Care Home: Dovecote View

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What the care home does well People who use the service said they like living here. They felt the home was always clean and fresh and provided them with a comfortable place to live. They thought staff were attentive to their needs, responding quickly to requests for help. Comments included: `Staff are very good, very friendly, I would recommend to a friend` `It`s a great place to live`, `The staff will do anything for you`, The service provides a wide range of activities and people are able to choose whether to join in. People felt they were able to make choices about how they spent the day, commenting: `You can do what you want`, `My privacy is respected` Attention to detail is given to individuals with regard to their personal care, leisure activities and how they spend their days. There is a relaxed and friendly rapport between staff and residents, People enjoyed the meals provided and said there was always a choice offered. Staff are encouraged and supported to develop their skills through training including National Vocational Qualifications ((NVQ). What has improved since the last inspection? The home has addressed the issue of wedging open fire doors after taking advice from the Fire and Rescue service. What the care home could do better: Two requirements were made as a result of this inspection. Initial assessments must be clearer and all medication must be kept under review and only administered as prescribed by a a doctor. Key inspection report Care homes for older people Name: Address: Dovecote View Claypit Lane Westhampnett Chichester West Sussex PO18 0NT     The quality rating for this care home is:   three star excellent 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: Liz Palmer     Date: 0 1 0 4 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. 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: Dovecote View Claypit Lane Westhampnett Chichester West Sussex PO18 0NT 01243779080 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dovecote View Limited Name of registered manager (if applicable) Mrs Julie Buck Type of registration: Number of places registered: care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 26 The registered person may provide the following category of service only: Care home only (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 (OP) Date of last inspection Brief description of the care home Dovecote View is a care home offering personal care to 26 residents in the category older person. Dovecote View is a detached property situated close to the city of Chichester, with a large garden to the rear. There is a spacious sun lounge at the back of the property Care Homes for Older People Page 4 of 24 Over 65 26 0 Brief description of the care home together with a patio for the use of residents. Mrs. Gaynor Moore privately owns the home and is also the responsible person. The Registered Manager is Mrs Julie Buck. Current fees are £425 to £520 per week 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection included a visit to the home over a period of six hours, starting at 9.00am. The registered manager was not available during the inspection and we were assisted by two deputy managers. During the inspection we spoke privately to three staff and three service users. Other staff and service users were met, observed and spoken to in passing during the day. We also met and spoke privately to a visiting district nurse and a visiting friend of a resident. Care plans, assessments, medication records, policies and some staff staff records were sampled. Other information used to make judgements about the standard of care in the home included the homes Annual Quality Assurance Assessment (AQAA) that they completed and returned to us. Care Homes for Older People Page 6 of 24 We also received four surveys from residents living in the home and seven from care staff employed by the home. Care Homes for Older People Page 7 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 8 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 9 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are assessed to ensure that only those whose needs can be met are admitted to the home. The assessments must be clearer including stating the primary need on admission to the home. Dovecote View does not provide intermediate care. Evidence: Two initial assessments were looked at, they contained a brief medical history, information about the persons care needs ad reason for admission, a brief social history and details of their interests and hobbies. One assessment stated under brief medical history the person has vascular dementia and although the deputy managers were clear that this persons primary need was personal care due to old age this was not stated on the assessment. People are able to visit the home prior to moving. All four of the surveys returned Care Homes for Older People Page 10 of 24 Evidence: from residents stated that they received enough information to help them decide if the home was right for them. They also stated they had all received written information about the homes terms and conditions. Care Homes for Older People Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their health and personal care needs met in a way that respects their views and upholds their right to privacy. The actions of staff regarding administration and recording of medication could put people at risk. Evidence: Three care plans were looked at. These are drawn up from the initial assessments undertaken prior to moving in. They were seen to be kept under regular review. Care plans are kept in residents bedrooms and cover all aspects of the care needed. For example; oral care; skin care and personal care. Risk assessments were seen to be in place and were clear and kept under review. Residents are aware of their care plans and say that they always get the care they need and as written on the plan. Three residents were spoken to privately in their rooms. Residents said they were treated with respect and that staff were patient, friendly and kind. They said they felt safe and well cared for. Care Homes for Older People Page 12 of 24 Evidence: The four surveys received from residents were all positive. They all said they always receive the care and support they need and the home always makes sure they get the medical care they need. Comments such as Pay attention to individual needs, Nothing is too much trouble for anyone and Provides a caring environment. A friend of a resident was met during the inspection who told us they had been visiting the home for two years. They said they were happy with the care provided to their friend. Staff were observed interacting in a friendly, polite and respectful manner to residents. Residents told us they could get medical assistance if they needed it and records are kept of district nurses and general practitioner (GP) visits and any follow up action to be taken. We spoke to a district nurse who has been visiting the home for over 8 years. She said staff are lovely and gorgeous to the residents. She said she could not praise them enough. She told us that the community nurses are never called out inappropriately and the home always follows the advice they give. She said she has never had any concerns about the home. She added that they are very patient and careful with people. The lunchtime administration of medication was observed. The records of three residents were looked at. During the lunchtime medication round we noted that for one persons medication administration record (MAR) a regular laxative had not been given for three days. The daily records in the home recorded the details of why it had been stopped. This was discussed with the deputy managers and a requirement has been made for all medication to be administered as