Care Home: Dormers Wells Lodge

Similar services:

• Ashlong House
• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home
• Spinney (The)

What the care home does well The residents we spoke with confirmed that the food provision in the home was good. Residents appeared to be well groomed and their clothing well maintained. What the care home could do better: Shortfalls were identified at this inspection and these were fed back to the Manager and the Responsible Individual at the end of the inspection. We observed that staff did not always assist residents with there meals in a respectful manner. We found shortfalls in the promotion of privacy and dignity. Staff communication was lacking when staff were carrying out care tasks for residents. We found evidence of inappropriate restraint where some residents were locked in their bedrooms for periods of time as a form of behaviour management. We found that staff did not always have the strategies in place to manage behaviour through various good practice techniques. The majority of bedroom doors are locked throughout the day and this practice must be reviewed in line with residents choices. Shortfalls with activities on the dementia unit were found and this must be addressed to ensure that residents are able to participate in meaningful and stimulatingactivities. We identified shortfalls with some areas of the environment, these included the dead bolt lock mechanism that was on every bedroom door, wedging of fire doors, odours on the first floor dementia lounge, radiator covers coming away from the wall and a shower door that did not close easily. A full environmental audit must be undertaken, shortfalls identified and addressed. All staff working in the home must undertake training in dementia care, challenging behaviour and safeguarding. Random inspection report Care homes for older people Name: Address: Dormers Wells Lodge Telford Road Southall Middlesex UB1 3JQ two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rekha Bhardwa Date: 2 4 0 9 2 0 1 0 Information about the care home Name of care home: Address: Dormers Wells Lodge Telford Road Southall Middlesex UB1 3JQ 0208-574-8400 02085748401 manager@dwlodge.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Blessing Tessy Oluku Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dormers Wells Lodge Limited care home 45 Number of places (if applicable): Under 65 Over 65 0 0 0 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 The maximum number of service users who can be accommodated is: 45. The Registered Person may provide the following categories 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 Physical Disability - Code P Dementia Code DE Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Dormers Wells Lodge is owned by Dormers Wells Lodge Ltd, which is a charitable trust and a non-profit making organisation. It is situated on a residential road in Southall, near to the Uxbridge Road, and is within easy reach of local amenities, including public transport. There is a parade of local shops nearby. The home has forty five single bedrooms. Twenty three of the rooms are located in the dementia unit and twenty two are for frail older people. There are eight toilets, located throughout the home, and six bathrooms. Two lifts serve the first floor and there is a small stair lift on the ground floor between the older persons unit and the dining room. The dining room is large and can accommodate everyone for meals, entertainments and activities. The homes rear garden is attractive and well maintained with a pond, summerhouse, seating areas and raised flowerbeds. Paved areas around the garden allow easy access for people who are dependant on mobility aids. There is a conservatory attached to the dementia care wing. A shelter in the garden is provided for residents who smoke. The home has a registered manager, a finance officer, administrator, administration assistant, 3 supervisors plus care staff. There are domestic, laundry, maintenance and catering staff. Care Homes for Older People Page 3 of 11 What we found: This was an unannounced random inspection carried out following a safeguarding alert received by the Commission from the Ealing safeguarding team. The inspection was carried out by two inspectors. We viewed information on staffing levels, observed interaction between staff and residents, undertook a tour of the premises, spent time talking with residents, staff and any visiting relatives. We also spoke with the Manager and the Responsible Individual during the inspection. We were informed by the Manager that the home had several residents on the dementia unit whos needs had changed. The Manager stated that staff had been having difficulties in managing the needs of the residents with aggressive behaviour. Ealing social services had been contacted by the home for a number of residents in recent weeks with a view to review the needs of the residents with aggressive behaviour. The Commission is aware that a review of residents needs is being undertaken by Ealing social services due to safeguarding concerns that have been raised. We discussed with the Manager the need to ensure that the pre-admission assessment for potential residents being admitted to the dementia unit, is carried out by staff who are knowledgeable and experienced in dementia care. We observed a part of the lunchtime meal being served during the inspection. All residents are brought down to the