Care Home: Dover House

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well People have their needs assessed before receiving the service, so that they are confident that their needs can be met. Care plans emphasised promoting peoples independence, choice and safety by recording what each person could do for themselves, associated risks, and what staff needed to do to support each individual. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 People and their relatives were pleased with the way personal and health care needs were met. One person`s relative said that they and their relative were, "one hundred percent consulted and involved in care", that they had, "seen the care plan", and that the owner/acting manager was, "bending over backwards to help people". The relative concluded that they, "always know what`s going on", and, "can`t fault the home or owner in any way". Similar positive comments were made by other people`s relatives, including that of one relative who said that the home was, "absolutely fantastic", and that, "the care is excellent". A detailed personal history of each person was taken.This meant that the things that were important to people, e.g. their past profession and education were recorded, in addition to hobbies, interests, religious needs etc. Without exception, all relatives said that they were always made welcome at the home and offered a drink of tea, and sometimes meals with their relative. We observed relatives being greeted by staff in a friendly manner and being offered drinks. This is good as it enables people to maintain their relationships with family and friends. People commented about the, "home cooked food", and said that it looked good and meal times were seen to be unhurried affairs. . People and their relatives said that people were treated with respect and a visiting community psychiatric nurse said that the owner/acting manager was, "very supportive of families", and had, "dealt with very distressed relatives admirably“, and stated, “I feel very confident, as I know if there is a problem the manager will contact me". The nurse concluded that staff, "always ask if I want to see the patient first", and, "always provide accurate information about the patient`s well-being and progress". This is good for people using the service. Without exception, people`s relatives said that they would have no hesitation in making a complaint to the owner/acting manager and felt confident that she would deal with it. One relative said that they had, "no problems at all in making a complaint to the owner", and added, "she`d appreciate it, see it as a positive thing, and would deal with it". People trusted the owner/acting manager. One relative said, "oh yes, I trust the manager, I have no reason not to, I really trust her", and another relative said, "definitely, without a doubt, I really, really, trust them". People and their relatives were positive about the staff who were described as, "very nice", and, "very caring". One person`s relative said that the staff were, "excellent, absolutely excellent". One relative commented that, "everything is above board”, and, "everything is good", and another relative concluded that the home was, "absolutely Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 8fantastic". A third relative concluded that it was the, "best home they`ve ever seen". The owner/acting manager provided records which demonstrated that health and safety checks, including fire safety checks, were completed appropriately in order that people`s health and safety was maintained. What has improved since the last inspection? Throughout the inspection we received lots of positive comments from people, their relatives and a visiting nurse about the owner/acting manager and the positive changes she had made to the service in the interests of people. The visiting nurse said that the owner/acting manager, "really cares about people", is, "very good, "very calm", "not afraid to seek professional advice", "very keen to get things right", "wants to help people", and was, "very professional". The nurse concluded that they had, "never had this kind of consistency from a care home, they are better than good”. One relative said that they had, "never seen anyone work so hard to help people", and added that the owner/acting manager had, "tried to update things", and had introduced "good communication", and improved the environment. Staff and people`s relatives said that they have the owner/acting manager’s mobile phone number and can contact her at any time. The level of detail in care plans had improved since the last inspection and the owner/acting manager had also addressed a requirement made at the last inspection concerning having risk assessments to better protect people. Management of people`s medication had improved by addressing a requirement made at the last inspection concerning the development of medication records. The owner/acting manager provided a detailed document concerning all the improvements made to the premises since the last inspection. This included redecoration and refurbishment of most rooms and replacement of soft furnishings. What the care home could do better: Care plans included some details of people`s nutritional needs, including likes and dislikes, but these needed to be more detailed and a recommendation was made about this. Overall, staff recruitment practice resulted in good outcomes for people using the service. However, the owner/acting manager acknowledged that some aspects of recruitment practice needed to improve. All radiators needed to be covered for safety reasons, unless a risk assessmentDover HouseDS0000069325.V376434.R01.S.doc Version 5.2 indicated that there were no risks to people. Key inspection report CARE HOMES FOR OLDER PEOPLE Dover House 30 Derbyshire Lane Stretford Manchester M32 8BJ Lead Inspector Helen Dempster Key Unannounced Inspection 28th July 2009 5:30pm DS0000069325.V376434.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 2 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 Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dover House Address 30 Derbyshire Lane Stretford Manchester M32 8BJ 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) 0161 7180248 0161 7185125 cathy.conchie@ntlworld.com Catherine Bernadette Conchie Mrs Patricia Carlon Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Dover House DS0000069325.V376434.