Care Home: Ditton Priors Residential Home

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What the care home does well The staff in this home receive the training that they need to meet the needs of the people who live there. They are cheerful, friendly and professional and are popular with the people that they look after. They try to find things of interest for people to do. Care plans are developed to help the staff to know what people like and dislike and the staff know what they contain. Tablets and other medicines are given promptly and reliably by staff that are trained to do so. Many of the people who live in this home say that it has a pleasant atmosphere and is set in an attractive location. What has improved since the last inspection? Since the last inspection improvements have been made to the home`s pre-admission assessment process and the new manager now has plans in hand to ensure that she, or one of her senior staff, meets regularly with her staff on a One to One basis to discuss any issues about the care that they provide. What the care home could do better: No requirements or recommendations have been made as a result of this inspection. Key inspection report Care homes for older people Name: Address: Ditton Priors Residential Home Ashfield Road Ditton Priors Bridgnorth Shropshire WV16 6TW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michael Moloney     Date: 1 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Ditton Priors Residential Home Ashfield Road Ditton Priors Bridgnorth Shropshire WV16 6TW 01746712656 01746712076 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.guardiancaregroup.co.uk Guardian Care Homes (UK) Ltd care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 23. The registered person may provide the following category of service only - Care home only - Code PC, to service users of the following gender: either; whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places 23); Dementia: Code DE (maximum number of places 10). Date of last inspection Brief description of the care home Ditton Priors Residential Home is registered to provide care for a maximum of 23 older people, of whom 10 may be suffering from dementia. The Home is on the edge of the small Shropshire Village of Ditton Priors with most rooms enjoying uninterrupted views of the Shropshire countryside. It has extensive well-maintained grounds with many shrubs, trees, flower borders, lawns and patios, and an area where vegetable produce is grown for use in the Homes Kitchen. The Home, purpose built as a residential care Care Homes for Older People Page 4 of 24 Over 65 0 23 10 0 Brief description of the care home Home during the 1970?s, has since been extended to provide additional care places. The Home is part of the Guardian Care UK Group. Guardian Care Homes (UK) Ltd make their services known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. Fees for Ditton Priors were not published in the homes service user guide. Care Homes for Older People Page 5 of 24 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: A range of evidence was used to make judgments about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 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. People looking to live in the home and their representatives have the information needed to choose a home which will meet their needs and they have those needs assessed to ensure that the home can meet them. Evidence: Should anybody wish to live in this home information was seen that outlines the service that they would receive, what they could expect of the staff and other information such as how to make a complaint and how much living there would cost them. The records of someone who had recently started to live in the home were also looked at. These showed that the home staff had assessed her needs before they had decided whether or not they could look after her. She had then been offered a place in the home. Care Homes for Older People Page 9 of 24 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 health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The records of two people who live in this home were looked at. Both were seen to have care plans that were drawn up after their needs had been assessed. Records were also seen that showed that these care plans were reviewed by the staff each month so that any comments made by people such as doctors and district nurses could be noted and acted upon. A variety of risk assessments were seen to be in place. Not only were the more general issues assessed but so were such things as falls, manual handling and nutrition. Talking to staff and watching how they assisted the people concerned showed that they were aware of what these documents said. The medication management was looked at and it was seen that two medication Care Homes for Older People Page 10 of 24 Evidence: trolleys, and controlled drugs cabinet which had been secured to the wall in a built in storage cupboard were used for storage. The general medication records as well as those for the controlled drugs were looked at and seen to have been fully completed. Looking at the staff training records and talking to the manager and her staff confirmed that only staff who had received appropriate training were allowed to administer medication. A number of the people who were living in the home said that they found the staff to be sensitive and discrete when helping them with their personal care. Staff were also seen providing guidance and direction to people who were confused or disorientated in a tactful and positive manner. Care Homes for Older People Page 11 of 24 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. People who live in this home are able to choose their social activities and keep in contact with family and friends. Social and recreational activities meet their expectations. They receive a healthy, varied diet according to their assessed requirement and choice. Evidence: The records of two of the people who live in this home were looked at and these showed that those peoples likes and dislikes had been identified. Social assessments had identified their work history, important life events, who members of their families were, interests such as cooking, whether or not they liked music (and what type), and what hobbies such as knitting they had liked doing. This type of information is valuable to the staff for when activities are arranged for groups or individuals. According to her records activities that had been organized by the Activities Organiser included such things as planting pot plants, cutting up fruit and tasting it, keep fit exercises, quizzes and communion. Talking with both staff and people who live in the home confirmed that these activities had taken place as did looking at the row of Care Homes for Older People Page 12 of 24 Evidence: sunflowers, each with a persons name on it, growing in a border in the front garden of the home. A list of activities for the future was seen on wall in the corridor. The home also has its own vegetable garden that produces some of the vegetables for use in meals provided to the people living there. One person whose room looks out onto this area said that although he did not help in vegetable patch he had seen one of the other people who live in the home doing so. Another person also explained how they had recently had a visit from somebody who had brought an owl for them to see and touch and how a lot of people had enjoyed this. A number of the people who live in this home explained how the Activities Organiser had asked each of