Care Home: Dovecote Lodge

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What the care home does well The home was cleaned, decorated and furnished to a good standard. Pre admission arrangements are satisfactory and the standard of care planning was good. People who live at the home and their relatives were generally satisfied with the care provided. Relatives views were generally positive one comment made about staff was "seem to be very good, relative always seems happy, says always have a laugh here". other positive comments were "keep the patients clean do not leave them to sit in wet or soiled clothes very helpful with day to day needs", "friendly caring, safe and supportive home for people" also "They look after mum the way I would" " a big thank you to them all" What has improved since the last inspection? The standard of care planning was improved and staff were recording now relevant information in the daily records to ensure needs are fully met. Menus have been revised and offer a variety of meals and ensure choices are available for people living at the home. The management of staff sickness and vacancies is better. Staff recruitment records, stored electronically, were available for checking that people are being cared for by a properly recruited staff group. Staff training records included their training and development plans and records of training provided to date were also available to enable checking that staff are skilled to meet peoples needs. The homes surveys have now been sent to people who live at the home, as part of the home`s quality assurance programme and the outcomes displayed on the notice board. What the care home could do better: CARE HOMES FOR OLDER PEOPLE Dovecote Lodge Dovecote Lane Horbury Wakefield WF4 6DJ Lead Inspector Susan Vardaxi Key Unannounced Inspection 5th December 2007 09:25a 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 Dovecote Lodge DS0000034928.V357087.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. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dovecote Lodge Address Dovecote Lane Horbury Wakefield WF4 6DJ 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) 01924 302935 01924 302936 www.wakefield.gov.uk Wakefield MDC Mrs Olwyn Fleming Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 category: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 28 The care staffing hours are calculated by the provider using the Residential Forum staffing model and the number of full time equivalent staff appointed is in accordance with this calculation or otherwise as agreed in writing with the Commission. Respite provision for two service users. 2. 3. 4. Date of last inspection 18th January 2007 Brief Description of the Service: Dovecote Lodge is a local authority run home which provides accommodation, personal care and support for 28 older people. Set back in its own grounds the home is situated in a residential part of Horbury close to the park. All accommodation provided is in single bedrooms, located on 2 floors. All areas of the home are maintained to a good standard and people are provided with a safe, homely and comfortable environment. The home has access for disabled people and provides assisted bathing and a passenger lift for those who require it. There are local shops nearby and the home is close to a main bus route In December 2007 the fees were £494.51 The services Statement of Purpose is provided to each person enquiring about the service and the last inspection report is available from the office. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home on the 5th December 2007. This took place over seven hours, starting at 9:25am. The visit included talking with some people who live at the home, the manager and staff, a walk round the building and checking some of the records kept. Additionally information provided on ten survey forms completed by people living at the home and five from relatives was considered along with information provided by the manager prior to the visit. Thanks are extended to the people living at the home, the manager and staff for their hospitality and cooperation during the visit. What the service does well: What has improved since the last inspection? The standard of care planning was improved and staff were recording now relevant information in the daily records to ensure needs are fully met. Menus have been revised and offer a variety of meals and ensure choices are available for people living at the home. The management of staff sickness and vacancies is better. Staff recruitment records, stored electronically, were available for checking that people are being cared for by a properly recruited staff group. Staff Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 6 training records included their training and development plans and records of training provided to date were also available to enable checking that staff are skilled to meet peoples needs. The homes surveys have now been sent to people who live at the home, as part of the home’s quality assurance programme and the outcomes displayed on the notice board. 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. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The pre admission arrangements ensure the home can met people’s needs appropriately. EVIDENCE: Information provided by the manager prior to the visit showed that people are visited at home or in hospital prior to admission. Pre admission assessments are completed by the home and where applicable by social workers. 15 surveys were received from people who use the service and their relatives, of these eleven considered they had been given enough information about the service. The manager said the home does not accept emergency admissions therefore a policy in respect of this has not been produced as required at the last visit. Intermediate care is not provided at the home. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Peoples needs are met by staff through clear care plans and safe medication practices. EVIDENCE: Care plans sampled included: people’s assessed needs, the action needed staff to ensure the needs were met, and they had been reviewed monthly as required at the last visit. And, appropriate risk assessments had been completed. Since the last inspection there has been discussion between the Commission and provider about the number of accidents reported in respect of one person living at the home. Following monitoring and action these began to reduce, and processes have been established to intervene earlier. Records seen showed that GP, district nurses and other health professionals had visited to meet peoples healthcare needs. Of the ten surveys received Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 10 from people living at the home eight stated they received medical support, and six considered they received good care and support. Comments made were “keep the patients clean do not leave them to sit in wet or soiled clothes very helpful with day to day needs”, “Friendly caring, safe and supportive home for people” also “They look after mum the way I would” “ a big thank you to them all” Information provided by the manager before the visit stated that medication training had been provided for all who dispence medications, staff spoken with confirmed this. The medication room was found to be tidy and medications were stored appropriately. The medication records seen had been generally well maintained and the medication in stock and records checked balanced. However, handwritten entries on the medication records had not been countersigned by staff, and there was discussion with the manager about how this good practice could serve to double-check the dose and directions are accurate. Staff were observed assisting people respectfully and appropriately throughout the visit. