Care Home: Dehnlea Rose

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What the care home does well The service provides good quality care and support for the group of service users living in the home. Staff are professional in their approach and treat the service users with dignity and respect. The standard of care planning is good and provides staff with all the required information to undertake their roles efficiently. The accommodation offered is comfortable, homey and safe. Communal areas are tastefully decorated and individual bedrooms are personalised and private. The home offers a good range of social and leisure activities in keeping with service user`s age range and interests. The home is well managed in the best interests of the service users. The Health, safety, and welfare of both service users are promoted. What has improved since the last inspection? The requirements made at the last inspection have been met. Provision has been made to provide service users representatives with a copy of the complaints procedure. An air conditioning machine has been provided to regulate the temperature in the home. Quality assurance surveys have been extended to relatives and other professionals with an interest in the service. Risk assessments have been identified and assessments in place including risks on staff. CARE HOMES FOR OLDER PEOPLE Dehnlea Rose Lambly Hill Virginia Water Surrey GU25 4BF Lead Inspector Mary Williamson Unannounced Inspection 10:00 13th May 2008 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 Dehnlea Rose DS0000013624.V363154.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. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dehnlea Rose Address Lambly Hill Virginia Water Surrey GU25 4BF 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) 01344 843221 hume.jehangeer@surreypct.nhs.uk Welmede Housing Association Ltd Mrs Bibi Humeanee Jehangeer Care Home 6 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (5), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1), Physical disability (1), Physical disability over 65 years of age (1) Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 5 Service users within the category LD(E), one of whom may also be in the categories PD(E) & MD(E). One service user may be in the categories LD & PD The age/age range of the persons to be accommodated will be: 58 TO OVER 65 YEARS OF AGE 15th May 2006 Date of last inspection Brief Description of the Service: Dehnlea Rose is a large detached bungalow located in the village of Virginia Water and was purpose built to accommodate up to six older adults with physical and learning disabilities. All service users have single bedrooms and the use of a communal lounge / dining room which has access to the garden. There is a large enclosed rear garden on two levels and car parking is available to the front of the property. Welmede Housing Association owns the service and the staff team are now also employed by Welmede having transferred from the North Surrey Primary Care Trust (NSPCT) recently. Dehnlea Rose DS0000013624.V363154.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 a two star rating. This means that people who use this service experience a good quality outcome. This was the site visit of a key inspection and was unannounced. Mary Williamson Regulation Inspector undertook the inspection. The deputy manager and a senior carer represented the organisation for the duration of the inspection. People who live in this service wish to be referred to as service users. It was possible to meet the residents and to gain some feedback about living in the home. A tour of the premises was undertaken, and records relating to the care of the service users and the management of the home were examined. Group discussions took place with staff and service users. The manager completed an Annual Quality Assurance Assessment (AQAA) as part of the inspection process. The Commission for Social Care Inspection would like to thank the service users and staff team for their help and hospitality during the inspection. What the service does well: The service provides good quality care and support for the group of service users living in the home. Staff are professional in their approach and treat the service users with dignity and respect. The standard of care planning is good and provides staff with all the required information to undertake their roles efficiently. The accommodation offered is comfortable, homey and safe. Communal areas are tastefully decorated and individual bedrooms are personalised and private. The home offers a good range of social and leisure activities in keeping with service user’s age range and interests. The home is well managed in the best interests of the service users. The Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 6 Health, safety, and welfare of both service users are promoted. What has improved since the last inspection? 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. Dehnlea Rose DS0000013624.V363154.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 Dehnlea Rose DS0000013624.V363154.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): 1, 2, and 6. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is access to sufficient information in order to help service users make a decision regarding the home. All service users have a needs assessment undertaken prior to admission. This service does not provide intermediate care. EVIDENCE: The home has a statement of purpose and service user guide in place. All service users, their relatives, or representative have access to this information in order to provide them with sufficient information about the home. This is also available in symbol format to enable service users to understand the content. All service users have a needs assessment in place. The manager undertakes this assessment on all service users prior to them being admitted to the home. