Care Home: Denewood House Care Home

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What the care home does well All the residents spoken with were complimentary of the care they received and the friendly nature of management and care staff. People considering moving into the home receive a full assessment and are provided with the opportunity to visit and spend time at the home to make sure that it is able to meet their needs. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. The house and gardens are maintained to provide a comfortable place to live. Residents are encouraged to personalise their rooms with items of furniture, pictures and a variety of mementos. Sufficient numbers of care staff are on duty throughout the day and night to meet the needs of the residents. Financial procedures within the home ensure residents` interests are protected. What has improved since the last inspection? Care planning processes and associated record keeping have been improved to provide staff with sufficient information to be able to meet the needs of residents. The range and frequency of social and recreational activities has been extended, but would benefit from further improvement to ensure the satisfaction of residents. What the care home could do better: Greater choice of menus and more opportunities to participate in recreational and social activities would be welcomed by some residents. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Denewood House Care Home 12-14 Denewood Road West Moors Ferndown Dorset BH22 0LX     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: Gloria Ashwell     Date: 0 8 0 5 2 0 0 9 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. 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. 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Denewood House Care Home 12-14 Denewood Road West Moors Ferndown Dorset BH22 0LX 01202892008 01258841255 samilycare-denewood@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Samily Care Ltd care home 21 Number of places (if applicable): Under 65 Over 65 21 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Denewood House is a detached house in a residential area of West Moors, local shops, churches, pubs and a library are available close by following a level walk. The home is registered to accommodate a maximum of 21 older people. It is privately owned by Samily Care Ltd and is managed by registered provider Caroline Bleach. The bedrooms are on the ground and first floors. There are two double bedrooms and 17 single rooms. The home does not have a passenger lift but a stair lift operates to the first floor; to access a number of the first floor bedrooms it is necessary to negotiate a single step up, beyond the landing to at which the stir lift arrives. The rear garden has lawn, flower beds, and seats; some bedrooms have patio doors opening out to the garden. Care Homes for Older People Page 4 of 26 Brief description of the care home Car parking spaces are available at the front of the building and parking on the road is unrestricted. Fees are charged weekly; the fee range quoted by the provider at the time of inspection was (per person) between £474 and £550. Up to date information on fees can be obtained from the service. Additional charges are made for hairdressing, chiropody, newspapers and personal shopping. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: Two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Commission for Social Care Inspection. This inspection was unannounced; the inspector arrived at 10:00 on 8 May 2009, Care Homes for Older People Page 6 of 26 toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with registered manager Mrs Bleach discussed and examined documents regarding care provision and management of the home. The duration of the inspection was 5 hours. During the inspection, particular residents were case tracked; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. In advance of the inspection an Annual Quality Assurance Questionnaire was completed by Mrs Bleach and returned to the Commission; the information it contained has been used to inform the findings of this inspection. During this inspection compliance with all key standards of the National Minimum Standards was assessed. 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.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 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. Evidence: All new admissions are planned to minimise distress to the new resident and to ensure that staff have available relevant information in order that they can properly meet each persons needs. The records of two residents admitted since the last inspection included clear details of pre admission assessment carried out by the manager while visiting the prospective residents at their previous addresses. In advance of making the decision to enter the home prospective residents or their representatives visited the home to view the premises and meet residents and staff. Care Homes for Older People Page 10 of 26 Evidence: Following pre admission assessment of each prospective residents needs and circumstances the home writes to them confirming the agreement and ability to provide accommodation and care. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. Care is planned to promote the individuality of each resident and to provide staff with sufficient information to enable the needs of each person to be properly met. Evidence: The care records of 3 people who live at the home were examined and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. The care plans were clear and comprehensive. Care Homes for Older People Page 12 of 26 Evidence: Medicine handling is carried out by staff trained in this work. Medication records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. To promote good practice it is recommended that each record includes the allergy status of the resident e.g. None Known, and that for every occasion on which a prescribed medicine is not administered the reason for omission is recorded. The Controlled Drug register had been properly kept and Controlled Drugs were correctly stored although a drug that is not of the Controlled status was also stored in the CD cabinet and a Controlled Drug no longer prescribed for the resident had not been promptly disposed of. Associated requirements are contained in this report. Residents spoken to during the inspection said they are treated with respect and their privacy is protected. One said that living at Denewood was like being at home. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. More should be done to provide opportunities for the residents to engage in recreational and social activities to reduce the probability that they become bored, apathetic and restless. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals are nutritional and appetising but opportunities for choice of meals should be improved. Evidence: The home does not employ an Activity Organiser and at the time of this inspection no programme of activities was displayed in communal areas; Mrs Bleach said that each resident is provided with a weekly programme which they keep in their bedrooms. Residents spoken with during the inspection did not know if any activities were scheduled and none took place during the inspection. Some residents commented that they would like more organised activities and it was noted that a comment received from an opinion survey conducted by the home during 2008 requested greater activity Care Homes for Older People Page 14 of 26 Evidence: provision. No menu was seen to be displayed in the home and residents did not know what the lunchtime choices were. Residents indicated that in general they are satisfied with the food which is plentiful and well cooked, but the impression received was that for main meals one meal is provided, with routine alternatives such as salad or sandwiches available to residents upon request. This report contains recommendations for the provision of more meaningful daytime activities suited to the individual interests, needs and capabilities of the residents, and for a greater focus on the provision of meal choices and advance information to residents, enabling them to select their preferred meal from a variety of options. Visitors are welcome at any time and residents spoken to during the inspection said their visitors are always made to feel welcome and placed at ease by the staff. Residents believe they are shown respect and properly treated; comments made during the inspection included I like the atmosphere. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and are confident their complaints would be listened to. Evidence: The home has a complaints policy and procedure and records are kept of investigation and outcome of complaints. The home has a written policy and procedure for the protection of vulnerable adults. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and clean. Evidence: Denewood is a traditionally built house which has been extended. To the rear of the premises is an enclosed garden with lawns, outdoor seating, flower beds and raised beds specifically provided for use by residents who enjoy gardening. Bedrooms are on the ground and first floors; there is a stair lift between the floors but to access a number of the first floor bedrooms it remains necessary to negotiate a separate step, so only people able to do this can be accommodated on the upper floor of the home. On each floor is a bathroom equipped with a bath hoist to provide assisted bathing facilities for residents with impaired mobility. The previous inspection report contained a requirement for arrangements to be made to safeguard people against risks of scalding from potentially hot radiators. Mrs Bleach said she has arranged for radiator covers to be installed to overcome these risks. Care Homes for Older People Page 17 of 26 Evidence: Residents without en suite toilet facilities are offered use of a portable commode; the home does not have a sluice room or a commode washer and it is therefore recommended that the home develop and implement a policy and procedure for the management of commodes, to ensure that all risks of infection are properly managed. The home appeared clean and free from any unpleasant odours. The laundry was well managed and adequate supplies of clean linen were seen to be available. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs enough staff to meet the needs of residents. The home promotes the achievement of nationally recognised care qualifications. Evidence: The home is at all times in the charge of an experienced person and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. The records of a recently employed care worker were examined and found to contain essential information including written references, interview assessment, health details, evidence of identity and a Criminal Records Bureau (CRB) disclosure obtained in advance of employment. The home meets the standard for at least 50 of staff to hold the National Vocational Qualification (NVQ) in care. The recently employed care worker had received induction training and from talking to staff and examining records we obtained evidence that staff are encouraged and supported to undertake training in subjects relevant to their work. Care Homes for Older People Page 19 of 26 Evidence: Residents we spoke to expressed satisfaction with the staff and one said they are all friendly. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed to ensure the best interests of residents are promoted. Evidence: The home is managed by Registered Provider Mrs Bleach. Mrs Bleach is an experienced manager, having managed this home for approximately 20 years but is nonetheless recommended to obtain a recognised qualification in this work. Prior to this inspection Mrs Bleach completed an annual quality assurance assessment (AQAA) identifying what she feels the home does well, what has improved during the past 12 months and plans for improvement over the next twelve months. The home has an internal quality assurance system and periodically issues questionnaires to residents and their representatives to learn their opinion of the home. Care Homes for Older People Page 21 of 26 Evidence: The home manages the personal expenditure of most residents. Records and receipts are kept of all transactions and the sample of records checked corresponded to the amount of cash held by the home for that person. Residents who are unable to personally undertake the responsibility of general finances have nominated relatives, friends or other representatives to do this on their behalf. Staff trained in First Aid and health care are on duty in the home at all times. The home has a written assessment of the Health & Safety of the premises and working practices but this provides incorrect information regarding moving and handling in that it provided direction for the actual lifting of residents by staff instead of statign that lifting equipment should be used, and accordingly should be reviewed to ensure accuracy of information. Policies and procedures should be improved to describe the management of commode pans. The fire safety assessment and escape plan should be amended to include details of each resident currently accommodated in the home and the means by which they will be evacuated in the event of such necessity. During the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 38 12(1) The Registered Person must 23/09/2008 make proper provision for the health and welfare of the residents. This must include the provision of radiator covers to minimise the risk of burns and scalds. The original timescale for action was 08/08/08; during this inspection the registered person advised that arrangements have been made for the installation of radiator covers. This requirement will remain until completion of the work. Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Controlled Drugs no longer in use at the home must be promptly disposed of in the correct manner. . 12/06/2009 2 9 13 Medicines which are not Controlled Drugs must not be kept in the Controlled Drug cabinet when it is being used to store Controlled Drugs. . 12/06/2009 . 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 Care Homes for Older People Page 24 of 26 improving their service. No. Refer to Standard Good Practice Recommendations 1 8 Records of investigation, assessment and outcome should be promptly recorded with regard to all accidents involving residents of the home, to ensure that risks of recurrence are minimised. When a prescribed medicine is not administered the reason for each occasion of omission should be recorded. 2 9 3 4 9 12 The allergy status of each resident should be recorded on the Medication Administration Records. The programme of social and recreational activities should be expanded to ensure that each resident has opportunities for enjoyable and meaningful activity. The menu should be prominently displayed and greater opportunities provided for residents to make their selection from a variety of options. A policy and procedure for the management of commodes should be developed and implemented, to provide staff with clear guidance on the particular control of infection methods. 5 15 6 26 7 36 The processes for staff supervision should be improved to ensure that any concerns are promptly identified and effectively managed. The recommendation of the Environmental Health Officer to provide mechanical ventilation to the kitchen should be met. The Health and Safety assessment of the premises should be reviewed to ensure accuracy, with particular regard to correct moving and handling processes and policies. The fire safety assessment should be amended to include details of each resident currently accommodated in the home and the means by which they will be evacuated in the event of such necessity. The registered manager should obtain a verifiable qualification in care work. 8 38 9 38 10 38 11 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. 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