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 people 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. The maximum number of people who can be accommodated is 10. Date of last inspection 13th December 2007 Brief Description of the Service: Dover House is a care home which provides residential accommodation with personal care for up to ten older people. The owner of the care home, Mrs Conchie, has been taking an active role in the day to day management of the care home due to the imminent retirement of the registered manager, Mrs Carlon, who was also the former owner. Mrs Conchie was about to submit her application to be the registered manager. The home is situated in a residential area of Stretford, and is close to Stretford Arndale Centre and local public transport and motorway networks. Dover House is a large Georgian house set in pleasant grounds. The steps to the front and side of the property have blocked paving. The home has gates with an electronic security system. Car parking space is available at the front of the building and on the roadside. To the rear of the property is an extensive patio area overlooking a local school. The grounds to the rear offer a secure external assembly area, which can be accessed via steps or via a recently built ramp from the lounge area. The home has ten bedrooms, all of which are en-suite. The first floor has stair lift access. The communal rooms consist of a large lounge/conservatory style area and a designated dining area. The kitchen is open plan onto the dining area. Information about the home can be obtained from the service users guide , which is a booklet that provides details of what the service can offer. Alternatively, information can be obtained from the owner/acting manager in Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 5 person or by telephone. The range of fees charged by the home are from £348:42 to £376:30 per week. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means that people who use the service experience excellent outcomes. This key unannounced inspection included a visit to the home on 28th July 2009. The manager and staff at the service did not know that this visit was going to take place. A second visit to the home was also conducted on the following day. In November 2008, an Annual Service Review (ASR) was done, as part of the lead up to this inspection. This involved the owner/manager filling in an annual quality assurance assessment (AQAA). This form gave the owner of the service the opportunity to tell us what they feel they do well, what they needed to do better and what had changed since the last key inspection. This helped us to determine if the owner/manager of the service saw the service they provided in the same way that we saw it. The form was well completed and the owner was able to tell us what plans there were to develop the service. At this time people who use the service and staff filled in surveys to tell us their views of the service. We then considered this information, and all the other information we had received about the service, so that we could decide when we needed to visit the home to do a key inspection. The outcomes for people who used the service at that time were good. This reassured us that people at the home continued to be happy with the way they were supported by the service and that they continued to receive a good service and this helped us to plan the timing of this inspection. All of the key inspection standards were assessed at the site visit and information was taken from various sources. This included observing care practices, talking with people who use the service, the relatives of four of these people, the staff, a community psychiatric nurse who was visiting their patients at the home, and the owner/acting manager. Three people were looked at in detail to learn about their experience of the service from when they first used it to the present-day. A selection of records were looked at, including medication records, training records and care records. What the service does well: People have their needs assessed before receiving the service, so that they are confident that their needs can be met. Care plans emphasised promoting peoples independence, choice and safety by recording what each person could do for themselves, associated risks, and what staff needed to do to support each individual. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 7 People and their relatives were pleased with the way personal and health care needs were met. One persons relative said that they and their relative were, one hundred percent consulted and involved in care, that they had, seen the care plan, and that the owner/acting manager was, bending over backwards to help people. The relative concluded that they, always know whats going on, and, cant fault the home or owner in any way. Similar positive comments were made by other peoples relatives, including that of one relative who said that the home was, absolutely fantastic, and that, the care is excellent. A detailed personal history of each person was taken.This meant that the things that were important to people, e.g. their past profession and education were recorded, in addition to hobbies, interests, religious needs etc. Without exception, all relatives said that they were always made welcome at the home and offered a drink of tea, and sometimes meals with their relative. We observed relatives being greeted by staff in a friendly manner and being offered drinks. This is good as it enables people to maintain their relationships with family and friends. People commented about the, home cooked food, and said that it looked good and meal times were seen to be unhurried affairs. . People and their relatives said that people were treated with respect and a visiting community psychiatric nurse said that the owner/acting manager was, very supportive of families, and had, dealt with very distressed relatives admirably“, and stated, “I feel very confident, as I know if there is a problem the manager will contact me. The nurse concluded that staff, always ask if I want to see the patient first, and, always provide accurate information about the patients well-being and progress. This is good for people using the service. Without exception, peoples relatives said that they would have no hesitation in making a complaint to the owner/acting manager and felt confident that she would deal with it. One relative said that they had, no problems at all in making a complaint to the owner, and added, shed appreciate it, see it as a positive thing, and would deal with it. People trusted the owner/acting manager. One relative said, oh yes, I trust the manager, I have no reason not to, I really trust her, and another