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 9 This assessment is discussed with the staff team to establish the suitability of the placement and if specific individual needs can be met. Three needs assessment were seen and these are informative and well documented. The home does not provide intermediate care, and this standard was not assessed. Dehnlea Rose DS0000013624.V363154.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. Individual care plans outline the care needs of the service uses, and how care is delivered. Arrangements in place to meet health care needs are good. The medication policy in place protects the service users. EVIDENCE: Service user care plans are in place, which are called “life plans”. These are well written based on the information gathered at the needs assessment, input from the service user whenever possible, information obtained from relatives and any other relevant reports and information. Three life plans were seen. These are well maintained, informative and provide the care team with all the necessary information required to undertake their roles. Life plans are reviewed monthly or when needs change. The home promotes health and wellbeing and the arrangements in place to meet the health care needs of the service users are satisfactory. All service Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 11 users are registered with a GP and are seen by him regularly either at the surgery or home visits depending on the nature of the illness. Yearly medical examinations also take place. Service users attend the chiropody clinic ever three months and visit the dentist when required. A service user was attending a dental appointment during the inspection, which the home facilitated with the help of two staff. There is also access to physiotherapy, district nurses, dietician, psychology and psychiatrist on referral from the GP. There is a medication policy in place, and all staff that administer medication are familiar with this policy. Medication is supplied by a local pharmacy, who also undertakes periodic audits of medication. The medication recording charts (MAR) were seen and are well maintained. Currently there are no service users in the home that self medicate. Privacy and dignity is promoted and respected. All service users receive personal care in private. Staff knock on bedroom doors prior to entering. Locks are provided on bathroom doors, currently no service user manages a key to their room but this facility can be arranged if requested. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 12 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Flexible arrangements are in place to meet service users recreational needs. Family and community links are maintained. Support is ongoing to enable choice, and the nutritional needs of service users are met. EVIDENCE: Individual programmes of activity are in place, which form part of the care plan. Activities include lunch at the day centre, bingo at the community centre, swimming, and shopping. Activities in house include aromatherapy, music, exercise, garden activity and games. Service users had visited the garden centre the previous day for plants and had helped to pant these in tubs around the patio area in the back garden. Activities are flexible and take into account weather and transport. Service users stated that they enjoyed their leisure and social time. Service users maintain contact with family, friends and the local community. Visitors are welcome in the home at any reasonable time and service users can maintain contact with friends and invite them for tea. Some service users do not have relatives and the home encourages advocacy whenever possible. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 13 The staff team explained how the catering arrangements are organised. All service users are encouraged to choose the menu for the coming week at house meeting every Tuesday. Symbols and pictures are used to support service users make a choice. The menus seen are varied and wholesome. Staff do the shopping and prepare meals with input from the service users whenever possible. Lunch was observed and service users had requested to eat lunch on the patio due to the nice weather. Everyone was enjoying a mixed salad in a relaxed atmosphere. Staff are aware of service users needs and dietary requirements, and were seen to offer service users help with feeding in a sensitive manner. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 14 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints procedure and safeguarding procedures in place protect the service users living in the home. EVIDENCE: The home has a complaints procedure in place, which is also available in symbol format. This is available to all service users, relatives, and advocates and a copy retained in individuals care plans. There is a complaint log maintained and there have been no complaints since the last inspection. There is a safeguarding procedure in place called “dealing with abuse”. This outlines in detail the step- by -step action to be taken in the event of a safeguarding issue. All the staff in the home have undertaken training in these procedures and are able to outline the action to be taken if necessary. The home also has a copy of Surreys Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults in place and all the senior staff team have attended training in these procedures. There is also a whistle blowing policy in place, which the staff are aware of. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 15 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, 20, 22, 24, and 26. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable and well -maintained home that is suitable for its stated purpose. The home is clean and hygienic. EVIDENCE: The home is well furnished, comfortable and safe. Communal space includes a large lounge/ dining room, which is spacious, well furnished and comfortable. Service users stated that they like to sit and watch TV or take part in activity in this room. The kitchen is domestic in nature, and also accommodates a dining room table and chairs, providing service users with a choice of where to sit for meals. The home has been adapted to meet the mobility needs of the service users. There is as assisted bathroom, assisted shower room, and adapted toilets. Hoists and wheelchairs are in use. Ramp access provided to a Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 16 well -maintained rear garden and a ramp is also provided to gain access to the front of the house. Individual bedrooms were seen and these are well decorated, comfortably furnished and have been personalised to reflect individual personalities. Staff support service users to maintain their personal space. The home is clean and hygienic and free from odour. The laundry is well equipped and meets the requirements of the home. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 17 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff employed in the home meets service users needs. Staff are trained and competent to do their job. There are minor shortfalls in the recruitment procedure. EVIDENCE: The staff duty rota evidenced that there are sufficient staff on duty at any one time to meet the assessed needs of the service users. The number of staff on duty is flexible to accommodate individual needs, preferences and activity. During the inspection an additional staff member arrived on duty to provide the second escort to accompany a service user to the dentist. Staff demonstrated their training and development profiles, which include all the training they have undertaken. All staff undertake induction training, which is two full days in the training centre, followed by the managers individual training programme. The inspector was informed that most of the staff have an NVQ level 2 and that some staff have also obtained their NVQ level 3. Certificates are retained in the training files. The home has a recruitment policy in place, which was seen. The manager was off duty and the deputy manager did not have access to the staff files. During the inspection the care services manager visited the home who had Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 18 access to staff files. Several files were requested to be seen. Some were not in the home; others had documents missing for example references and application forms. The inspector was informed by the deputy manager and the care service manager that there had been an organisational change since the last inspection. The staff no longer work for the NHS Trust and have been employed by Welmede. The organisation is in the process of updating staff files and some files were in the HR department. Staff confirmed the interview process and the checks, which were undertaken prior to employment. A requirement has been made to ensure all employment records are retained in the home for inspection by the CSCI at any time. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 19 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 this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed in the best interests of the service users. Health and safety is observed and promoted. EVIDENCE: The registered manager who has been in post for several years manages the home efficiently. She was off duty during the inspection. The deputy manager was in charge and was present for the duration of the visit. There is good line management structure in place to ensure that the home is well supported at all times. Systems are in place to monitor quality assurance. House meetings take place to monitor services provided. Service users meet regularly without staff to air Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 20 their views and feedback to the manager. Regulation 26 visits are undertaken monthly and the reports are retained in the home for information. Annual quality assurance surveys are sent to service users, relatives, and people with an interest in the service, and results of these are sent to the home in a report. Service users financial interests are safeguarded. All the service users have a bank account, which is overseen by the manager. Systems are in place for checking and recording all financial transactions, and all receipts retained for regular audits. The home does not handle fees. The health, safety, and welfare of the service users and the staff are observed and promoted. There is a wide range of health and safety policies and procedures in place and staff were seen to adhere to these procedures during the inspection. COSHH procedures are also in place. All staff undertake induction training in health and safety and this training is mandatory yearly. Risk assessments are in place for all identified risks and safe working practice. All staff receive training in fire safety. The fire alarm system is checked weekly and there is a contract in place for the maintenance of fire fighting equipment and emergency lighting. All accidents, injuries and incidents of illness or communicable disease are recorded and reported. Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? 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. 1 Standard OP29 Regulation 19 (1)(b)(i) Requirement The registered person shall not employ a person to work in the care home unless all the documents listed in Schedule 2 are in place, including written references and a completed application form. Timescale for action 19/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Dehnlea Rose DS0000013624.V363154.R01.S.doc Version 5.2 Page 24 - 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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