is focused on achieving positive outcomes for people living at the home and leads and supports a staff team who share the same values. The home places great emphasis on ensuring that routines are flexible and are planned around people`s needs and wishes. What has improved since the last inspection? Since the last inspection the home has improved the fire safety arrangements in respect of the front entrance to the home and staffing rotas now show the arrangements to support the member of staff who works at night. What the care home could do better: Shortfalls in this service are few and the people we spoke with could not think of anything, which could improve the quality of their lives at Deansfield. To comply with changes to legislation the home is required to fit a specific cupboard for the purpose of storing controlled drugs securely. The home is also strongly recommended to obtain a copy of the guidance document in respect of the safe use of bed rails. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Deansfield Deansfield Kynnersley Telford Shropshire TF6 6DY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rosalind Dennis     Date: 1 9 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Deansfield Deansfield Kynnersley Telford Shropshire TF6 6DY 01952603267 01952605939 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs. Sheila Francis May Foster,Mr. David Barry Foster,Mrs Thelma Buenafe Foster Name of registered manager (if applicable) Mrs Daphne Coope Type of registration: Number of places registered: care home 15 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 Deansfield is owned by Mrs S Foster, Mrs T B Foster and Mr D B Foster, and is registered with the Commission for Social Care Inspection to provide care for 15 Older People. The Registered Manager is Mrs Daphne Coope. It is a care home providing personal care situated in a former Victorian Rectory and is set within two acres of attractive gardens in the rural village of Kynnersley, Nr Telford. The village is accessible by the local bus service or by car. Information on the fees charged by the home is included within the service user guides, where it is documented that weekly fees are 355 pounds and 93 pence. The reader is advised to contact the home to obtain up date information on the fees charged. People can obtain information about this service from the homes Statement of Purpose and Service User Guide. Inspection Care Homes for Older People Page 4 of 25 Over 65 15 0 Brief description of the care home reports produced by CSCI can be obtained direct from the provider or are available on CSCIs website at www.csci.org.uk. Care Homes for Older People Page 5 of 25 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: This inspection was unannounced and was conducted by one inspector over a period of around 5 hours. All key standards were assessed during the day- that is those areas of service delivery that are considered essential to the running of a care home. During the inspection time was spent speaking with people living at the home and their visitors, as well as looking at documentation and observing staff in their work. The inspection found the home functioning well, people living at the home appeared very content and eager to provide their views on how their needs are met at Deansfield. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the manager for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting Care Homes for Older People Page 6 of 25 outcomes for people using their service and is an opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed-Deansfield returned their completed AQAA to us within the given timescale. Information provided within the AQAA has been used to supplement the inspection process. The last key inspection of Deansfield took place on the 19th December 2006. We also conducted an Annual Service Review (ASR) on the 28th February 2008, when we looked at the information about the service we had received since the last inspection and made a judgement about when we would next do an inspection. As part of the ASR we sent surveys to people living at the home and the feedback and comments we received were positive. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 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 9 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. Deansfield has a good assessment and admission procedure, which ensures that people are only admitted to the home if the service is confident that it can meet their needs. Evidence: During the inspection we spoke with most of the people who live at the home and everyone described how content they have been since moving to Deansfield. People provided comments such as Im very happy here and its like a home from home. We looked at a selection of care files, which shows that the manager conducts detailed assessments of peoples needs prior to and on their admission to the home. These assessments show that the home seeks detailed information about the individuals care needs and any other matters that are important to them, such as their significant others, hobbies, cultural and religious needs-observation of care plans shows that this Care Homes for Older People Page 10 of 25 Evidence: information is then used to plan the persons care. Where applicable the manager also obtains a copy of the assessment undertaken by a social work professional and uses this information to plan peoples care needs. The home has a Service user guide, which provides people with detailed information about the home, facilities and services offered. Information on the homes fees is included within the Service User guide and the contracts we observed also provide people with clear information on what is included within the homes fees as well as information on those services, which incur additional cost. Care Homes for Older People Page 11 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. Care plans and risk assessments are well written and provide staff with information to meet peoples needs. People who are able to comment