prescribed. There was evidence to show that this was done in the best interests of the resident, however it does not meet what is required by the Royal Pharmaceutical Guidelines. The storage and recording of medication was seen to be safe. No controlled drugs are currently used in the home and no suitable storage was available should they be needed. The deputy managers agreed to inform the manager that suitable safe storage for this is required. Since our visit the manager has informed us that she has fitted suitable, safe storage that meets the requirements of the Royal Pharmaceutical Guidelines. Care Homes for Older People Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a wide range of activities on offer in the home and they are happy with the choices. People are satisfied with the food provided. Evidence: Dovecote view continues to excel in this area. In the homes AQAA they state that a range of activities are organised by the activities coordinator. A notice in the home showed at least two activities are offered seven days a week. The activities offered were a good mix of physical activity, mental stimulation and pampering. The range showed individual and collective preferences were considered including for males and females. The activities programme includes a variety of outside entertainment trips outside. Peoples religious and cultural needs are noted in their care plans and people are supported to express themselves individually. The surveys returned by residents stated the home always arranges activities that they can take part in. Those spoken to confirmed this. One person said they did not join in the activities much as they were kept busy with their many visitors. We were told visitors could visit freely and this was observed during the inspection. A friendly rapport was noticed between staff and visitors and they were seen to be offered a drink and made welcome. Care Homes for Older People Page 14 of 24 Evidence: A friend of a resident was met during the inspection who told us they had been visiting the home for two years. They said they were always made welcome and their friend was satisfied with the food and often had second helpings. All surveys returned and residents spoken to on the day said they were happy with the food. We observed part of the lunch time and saw that their was a relaxed atmosphere and staff were attentive and polite. Care Homes for Older People Page 15 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 living in the home and their families can be confident that any complaints will be taken seriously and acted upon and staff training and practise is designed to protect residents from risk of abuse. Evidence: A complaints procedure is displayed in the home and residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the manager. Two surveys from residents stated they did not know how to make a formal complaint. All five surveys said there is someone they can talk to if unhappy. There was an open and relaxed atmosphere and staff dealt promptly with requests. The homes AQAA tells us that no complaints have been made in the last twelve months. They say their Safeguarding of Vulnerable Adults training is up to date and their are no ongoing safeguarding issues. Staff spoken to were aware of the homes policy and were confident about their responsibilities within it. Care Homes for Older People Page 16 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. People who use the service benefit from a clean and homely environment, which is well maintained. Evidence: The outside of the home is maintained to a high standard. Inside the home is decorated and furnished to a high standard and is kept clean and hygienic. Staff were seen to be wearing suitable gloves and aprons on the day. The large lounge and conservatory had adequate seating made of a wipe clean fabric. It was arranged in a homely way that made conversation and socialising possible with quiet areas for those that wanted it. Residents are encouraged to personalise their rooms with their own belongings. There is an going maintenance programme to ensure continuous update and improvement. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by well trained, supervised staff, in sufficient numbers to meet their needs. The robust recruitment procedure makes sure the risks to people who use the service are minimised. Evidence: People who use the service said staff always responded quickly to their requests for assistance and staff were seen answering call bells efficiently throughout the visit. The staff spoken to said staffing levels were always sufficient and the surveys received confirmed this. Staff told us that they are well supported and receive regular supervision. The last report tells us that the service has a robust recruitment procedure that makes sure all relevant checks, such as Criminal Records Bureau (CRB) checks. The AQAA states that there is a long standing, highly valued and well trained staff team. Two new staff have been employed since the last inspection. It was not possible to check their recruitment records as the manager was on leave. The new staff told us that the had undergone a thorough recruitment process which included an application form, CRB check and taking up of references. New staff are required to complete an induction programme, which includes shadowing experienced staff, attending training courses and completing an induction record. Staff said they found their induction very Care Homes for Older People Page 18 of 24 Evidence: good andfelt supported. The AQAA recorded that 13 out of 19 staff had completed a National Vocational Qualification (NVQ), this exceeds the 50 recommendation. All staff were required to complete mandatory training and had in house training as well as being able to attend external courses including a two day dementia course that most staff had undertaken. 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. Overall the home is well run, by an experienced and suitably qualified manager. Management decisions about recruitment practises may have placed people at risk. Evidence: The home does not hold any monies on behalf of residents and any expenses incurred are invoiced to relatives or legal representatives. The registered manager is qualified to NVQ level 4 and has completed the registered managers award. The deputy managers are also qualified to NVQ level 4. They assisted with the inspection in a confident and competent manner and were not phased by the absence of the manager. All staff and residents spoken to said the thought the home was well run and that the manager was approachable and helpful. The home sent us their AQAA when we asked for it. The detail was brief and told us most of what we needed to know. Staff and residents are consulted on the running of the home at resident meetings and monthly staff meetings. The home sends annual Care Homes for Older People Page 20 of 24 Evidence: questionnaires to residents and relatives. One was being completed by a family during the inspection. The home does not hold any money on behalf of residents, they were supported by their relatives or power of attorneys in this matter. We sampled records for fire safety, these were up to date. Fire training had been provided and doors were not seen to be wedged open as was noted at the last inspection. 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 1 3 14 All prospective service users 24/05/2010 must have a full assessment of need prior to moving to the home. This must clearly state their primary need for moving to the home and how all needs will be met. To ensure all needs can be met in the home. 2 9 14 Medication must only be given as prescribed. To protect people who require assistance with their medication. 24/05/2010 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. 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