dining room. Where residents required assistance from staff we found that two members of staff stood over the residents rather than sitting next to them whilst they were being assisted. We discussed this with the Manager and highlighted the need for staff to assist the residents in a manner which respects the residents ability and dignity. We spent some time speaking with residents in the dining room and one relative. They all confirmed that they were satisfied with the meal provision. We spent time during the inspection observing staff interaction with residents and found that in many instances staff did not speak or explain to the residents what care activity they were carrying out. For some residents who have memory loss this could be frightening if there is no communication from the staff member carrying out the care. For some residents this could mean that they do not get the support that meets their needs and abilities. Some concerns were raised regarding the management of residents challenging behaviour. We were informed by the Manager that some residents are locked into their bedrooms for a period of time mainly at night, as a form of behaviour management and to settle them down.The Manager informed us that the locking of residents in their bedrooms on this unit had been agreed with Social Services through the Deprivation of Liberty Safeguards and Best Interest Assessments. This is poor practice and an inappropriate use of restraint which is not normally permissible in a care home. We discussed the need to have clear risk assessments and policies and procedures for behaviour management. Restraint of this type does not respect the residents human rights and does not protect the resident from abuse. Care Homes for Older People Page 4 of 11 During the course of the inspection we met the activities co-ordinator who was preparing for the afternoon session of activities. Residents were in the dining room and the planned activity was playing various games. When we spoke with the activity co-ordinator she confirmed that she worked from Tuesday to Friday from 1pm to 4pm during the afternoons. We asked whether she undertook any specific activities for residents within the dementia unit she stated that she did not, however the residents from this unit were able to join the main activity being undertaken in the main unit. We spent time on the dementia unit observing staff interaction with the residents. Several of the residents on this unit wander and spend little or no time sitting down. Staff that we spoke with said that they carry out activities such as bingo, exercise, playing movies and music. We observed several residents who have a very short attention span, some of the activities described would require some concentration and attention. Where residents are unable to do this, there is a potential for the residents to experience feelings of frustration that could lead to challenging behaviour. A tour of the premises was undertaken. Overall the home was clean, however we did note some odours on the first floor dementia lounge. We looked at the locking mechanism on each bedroom door. The doors had two locks in place. One lock could be locked with a key and opened from the inside. The second lock in place was a deadbolt lock that could only be operated from the outside with a key. We were concerned that this lock was being used and staff we spoke with stated that this lock was not used, however some staff had a key on their person for this lock. We spoke with the Manager and Responsible Individual and requested that the second dead bolt lock be disabled, in order that it could not be used. Several of the bedroom doors were locked on both the general unit and the dementia unit. The staff on the dementia unit explained that several residents tended to wander into other residents bedrooms and for this reason the doors were locked. We were not provided with an explanation as to why the majority of bedroom doors were locked on the general unit. This practice needs to be reviewed to ensure that the bedrooms of residents are only kept locked with the informed consent of residents, with records kept. Where some bedroom doors were open we found evidence that the bedrooms had been personalised On the dementia unit groundfloor lounge we found that a chest of drawers contained various items which could be potentially harmful. These included nail polish remover, finishing spray, nail clippers, bubble bath, nail polish, toothpaste, a tub of aqueous cream and a disposable razor with no security cover. This was bought to the attention of the staff member in the lounge and a request made for these items to be stored securely. The door to this lounge had been wedged open with paper towels.The Manager informed us that this lounge had been re carpeted and that the lounge was to be repainted. Several of the radiator covers have come off and were in the process of being re fixed to the wall by the maintenance man. The groundfloor shower room door did not appear to slide across and the carer demonstrated how the door had to be lifted and pulled to slide across. This action required a considerable amount of force, strength and dexterity. We Care Homes for Older People Page 5 of 11 found that residents living on this floor potentially would not be able to close this door when they were using the shower facility. Through a safeguarding alert we had been notified that 8 members of staff had been suspended from