on the service are pleased with the care they receive. Evidence: Nine people living at the home who were spoken with during the inspection provided very positive comments on how they are cared for at Deansfield, comments included staff are kind and caring, nothing is too much trouble for the staff, everyone looks after me well. People who need assistance to move spoke of how staff are patient and gentle when they help them to move. People confirmed that staff treat them with dignity, respect and offer them privacy. Two people visiting the home spoke of their satisfaction with how the home and staff group looks after people. People spoke of how staff always take into account their likes and dislikes when providing care. The manager currently takes the lead in drawing up and reviewing care plans and the service is commended on the care planning process, Care Homes for Older People Page 12 of 25 Evidence: which ensures that care is focussed on the needs of the person. The care plans we saw provided comprehensive information on how people want their needs to be met and the actual care required from staff to meet those needs. One person spoke of how they like to get up early and that staff help them to do this, when we looked at their care file this preference was clearly recorded in their care plan. One person described to us how they are only able to eat small meals, this was clearly recorded in their care plan and the person confirmed to us that the meals they receive are always to their preferred quantity. A care plan we saw provided staff with comprehensive information about the specific equipment needed by a person and where to seek specialist advice if urgent attention is needed. We saw the person using the equipment as described in their care plan. A range of detailed risk assessments were present on the files we observed demonstrating that the home looks at ways to reduce any risks to the health and welfare of people living at the home. To ensure that staff are aware of particular risks, staff sign to confirm when they have read peoples care plans and risk assessments. Observation of peoples care files shows that Deansfield has positive and proactive links with other professionals to ensure that health and care needs are metpeople confirmed that District Nurses and GPs visit the home on a regular basis and a GP visited the home during the afternoon of the inspection. Certificates were available to show that staff who administer medication have attended training in the safe handling of medicines and we saw documentation which demonstrates that the manager actively seeks information about different types of medication to ensure staff are provided with up to date guidance. A staff member seen administering medication at the time of inspection appeared competent with this procedure. A selection of Medication Administration Record sheets that were observed had been completed accurately. We informed the home that it will need to ensure that a specific cabinet for the storage of Controlled Drugs is fitted which complies with new legislation. Care Homes for Older People Page 13 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. Staff at Deansfield assist people to exercise choice as far as possible and according to capabilities. The home provides meals that offer variety and cater for different nutritional needs. Evidence: People spoke about how they are pleased with how they spend their time chatting to other people and staff, watching TV, listening to the radio, reading and how they particularly enjoy watching the different birds and wildlife which visits the garden. People spoke about they are able to attend the church next door to the home, or if they dont feel well enough how representatives of the church will visit the home. It is clear from discussions with people that the home places great emphasis on ensuring that routines are flexible and are planned around their needs and wishes. Throughout the inspection there was a relaxed, friendly atmosphere where people felt able to share their views. People confirmed that families and friends are able to pop in to see them when they wish and the visitors we spoke with confirmed they are made to feel welcome when they visit. Care Homes for Older People Page 14 of 25 Evidence: All people spoken with during the inspection confirmed they enjoy all the meals and snacks provided by the home and that staff are fully aware of their likes and dislikes. We observed staff making people regular drinks and people confirmed that staff will always make them another drink as and when they want one. Care Homes for Older People Page 15 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. The home ensures that people have access to a clear complaints procedure and staff are provided with training to equip them with the knowledge and skills to safeguard adults from the risk of abuse or neglect. Evidence: The complaints procedure is clearly displayed in the Reception area and within the service user guide. The people we spoke with during the inspection did not have any concerns about the home and were very eager to provide positive feedback, all stated that if they had any concerns they would be able to raise them with the manager or other staff. The manager confirmed that the home has not received any recent complaints. Information provided by the manager and observation of staff training certificates confirms that staff receive training in the protection of vulnerable adults. We observed that the home has a copy of the local area multi agency adult protection policy. People living at the home stated they feel safe and confirmed that staff are always kind in their approaches with them. 