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are satisfied with the meals, and generally enjoy the activities provided. EVIDENCE: Activities provided at the home were seen displayed on the notice board near the entrance to the home, these included visits from the local clergy and a weekly coffee morning. A person spoken with said they join in activities and they enjoy reading the daily newspapers. People’s personal choices and preferences; including activities, were recorded in some care plans seen. One survey response stated “there should be more activities, one artist all fortnight, he was very good.” “I would like more trips out”. Five surveys received from relatives/representatives showed that people living at the home are encouraged to maintain links with families and friends. Information provided by the manager stated that they are trying to encourage people to participate more in activities. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 12 Information provided by the manager stated that menus had been revised, the menus seen provided a variety of meals, and following a finding at the last inspection choices were available. Care plans showed that nutritional assessments had been completed to ensure people’s dietary needs are met appropriately. Of ten surveys completed by people living at the home five considered the meals were sufficient and four people “sometimes”. People spoken with said they were satisfied with the meals. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The procedure for dealing with complaints ensures people concerns are dealt with and people are safeguarded. EVIDENCE: The home complaints procedure is on display, and records seen showed that complaints are dealt with and appropriate action taken. Of 15 surveys received from people living at the home and relatives twelve said they knew how to make a complaint, whilst two said they didn’t, however considered “staff were easy to speak to”. Staff spoken with said that safeguarding training had been provided and staff training records seen confirmed this as a satisfactory. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24,26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides a clean well maintained environment for people to live in. EVIDENCE: It was observed during a walk round the building that the home was clean and tidy and decorated to a good standard. Some new carpets had been fitted and furniture replaced. People’s bedrooms seen were clean and tidy and personalised. There was discussion with the manager regarding a torn commode cover, which she said would be dealt with as soon as possible. A new bath and floor covering were being fitted in a ground floor bathroom. Some hot running water temperatures were checked, these did not exceed the recommended 43 degrees centigrade and protected people from scalding. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 15 Eight, of the ten surveys completed considered the home to be clean. The laundry room was clean and tidy and procedures to prevent cross infections were being used to protect people living in the home. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The staffing arrangements and recruitment procedures ensure people’s needs are met and they are safe. EVIDENCE: The manager said that before the visit sickness and people leaving had affected staffing levels, so admissions had been suspended until more staff were recruited to ensure there were enough staff on duty. Staff rosters seen confirmed this. Staff spoken with said on occasions this had been difficult however the manager always tried to cover shortfalls in staffing levels to ensure peoples needs were met. Staff said training is provided on an ongoing basis to ensure they have the knowledge and skills required to meet people’s needs appropriately, their records seen confirmed this, and included personal development plans. Surveys received showed that people living at the home and their relatives generally consider the “staff listen” and that “staff have the skills required”. One survey stated, “Some seem more caring than others”. Staff “Seem to be very good, relative always seems happy, says always have a laugh here”. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 17 The recruitment files for two members of staff were seen and checks had been completed and satisfactory responses received prior to them starting work ensuring people are protected. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 38 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People live in a home that is managed effectively. EVIDENCE: The manager has recently returned to the home following a planned management task elsewhere in the council. She has continued to address the improvements identified at the last inspection. Information provided by the manager prior to the visit shows that a survey had been completed to obtain people’s views of the service. The results were positive and had been recorded onto a matrix, which was displayed on the notice board. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 19 Records of meetings held with people living at the home were seen; they had provided opportunities for them to discuss social requirements and any concerns they may have that could affect the care provided. Three meetings had been held since March 2007 which has ensured peoples wishes can be used to develop the service. Some people’s financial records and cash held by the home were checked and balanced to date and receipts for purchases obtained, these found processes protect peoples finances. There were no health and safe concerns observed on the day other that those in respect of accidents addressed in standard 7-11. Staff spoken with said manual handling, fire, Infection control, and first aid training are provided and updated as required, ensuring people are safely cared for. The manager had completed a fire risk assessment in October 2007 to ensure peoples safety in the event of a fire. She said all people have received fire training as required at the last visit. Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 20 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 2 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 3 3 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 Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N0 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 OP9 Good Practice Recommendations Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Dovecote Lodge DS0000034928.V357087.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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