them what activities they would like to take part in. Copies of surveys designed by the Activities Organiser and distributed to the people in the home were also seen. The manager went on to say that the home was hoping to arrange visits from the local primary school so that the people there would have the chance to interact with a broad age range of people. The people spoken to all said that they enjoyed the food that was prepared for them. The manager said, and people living in the home confirmed, that menus were discussed in Resident meetings and were developed from there. The menus contained an alternative for those who did not want the main choice. Typical alternatives were liver and onions or pie and chips, chicken salad or beef-burger, ham with parsley sauce or chicken and chips, ham and leek pie or fish and chips. Those meals were seen to be cut up or other assistance given by staff according to the needs of the people eating them. The manager said that special diets, such as low sugar, are catered for as necessary. She also said that taxis are arranged to get people to live at the home to appointments as necessary as are extra staff as escorts. Care Homes for Older People Page 13 of 24 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 people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: The Manager confirmed that the home had received two complaints. The complaint records showed how these had been dealt with and what the outcome of the investigations were. A new complaints procedure was seen to contain the up to date information that someone would need should they wish to make a complaint about this service. The service user guide and the statement of purpose also contained guidance on the complaints procedure. The manager confirmed that there had been no recent referrals into the local procedures that are designed to investigate any issues of the abuse of vulnerable adults. Training records showed and the staff spoken to confirmed that they had received training in those procedures. Talking to them confirmed that they knew what was expected of them if they were to observe an incident of abuse. Talking with some of the service users showed that they also knew what to do if they Care Homes for Older People Page 14 of 24 Evidence: had any issues of this kind. Care Homes for Older People Page 15 of 24 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 design and layout of the home gives anyone living there a safe, well-maintained and comfortable environment which encourages independence. Evidence: The home is situated in the village of Ditton Priors and is a property that has been developed to its present use in a sensitive and practical manner since it was originally built as a care home in the 1970s. The rooms that lead off the entrance hall now contain only lounge furniture. The dining area is now where the lounge was which is a room with good views of the garden. A number of the people living in the home said that they prefer this arrangement. The rooms were all seen to be bright and airy and kept at a comfortable temperature. A number of the bedrooms had been redecorated since the last visit. Talking with one of the people whose room had been redecorated established that her en-suite bathing facilities had also been improved and she said she was pleased with the improvements made as she now found it much easier to have a shower. The laundry is equipped with a washing machine that has a sluicing facility for dealing Care Homes for Older People Page 16 of 24 Evidence: with heavily soiled items. The staff confirmed that they have received training in infection control which will help to stop the spread of any infections. The grounds of the home were seen to be well maintained with parking at the front. The rest of the gardens can be used by the people living in the home for such things as vegetable gardening and the growing of plants such as sun flowers. A number of people made favorable comments on the scenic views from their bedroom windows. Care Homes for Older People Page 17 of 24 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. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of people who live in this home. Evidence: The employment records of two of the staff were looked at and these showed that appropriate references had been obtained before people had access to service users as part of the procedure that ensures that they are fit do so. During the inspection a lot of conversations between residents and staff were seen and heard. The staff were always professional, clear and polite when they spoke. Looking at the staff rota as well as talking with the residents, the manager and staff showed that there are enough staff on duty to make sure that the care needs of the people living in the home are met. Talking with a number of the staff confirmed that they have received or were about to go on the training that would ensure that they are able to meet the needs of the people living at the home. This was confirmed by talking with the manager and looking at the training records. Talking to staff, the manager and looking at records also confirmed that a significant Care Homes for Older People Page 18 of 24 Evidence: number of staff had achieved National Vocational Qualification level 2 or above in care and that others were making progress towards obtaining it. Care Homes for Older People Page 19 of 24 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 management and administration of the home is based on openness and respect, has effective quality assurance systems. Evidence: At the time of this inspection the manager was in the process of completing an application to be registered with the Commission for Social Care Inspection. This process is designed to assess the suitability of the applicant to manage a service such as this. The manager confirmed that she had yet to undertake training in how to manage situations where it was necessary to deprive people of their liberty but would be doing so in the near future. She went on to say that she had consulted the guidance on this issue and feels that no such situations were present within this home and therefore no referrals into the local authority procedures that deal with such issues would be necessary but she would review the situation when she had received the training.. Care Homes for Older People Page 20 of 24 Evidence: Records were seen that showed that a member of the proprietors senior management visits the home at least once a month. These visits are so that the owners can make themselves aware of how well the home is meeting the needs of the people living there. Talking to people who live in this home confirmed that Residents Meetings take place once a month where such things as menus are discussed. Copies of the satisfaction survey that was recently carried were also seen. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans and policies. The home does store cash for some of the people living there. The system for recording this was seen to be transparent and accurate. Various records were seen to be kept that monitored systems and the environment in order to make sure the people living in the home safe. These were found to be kept up to date. Hazardous materials such as some cleaning fluids were seen to be kept securely and instructions about how they should be used safely were also available. Care Homes for Older People Page 21 of 24 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 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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