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 standard of the environment is good providing people with an attractive, clean and homely place to live. Evidence: Information provided by the manager prior to this inspection demonstrates that the home has an ongoing programme of redecoration. A random selection of bedrooms and communal areas were observed and these appeared clean and the decor satisfactory. Although observation of some areas would suggest that further redecoration may enhance rooms and corridors, none of the people living at the home raised this is an issue and everyone we spoke with commented on how pleased they are with their rooms and the homes cosy atmosphere. All parts of the home were clean and hand-washing facilities are available for staff to use at the point of delivery of care, such as in peoples bedrooms. The manager confirmed that 7 staff have received training in infection control. The fire officer visited the service in July 2007 and was satisfied that the home had addressed previously identified fire safety deficits. We looked at a copy of the report from Environmental Health who had visited the home recently, two points of action were noted and the manager confirmed these will Care Homes for Older People Page 17 of 25 Evidence: be attended to. 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. Training opportunities within the home are good which ensures that Deansfield provides a well-trained and committed staff group who work positively to improve peoples quality of life. Recruitment practices are robust and safeguard people from the risk of employment of inappropriate staff. Evidence: Observation of staffing rotas demonstrates that the home now includes on the rota, the arrangements to support the one member of waking night staff. The people we spoke with confirmed that their needs are always met during the day and at night. Information provided by the manager earlier this year and before this inspection shows that staff are provided with a range of training, which is ongoing and designed to meet the needs of people who live at Deansfield. Besides ensuring that staff receive training in safe working practice topics such as moving and handling, infection control and fire safety, the manager also encourages staff to attend other training including stoma care, diabetes, dementia care and a training session in optical and hearing awareness recently took place, which some people living at the home also attended along with staff. Care Homes for Older People Page 19 of 25 Evidence: The manager confirmed that over 50 of care staff have achieved a recognised qualification in care (NVQ level 2) and some staff are studying for NVQ Level3. Most of the staff who work at Deansfield have worked at the home for sometime. The manager is currently recruiting for another member of care staff and was able to define the process to follow to ensure the recruitment procedure is robust and meets legislative requirements. We looked at two personnel files for staff already employed at the home, which showed that all pre-employment checks had been obtained. The manager confirmed that new staff will be provided with an induction, which meets Skills for care standards. 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 manager is focused on positive outcomes for people living at the home, leading and supporting a staff team who share the same values. Evidence: Information available at this inspection demonstrates that staff and management at Deansfield are committed to ensuring that people consistently receive a good standard of care. The home is well managed by Daphne Coope who has considerable experience in caring for older people and experience is supplemented by management qualification, along with training in other areas. People living at the home described how Daphne Coope speaks with them on a daily basis and listens to what they have to say. People are also able to comment on the service through the services own quality assurance processes, such as surveys, which the manager reported have recently been distributed for people to complete. For the purpose of this inspection Daphne Coope had responded to a request by the Care Homes for Older People Page 21 of 25 Evidence: Commission to complete an annual quality assessment document (AQAA)- this is an opportunity for providers to share with us areas that they believe they are doing well, and where they could improve. The information contained within the AQAA shows that Daphne Coope acknowledges the strengths and weaknesses within the service. The AQAA contained little information on how the home thinks it could improve however we spoke with people during the inspection to find out if they thought the home needed to improve, everyone we spoke with could not find any faults with the home and could not think of anything, which needs improving. The manager confirmed within their AQAA and at the time of inspection that the home does not to have any involvement with peoples financial affairs as people and/or their representatives maintain responsibility for their own financial affairs. Information was provided within the AQAA to confirm that servicing and maintenance of equipment is undertaken and policies and procedures are regularly reviewed. We looked at a selection of maintenance records and these were all up to date. One person who has been assessed as needing bedrails had a risk assessment for this practice in their care file and we looked at the bed rails on their bed, which appeared to be fitted correctly. We informed the manager of where to locate information about the safe fitting of bed rails and of the need to ensure all staff are aware of and understand this document. 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 1 9 13 The home must ensure that a cabinet for the purpose of storing Controlled Drugs is installed, which complies with new legislation This is to ensure that Controlled Drugs are stored safely 01/02/2009 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 38 The home should ensure that all staff are made aware of the MHRA guidance document in the safe use of bed rails and that any staff involved in the fitting of bed rails are competent at this procedure. This is to ensure bed rails are fitted correctly and people are safe. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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