relative said, definitely, without a doubt, I really, really, trust them. People and their relatives were positive about the staff who were described as, very nice, and, very caring. One persons relative said that the staff were, excellent, absolutely excellent. One relative commented that, everything is above board”, and, everything is good, and another relative concluded that the home was, absolutely Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 8 fantastic. A third relative concluded that it was the, best home theyve ever seen. The owner/acting manager provided records which demonstrated that health and safety checks, including fire safety checks, were completed appropriately in order that peoples health and safety was maintained. What has improved since the last inspection? What they could do better: Care plans included some details of peoples nutritional needs, including likes and dislikes, but these needed to be more detailed and a recommendation was made about this. Overall, staff recruitment practice resulted in good outcomes for people using the service. However, the owner/acting manager acknowledged that some aspects of recruitment practice needed to improve. All radiators needed to be covered for safety reasons, unless a risk assessment Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 9 indicated that there were no risks to people. 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. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 10 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 Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 have their needs assessed before receiving the service, so that they are confident that their needs can be met. EVIDENCE: In the AQAA the owner/acting manager stated, “Initially, we invite the families of the potential resident to call, usually unannounced to view the Home in operation. A history of the resident is sought along with any medical/mobility needs. The next stage is for the owner/manager to visit the resident accompanied by a senior carer, at which time a further assessment is made. Information is also sought from the resident’s social worker or current carer”. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 12 To find out whether this was the case, we looked at a range of documents and we looked carefully at the care provided to three people from the point of their admission to the present time. We also talked to people using the service, their relatives and staff. We saw the home’s pre-assessment record. The owner/acting manager said that while they are actually assessing the people in their own homes or in hospital, they try not to write too many notes in front of them as this can disrupt the assessment. She added that on return from the assessment visit, the information obtained is recorded on to the initial care plan, so that this can be developed into the working care plan once the person has been admitted. We saw examples of these initial care plans on the files of the three people whose care we looked at which demonstrated that peoples needs and preferences had been assessed, including background information about their lives which would inform the staff of what was, and is, important to that individual. The relatives of people we spoke to were pleased with the way that they and their relatives were supported during the admission process. One persons relative said the manager and a senior carer came out to their relatives flat to complete an assessment. This relative said that this process was, quite informal, they had a drink and chatted, and added, they asked all about background information, and, they made (them) feel really relaxed. This relative concluded that the assessment was, very in depth. The relative said that after the initial assessment, the owner/manager personally collected their relative for a visit to the home, where they spent an afternoon and had a meal with other residents. On collecting their relative that evening, the family members said that the person, seemed so much more relaxed and happy there. The relative said that the person’s family, were all a bit worried but were not worried now, and that the family were pleased that their relative, looks so much better and seems at ease, and that they had all, “noticed such an improvement. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 benefited from support to maintain their health and personal care needs, in the way they preferred, and with respect for their privacy, dignity, rights and choices. EVIDENCE: In the AQAA the owner/acting manager stated, “Dover House ensures all residents health needs are fully met and, in fact, are often exceeded. Residents are always treated with respect and every effort is made to encourage them to live as independently as possible”. To find out whether this was the case, we looked at a range of documents and we looked carefully at the care provided to three people from the point of their admission to the Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 14 present time. We also talked to people using the service, their relatives, staff and a community psychiatric nurse. The level of detail in care plans had improved since the last inspection, and a ‘key worker system’ had been introduced, which means that certain staff have lead responsibility for certain people using the service. The owner/acting manager had also addressed a requirement made at the last inspection concerning having risk assessments to better protect people. The care plans for the three people whose care we looked at in depth, were written from the point of view of the person receiving the care, so that staff were well-informed of their needs and preferences. Care plans had been revised to address a range of aspects of needs for each person. These included carer and family involvement, personal care and well-being, foot care, dental care, communication, mobility, medication, mental health and cognition, diet and weight, religious observance, social interests and activities, sleep patterns and night time care. Each aspect of care was divided into three sections headed, competence, risk, and, needs and care. This demonstrated the emphasis on promoting peoples independence, choice and safety by recording what each person could do for themselves, associated risks, and what staff needed to do to support each individual. This is good for people using the service. We saw that day-to-day records were in place with three records made each day concerning the progress of each person. These records contained a good mix of social and medical