duty following safeguarding concerns being raised with the Ealing SOVA team. We spoke with the Manager and she confirmed that 8 staff had been suspended from duty and that she had managed to cover the duty rota until the 3rd October 2010. Agency staff were not being used and shifts were being covered with bank staff. The Manager also informed us that she had requested that Ealing social services move a number of residents from the dementia unit as she did not have experienced staff to work on this unit due to the suspension of the eight staff. This request was being reviewed by Ealing social services. The Manager was aware that she needed to notify the Commission if she was unable to staff the home in line with the residents assessed needs. We met the Responsible Individual during the inspection and he informed us that he had offered independent management support for the Manager. This offer had been declined by the Manager for the present time. The Manager informed us that all staff except recently appointed staff had received training in dementia and managing challenging behaviour. We discussed the need for staff including the Manager to have ongoing training in these areas to ensure that the care practice being used in the home were up to date and meeting the needs of the residents. We also discussed the need for staff to be aware of their actions in relation to potential abuse and for them to have the skills and knowledge to recognise and report abuse. The Manager informed us that the majority of staff had received training in Deprivation of Liberty Safeguards. What the care home does well: What they could do better: Shortfalls were identified at this inspection and these were fed back to the Manager and the Responsible Individual at the end of the inspection. We observed that staff did not always assist residents with there meals in a respectful manner. We found shortfalls in the promotion of privacy and dignity. Staff communication was lacking when staff were carrying out care tasks for residents. We found evidence of inappropriate restraint where some residents were locked in their bedrooms for periods of time as a form of behaviour management. We found that staff did not always have the strategies in place to manage behaviour through various good practice techniques. The majority of bedroom doors are locked throughout the day and this practice must be reviewed in line with residents choices. Shortfalls with activities on the dementia unit were found and this must be addressed to ensure that residents are able to participate in meaningful and stimulating Care Homes for Older People Page 6 of 11 activities. We identified shortfalls with some areas of the environment, these included the dead bolt lock mechanism that was on every bedroom door, wedging of fire doors, odours on the first floor dementia lounge, radiator covers coming away from the wall and a shower door that did not close easily. A full environmental audit must be undertaken, shortfalls identified and addressed. All staff working in the home must undertake training in dementia care, challenging behaviour and safeguarding. 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 2. Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 11 12 There must be evidence that 01/06/2009 residents have been offered the opportunity to discuss their wishes in respect of health deterioration and end of life care, and the outcome of such discussion must be recorded so that their wishes can be met. Activities suited to the needs 01/05/2009 of residents with dementia care needs must be provided as part of daily life in the home, so that their specific needs can be catered for. 2 12 16(n) Care Homes for Older People Page 8 of 11 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, 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 10 12 Staff working with residents 04/10/2010 must ensure that they clearly and effectively communicate and explain to residents what they are doing during all care provision. This is to ensure that residents privacy, dignity and choices are respected. 2 12 16 The activities provision on 18/10/2010 the dementia unit must be reviewed. To ensure that a programme of meaningful and stimulating activities are offered to residents which will meet their needs and abilities. The practice of restraining 08/10/2010 residents in their bedrooms must cease. Any other form of restraint that is used on a resident must be risk assessed, discussed, recorded and agreed within a multi-disciplinary team. 3 18 13 Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 This is to ensure that residents are protected from abuse. 4 19 23 An environmental audit must 22/10/2010 be undertaken. Where shortfalls are identified, an action plan with timescales must be developed to address the shortfalls. This is to ensure that resident live in a safe and well maintained environment. The dead bolt lock on individual bedroom doors must be disabled or removed. In order that it is not used to lock residents in their bedrooms. 6 30 18 Staff must receive refresher training in dementia care, safeguarding and behaviour management. This is to ensure that the staff have up to date skills and knowledge to care for the residents effectively and safely. 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 5 19 12 08/10/2010 29/10/2010 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 11 of 11 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!