Care Home: Devenish House

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What the care home does well What has improved since the last inspection? The home has a new manager, who is committed to ensuring the home continues to provide the best possible quality of service to residents and continues to look at ways of making further improvements. Building works were ongoing at the time of the visit to increase the size and facilities of rooms to the benefit of residents concerned. The care planning system is being refined in order to promote greater person centred planning, to streamline systems and promote more responsive support. In order to meet the needs of resident who enjoy the company of animals the home plan to introduce "Pets as Therapy". We are also looking at the possibility of increasing the Activities Coordinators` hours. There are plans to refurbish the dining room, including furniture and fittings, and new floor covering. What the care home could do better: Over a period of time some staff supervisions had not been carried out to the national minimum standards. The managers have put in place a system to remedy this, but it will take some months to catch up and provide the correct number of supervision meetings to each care staff member. Senior staff who will be delegated supervisory duties will need to be provided with the appropriate training to ensure they can carry out these duties. CARE HOMES FOR OLDER PEOPLE Devenish House 49 Southgate Street Winchester Hampshire SO23 9EH Lead Inspector Richard Slimm Unannounced Inspection 30th October 2007 09:30 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 Devenish House DS0000039639.V347615.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. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Devenish House Address 49 Southgate Street Winchester Hampshire SO23 9EH 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) 01962 842878 01962 868437 St John`s Winchester Charity vacant post Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21), Terminally ill over 65 years of age (21) of places Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2007 Brief Description of the Service: Devenish House is a residential care home with nursing for twenty-one residents over the age of sixty-five years. The home is a listed building that has been purpose-modernised internally to provide accommodation of a high standard on three floors. All residents are accommodated in single rooms with en-suite facilities. The home has a large conservatory style room used as the main lounge on the second floor, a dining room on the ground floor and small sitting areas are provided on each floor. Devenish House also has a small chapel/quiet room for use by residents, staff and visitors. There is a small courtyard/garden area with seating and residents are able to access the gardens of the cathedral which is close by. The home is situated in the heart of Winchester, close to all local amenities. Devenish House is part of a range of integrated care for older people in Winchester, provided by a Christian organisation, the St Johns Winchester Charity. The current fees provided by the registered manager are from £335.23 to £442.12 per week. Items not covered by the fees include hairdressing, chiropody, toiletries and newspapers. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection carried out by one inspector over 6 hours. The key standards were assessed by case tracking residents and talking with 11 people currently living in the home and a visitor. Time was also spent observing staff practices and the daily routines of the home. There was an opportunity to talk with 4 care staff, and interview 2 care staff the new manager (who is applying to register with us) and the deputy manager. Some time was spent reviewing a random selection of documentation and a partial tour of the premises was carried out. Prior to the visit a review of the home’s recent history was undertaken, including the previous reports. Information was also gathered from the annual quality assurance assessment (AQAA), which was completed by the home and returned to us. Surveys sent to people living at the home, staff working there and other stakeholders informed the inspection process also. The people living in the home had previously expressed their wish to be called residents. This term is therefore used throughout this report. What the service does well: Residents interviewed and spoken to said they felt they were extremely well cared for and that their rights were promoted and respected. Comments made included: • • • • • • • ‘Staff members are very helpful and attentive.’ ‘I am very happy here.’ ‘Home is always fresh & clean. ‘I sometimes take part in activities.’ ‘Activities could be better.’ ‘I usually like the meals.’ The food is always good and you get a good choice We’re all very lucky here A visit by the manager before moving in was a great help. It made sure I was OK for the home and had a chance to meet me. The organisation has a very clear commitment to achieving the best possible outcomes for the people living at Devenish House. This was displayed by management and staff commitment, and confirmed by observations and comments. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 6 The atmosphere at the home was warm, welcoming and friendly. One resident invited the inspector to take lunch with her, and this gave an opportunity to speak informally about the home. It was also evident that residents had the opportunity to express them selves and take ownership of such things as their plans of support and other assessments. There was also a culture evident of striving to improve the service to the benefit of residents. The home was very clean and presented in a valuing way. Even though building works were ongoing at the home, great care was taken to ensure this did not impinge on the residents in any way. Residents are consulted regularly and the views of the people living at the home inform all aspects of service provision and development. The home employ activity co-ordinators and this ensures residents have the opportunity to join in a wide range of activities, based on their interests and needs and time is planned for them to spend one to one time doing what they like as individuals as well as having group activities. The home has a mini bus and outings are arranged as often as possible. One resident said it would be good if there were more outings as she did not have any family locally who could take her out. What has improved since the last inspection? The home has a new manager, who is committed to ensuring the home continues to provide the best possible quality of service to residents and continues to look at ways of making further improvements. Building works were ongoing at the time of the visit to increase the size and facilities of rooms to the benefit of residents concerned. The care planning system is being refined in order to promote greater person centred planning, to streamline systems and promote more responsive support. In order to meet the needs of resident who enjoy the company of animals the home plan to introduce “Pets as Therapy”. We are also looking at the possibility of increasing the Activities Coordinators hours. There are plans to refurbish the dining room, including furniture and fittings, and new floor covering. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 7 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. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 8 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 Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 9 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): Standard 3 was assessed - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. EVIDENCE: 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 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 Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 10 home that includes how much they will pay and what the home provides for the money. The evidence to support the above came from case tracking records, interviews with residents, staff involved in supporting residents, stakeholder surveys and a visitor. Observations and relevant procedures also provided evidence that the outcomes in this area were good. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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, may be 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. EVIDENCE: 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. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 12 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. The evidence to support the above came from case tracking records, interviews with residents, staff involved in supporting residents, stakeholder surveys and a visitor. Observations of practice, pre-inspection information provided to us, and relevant procedures also provided evidence that the outcomes in this area were good. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: 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. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 14 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. The evidence to support the above came from case tracking records, interviews with residents, staff involved in supporting residents, stakeholder surveys and a visitor. Observations of practice and relevant procedures also provided evidence that the outcomes in this area were good. The home provides a mini bus to support regular outings. A specific staff member is delegated the duties of ensuring activities are organised in line with the needs and wishes of the residents. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 17 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: There had been one complaint since the last key inspection. Records were maintained and provided evidence that the complaint had been investigated and resolved with the complainant. 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. There was clear evidence from relevant records, interviews with residents, the manager, stakeholder surveys and a visitor. The organisation ensures that all staff employed are checked rigorously in line with best practice and the national standards to the benefit of people using the home. Staff members receive relevant training in safeguarding. Observations of relevant procedures, and the culture of openness at the home also provided evidence that the outcomes in this area were good. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. The home was re-developed in the early 1990’s and was of a purpose design that won an award. 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. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 17 The only issue at this home is the lack of a larger outdoor space/garden. There is a small courtyard that is due to be developed further in consultation with the residents, and the main lounge area is of the design of a large conservatory. The manager advised that as the site of the home was central Winchester it is no different to other properties in the area in this respect. The home supports residents to go out in warmer weather to the local cathedral grounds; other public gardens/parks and other outings include visits to garden centres. There was clear evidence from building works ongoing at the time of the visit of an organisation that is investing in the service it runs. The inspector checked relevant records; interviewed a number of residents and took resident surveys, and an interview with the manager into account. One visitor interviewed stated that he comes to the home regularly and on an unannounced basis and there is never any “bad smells”. His view was that the home was excellent. Stakeholder surveys also provided positive feedback about the quality of the service provided at the home. The organisation ensures that specific domestic staff members are employed that keep the home clean, hygienic and tidy to the benefit of people using the home. Observations of relevant procedures, and the availability of resources, including training for staff to promote good infection control at the home also provided evidence that the outcomes in this area were good. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff meets the needs of ‘Service users’. Service users are in safe hands at all times. As identified above, Service users are supported and protected by the home’s recruitment policy and practices. Staff members are trained and competent to do their jobs. EVIDENCE: 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 that get the relevant training and support from their managers. Prior to the new manager taking over some aspects of care staff support and supervision had lapsed, action is being taken to address this matter, and this report makes recommendation in this respect. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 19 There was clear evidence from relevant records; interviews with residents and staff members as well as resident and staff surveys, that the quality of staff was good and the needs of residents were being met. Two care staff members were interviewed and stated that they are well supported by the senior staff and felt valued by the organisation they worked for. Stakeholder surveys once more provided positive feedback about the quality of the service provided at the home in this area. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. The home is run in the best interests of service users. Service users’ financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 21 EVIDENCE: 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. This was confirmed in the home’s declaration in the AQAA and from observations at the time of the site inspection. Two care staff members indicated during interview that they had not received the 6 supervision sessions needed to meet the standards. The managers and relevant records confirmed this, and explained that there are now systems in place to ensure care staff do get their supervision to the standard, but as these arrangements had slipped the home are still catching up. The home has a new manager who is in the process of registering with us as the manager. The manager is a professionally trained Registered General Nurse, is a qualified midwife and has a BA honours degree in Health care management. There was evidence that the home was providing good outcomes across all areas, and residents are being consulted and put at the centre of how the home is organised and run. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard AP30 Good Practice Recommendations It is recommended that senor staff members who are to be delegated supervisory duties are trained to ensure they carry out these duties effectively and efficiently. Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 24 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 Devenish House DS0000039639.V347615.R01.S.doc Version 5.2 Page 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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