information. The outcomes of visits by a range of healthcare professionals, including dentists, the podiatrist, nurses and GPs, were recorded separately. We spoke to a community psychiatric nurse (CPN) who was visiting patients at the home. The nurse said that they had observed interactions between staff and people who use the service, which were, respectful, and the nurse added that staff, try different approaches. People and their relatives also said that people were treated with respect. The nurse said that the owner/acting manager sought help, and training, from mental health services to support the staff in managing challenging behaviour and was, grateful, and, cooperated fully with the training. The nurse was impressed that, all staff attended the training, even those who were on their day off. The nurse also added that, the manager attends outpatient appointments personally with residents. This was confirmed by peoples relatives and staff. The nurse said that the owner/acting manager was, very supportive of families, and had, dealt with very distressed relatives admirably“, and stated, “I feel very confident, as I know if there is a problem the manager will contact me. The nurse concluded that staff, always ask if I want to see the patient first, and, always provide accurate information about the patients well-being and progress. This is good for people using the service. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 15 People and their relatives were also pleased with the way personal and health care needs were met. One persons relative said that they and their relative were, one hundred percent consulted and involved in care, that they had, seen the care plan, and that the owner/acting manager was, bending over backwards to help people. The relative concluded that they, always know whats going on, and, cant fault the home or owner in any way. Similar positive comments were made by other peoples relatives, including that of one relative who said that the home was, absolutely fantastic and that, the care is excellent. Management of peoples medication had improved since the last inspection by addressing a requirement made at the last inspection concerning the development of medication records. We saw that staff were checking and signing for the receipt and administration of medication. The staff we spoke to said that there is a regular slot in the staff meetings to discuss the safe administration of medication. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 benefit from choices to enable them to exercise day to day control over their lives and enjoy the activities and food of their choice. EVIDENCE: In the AQAA the owner/acting manager stated, “The open plan communal living area naturally encourages informal interaction with residents and there is often continuous conversation between staff, residents and visitors which replicates a happy family environment”. The owner/acting manager added, “over the past year increased emphasis has been placed on ensuring that residents enjoy varied activities with a number of new interests being introduced”. To find out whether this was the case, we talked to people, their relatives and staff, saw meals being served and looked at the programme of activities. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 17 A personal profile was on file for each person. The stated purpose of the profile was to, learn about the life of the person. This meant that the things that were important to them, e.g. their past profession and education were recorded, in addition to hobbies, interests, religious needs etc. All three of the personal profiles we saw described people very positively. Examples included people being described as, sociable, an accomplished cook, and, astute and articulate. People’s interests which relate to their professions were also recorded, including a former accountant still having, “a love of figures and enjoying a game of cards. Dover House is a small home and activities included such things as sitting outside in good weather and watching the schoolchildren on the playing fields that the home overlooks. Planned activities included having pub lunches, a trip to Blackpool, birthday parties for all residents, and the use of a snooker table. Special events were also celebrated, including a having a Halloween party and a strawberry tea for Wimbledon. Without exception, all relatives said that they were always made welcome at the home and offered a drink of tea, and sometimes meals with their relative. We observed relatives being greeted by staff in a friendly manner and being offered drinks. This is good as it enables people to maintain their relationships with family and friends. At the time of the visits, several meals were seen to be served. One such meal was roast chicken (or sausages,) vegetables and potatoes followed by cake and custard. Other choices included fresh fruit, yoghurt etc. The table was nicely set and as the home only accommodates 10 people, the meals are served in the main dining room which adjoins the lounge and open plan kitchen. People said that the food was good. Staff were seen to offer extra food to anybody who wanted more and people were relaxed and unhurried. People, their relatives, and a visiting nurse said that the food was good. Several people commented about the, home cooked food, and said that it looked good. Care plans included some details of peoples nutritional needs, including likes and dislikes but these needed to be more detailed and a recommendation was made about this. Peoples weight was recorded on a monthly basis and we saw one care plan which highlighted the fact that that person had a, “slight build and was a, slow eater, and was at risk of losing weight. This was one example of a care plan that required a more detailed nutritional assessment. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 were confident that the manager and staff would listen to their concerns and management/staff training in, and commitment to, the protection of vulnerable adults ensured that people were safeguarded from abuse. EVIDENCE: In the AQAA the owner/acting manager stated, “All staff are receptive to comments both positive and negative and relay them verbally and in writing to their colleagues and management. All residents, and their relatives, are frequently asked if the level and standard of care is continuing to meet their needs. To see if this was the case, we looked at policies, procedures and records and talked to people, their relatives and the staff. The complaints policy was clear and detailed and stated, complaints often provide an opportunity to do something better in future and as such form part of our policy to engender a culture of continuous improvement. Therefore we operate a no blame policy, so that any complaint allows full, thorough and open investigation because persons involved are not threatened by the outcome. We found lots of evidence to demonstrate that this was the case. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 19 This included having detailed records of the outcomes of complaints and details of the independent complaints advocacy service should people require it. It was encouraging to see that in one complaint the owner manager had advised staff to consider that when this person made relatively minor complaints about food, staff needed to consider that there might be more serious underlying concerns as the person suffers from depression. In addition, we saw that family members had been consulted with the permission of the person when complaints were made. Without exception, peoples relatives said that they would have no hesitation in making a complaint to the owner/acting manager and felt confident that she would deal with it. One relative said that they had, no problems at all in making a complaint to the owner, and added, shed appreciate it, see it as a positive thing, and would deal with it. Other relatives said that they were very happy with the home, that the care was, very good, and that they had, no complaints. We saw a number of compliment records and cards including an e-mail from a Trafford Council neighbourhood manager which thanked the owner/acting manager for, having such an embedded can-do attitude. Throughout the inspection, it was clear from records seen, discussion with the manager and staff and discussion with people and their relatives that the owner/acting manager was very proactive in being a good advocate for the people living at the home. One example was the owner/acting manager complaining to the chief executive of a local hospital about the poor service provided to people by the hospital. This resulted in the chief executive endeavouring to open better lines of communication with other care providers and the local council to ensure a better service for older people. Trafford Borough Council’s Protection of Vulnerable Adults policy was readily available and all staff had signed to indicate that they had read and understood it. All staff, apart from one, had recently received training in the protection of vulnerable adults provided by Trafford Council. The remaining member of staff was due to attend this training. Staff interviewed demonstrated a good understanding of, and commitment to, the protection of vulnerable adults. We saw evidence to demonstrate that the owner/acting manager was very proactive in the protection of vulnerable adults. in particular, she is a member of the vulnerable adults steering group to influence the policy process where the police become involved in protection of vulnerable adults cases in care homes and contributed to the production of the policy document, The Police Response To Vulnerable Adult Abuse In Care Settings. This process had led to the owner/acting manager representing care homes concerning how the police interact with care homes and people when investigating adult abuse allegations. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 20 When asked whether they trusted the owner/acting manager; staff, people and their relatives said that they did. One relative said, oh yes, I trust the manager, I have no reason not to, I really trust her, and another relative said, definitely, without a doubt, I really, really, trust them. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 benefited from a warm, clean, safe and well maintained environment that had been significantly improved. EVIDENCE: In the AQAA the owner/acting manager stated, “The safety of residents, visitors and staff is paramount and all appliances and fixtures and fittings are regularly checked and where necessary updated. All bedrooms, though differing in size, are furnished to a regular standard and offer residents a place Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 22 of privacy for themselves and their visitors”. We saw a selection of bedrooms and all communal areas.. All bedrooms have an ensuite toilet and most had been redecorated to a high standard. People and their relatives were positive about the premises. One relative said that the home was, very, very, clean and doesnt smell. Since the last inspection liquid soap and paper towels had been provided in communal toilets and the owner/acting manager manager had sought the advice of continence advisers for people for whom continence issues had an impact on their environment. A carpet cleaner had been recently purchased. Although most radiators had been covered, some, including the radiator in the toilet in one room had not. It was strongly recommended that all radiators are covered for safety reasons unless a risk assessment indicates that there are no risks to people. Although the layout of the ground floor communal areas lends itself well to providing a family like atmosphere, it was clear that confidentiality could be a problem, as staff were working in the kitchen which was open plan opening onto the dining room and lounge. This was recognised by the owner/acting manager and had been addressed by the manager through the confidentiality policy and staff training. The owner/acting manager provided a detailed document concerning all the improvements made to the premises since the last inspection. This included redecoration and refurbishment of most rooms and replacement of soft furnishings. One of the improvements to the premises that people and their relatives were most pleased about was the creation of a large patio area, with lots of seating areas, which overlooked the playing fields of the nearby school. People and their relatives said that they enjoyed sitting here when weather permitted. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 support provided by experienced and committed staff that they trust. Aspects of the recruitment procedure needed to improve and this was recognised by the owner/acting manager. EVIDENCE: In the AQAA the owner/acting manager stated, “All the staff are professional yet relaxed in their approach and more often than not go above and beyond the requirements of their job descriptions by carrying out small acts of kindness which can make a huge difference to residents lives”. To see if this was the case we looked at the recruitment procedure, staff files and training records and we talked to people, their relatives, the manager, and the staff. We saw that the minimum staffing levels for the 10 people accommodated were 2 staff at all times and often the manager in addition to this. This was confirmed by staff, and by people and their relatives. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 24 We saw employee safety handbooks and employee handbooks which were provided to all staff when they were recruited to provide them with all employment information and health and safety and general policy information about the home. All staff had signed for receipt of these handbooks. Overall, recruitment practice resulted in good outcomes for people using the service. However, more care needed to be taken to check for gaps in potential staffs’ employment histories and a recommendation was made about this. In addition, while we saw evidence to demonstrate that the owner/acting manager applied for a criminal records bureau (CRB) check as soon as she had interviewed a successful applicant, the initial POVA first check was not always in place before a member of staff commenced work at home. This was discussed with the owner/acting manager, who contacted the organisation who processed criminal record bureau (CRB) applications. The owner/acting manager was advised that although the fee included the initial POVA first check, if the manager did not specifically request for this to be actioned immediately, it often came back at the same time as the CRB check. We were assured that, as a result of this telephone conversation, the owner/acting manager would not have this problem in future. Staff we interviewed also said that they did not work unsupervised with people until their CRB check was received. We saw a training matrix which demonstrated that staff received a wide range of training. Staff we interviewed were also positive about good access to training. The visiting psychiatric nurse said, I feel staff are open to learning and are learning how to deal with situations. People and their relatives were positive about the staff who were described as, very nice, and, very caring. One persons relative said that the staff were, excellent, absolutely excellent. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 25 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 and their relatives were confident that the owner/acting manager ran the home in the best interests of people who live there and that their safety and welfare were promoted. EVIDENCE: In the AQAA the owner/acting manager stated, “New policies and procedures have been introduced and documented so that there is virtually no situation that could arise where staff are left in any doubt has to how to deal with it”. To Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 26 see if this was the case we looked at records and spoke to people and their relatives, the manager and staff. The registered manager of the home, who was the previous owner, was about to retire. The registered manager had been taking a more limited role in the running of the home, as the new owner took over many of the management functions in preparation for the retirement of the registered manager. During this time, the owner/acting manager had been completing the National Vocational Qualification (NVQ) Level 4 in management in preparation for her application to be the new registered manager. We saw that the owner/acting manager was in the process of completing the application for this change in registration. Throughout the inspection we received lots of positive comments from people, their relatives and a visiting nurse about the owner/acting manager and the positive changes she had made to the service in the interests of people. The visiting nurse said that the owner/acting manager, really cares about people, is, very good, very calm, not afraid to seek professional advice, very keen to get things right, wants to help people, and was, very professional. The nurse concluded that they had, never had this kind of consistency from a care home, they are better than good”. One relative said that they had, never seen anyone work so hard to help people, and added that the owner/acting manager had, tried to update things, and had introduced good communication, and improved the environment. Staff and peoples relatives said that they have the owner/acting manager’s mobile phone number and can contact her at any time. One relative commented, everything is above board”, everything is good and another relative concluded that the home was, absolutely fantastic. A third relative concluded that it was the, best home theyve ever seen. The owner/acting manager provided records which demonstrated that health and safety checks, including fire safety checks, were completed appropriately in order that peoples health and safety was maintained. Only one person living at the home manages their finances independently. All the other people were supported by their family to manage their finances. The owner/acting manager’s involvement in peoples personal finances was limited to holding petty cash should anyone need any money, and holding a small amount of money provided by people’s family members to pay for things such as hairdressing bills. We saw records of money held on behalf of people. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 27 Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 28 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 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X X X 3 Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations It is strongly recommended that care plans always include all the details of peoples nutritional needs, including associated risks and likes and dislikes. This is necessary to ensure that peoples health and welfare is maintained . It is strongly recommended that all radiators are covered for safety reasons unless a risk assessment indicates that there are no risks to people. It is strongly recommended that staff recruitment practice always includes checking carefully for any gaps in the employment history and ensuring that while awaiting receipt of the Criminal Records Bureau (CRB ) check, the POVA first check is in place before a member of staff is employed to support people. This is necessary to ensure peoples safety and welfare. 2. OP19 3. OP29 Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 30 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. Dover House DS0000069325.V376434.R01.S.doc Version 5.2 Page 31 - 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!