Care Home: Downsvale

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The home is comfortable and homely for the residents. People that live in the home say that they have their needs met and that they are happy with the care they receive. The staff in the home are trained and qualified and treat the residents with kindness and respect. People in the home are supported to participate in a range of activities both in the home and within the local community. They enjoy a range of meals in a pleasant environment. The manager of the home ensures the service is run in the best interests of the residents and that the quality of the service is continually reviewed and improved. What has improved since the last inspection? Since the last inspection the care plans have been reviewed to ensure that they are personalised to the individual resident. The pre admission assessment has been expanded to cover all areas of support need a person may have. What the care home could do better: There are no requirements or recommendations from this inspection. CARE HOMES FOR OLDER PEOPLE Downsvale 6 - 8 Pixham Lane Dorking Surrey RH4 1PT Lead Inspector Jo Griffiths Unannounced Inspection 18th December 2008 09:45 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 Downsvale DS0000013316.V373544.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. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downsvale Address 6 - 8 Pixham Lane Dorking Surrey RH4 1PT 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) 01306 887652 brianmathews@btconnect.com Dr B H Mathews Miss A Douglass, Mrs P Mathews Miss Amanda Jane Douglass Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 4 service users who are in need of palliative care may be accommodated at any one time 2 service users who are in need of palliative care aged between 50 and 65 years may also be accommodated 11th December 2007 Date of last inspection Brief Description of the Service: Downsvale is a Registered Nursing Home caring for up to 35 older persons. The home consists of two large detached houses joined by a covering link way. It is set within a large garden in a residential road close to the town centre of Dorking. There are four shared bedrooms and twenty seven single bedrooms. One bedroom has en-suite facilities and there are communal bathrooms and shower facilities situated around the home to meet people’s needs. The fees charged for this service range from £750 - £825 dependant on the room accommodated within the home. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a key inspection of Downsvale Nursing Home that took place on 18th December 2008 between 09.45 am and 1.30pm. The Inspector had a look around the home and spoke with some of the people that live there to gather their views about the service they receive. Prior to the inspection visit the Registered Manager had completed and returned the Annual Quality Assurance Questionnaire (AQAA) to the Commission. This provided useful information about the management of the service. The Registered Manager was present during the inspection and gave feedback on the improvements made since the last visit. Some of the care plans and records were examined to provide further evidence in order to make a judgement about the care that is provided at the home. The inspector would like to thank all the residents and staff in the home for their hospitality during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 6 There are no requirements or recommendations from this inspection. 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. Downsvale DS0000013316.V373544.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 Downsvale DS0000013316.V373544.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): Standards 2 and 5 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People wishing to use the service have a full assessment of their needs and are ensured these can be met before they move into the home. EVIDENCE: People that live in the home said that they had been able to choose whether they moved in and had been offered the opportunity to visit the home to look around. Everyone spoken with said they were happy with the support they received and felt that their needs were being met. The assessment form that is used to assess people’s needs before they move to the home has been expanded. This now covers all areas of people’s need including their physical, emotional, social and cultural needs. Three people’s assessments were seen and these had been fully completed and agreed with the resident. The manager visits the person in their own home or hospital to Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 9 carry out the assessment and takes into account the views of the person and their relatives. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 10 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): Standards 7, 8, 9, 10 and 11 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have a care plan that ensures their physical, social and emotional needs are met. They have their health needs met and are supported to take the medication they need at the appropriate times and in the way they prefer. People living in the home feel they are treated with respect and that their privacy and dignity are maintained. Sensitive and appropriate care is provided for people at the end of life based on their expressed wishes. EVIDENCE: Each resident has a care plan that is based on their assessment of need. The care plan states the action required by nursing and care staff to ensure that the person has their needs fully met. Three care plans were inspected. These were found to address the needs identified in the pre admission assessment. The three care plans had been reviewed monthly by the keyworker and designated nurse and there was evidence that changes had been made to the Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 11 plans, as needed, between formal reviews. The three care plans had been agreed and signed by the individual resident or their relative. Individuals’ health needs are met through the care plan, by the nursing staff and the GP, who visits the home weekly. Records are maintained of all health appointments. Each person has a nutritional assessment and their weight is monitored and recorded in their care plan. Any changes in appetite are recorded on the care plan and action is taken to ensure their diet is supplemented where needed. The home’s brochure states that residents can use the chiropodist that visits the home or can be supported to make their own arrangements. Dental and audiologist appointments are made annually for residents or more frequently if needed. The nursing staff carry out assessments of the risk of skin breakdown and arrange for the necessary equipment to be provided to ensure skin integrity is maintained. A number of people in the home are nursed in bed, however there have been no incidence of pressure sores due to the effective preventative care carried out by the staff. People that live in the home said that the care staff and nurses are very quick to respond to their health needs and support them to see the GP when needed. Following the previous key inspection a pharmacy inspector from the Commission visited the home to carry out a random inspection focusing on medication practices. A copy of the report was sent to the manager of the home. A recommendation was made that a second nurse checks the transcribed MAR sheets to ensure the information relating to doses has been entered correctly. This has been actioned and examples of completed sheets were seen. The deputy manager now completes a monthly stock check of medicines in the home. Issues relating to privacy and dignity were included in the care plans that were seen. Throughout the inspection the staff were observed to interact with residents in a respectful and patient manner demonstrating an understanding of their communication and health needs. The care plans also evidenced that equality and diversity issues had been considered when assessing the needs of the individual and agreeing their care package. Staff receive training in Equality and Diversity and certificates for this were seen on the two staff files inspected. The home uses the Gold Standard ‘end of life’ planning documents to ensure that people’s wishes, thoughts and preferences are known by the relatives and by the staff that support them. The manager is currently working toward obtaining Gold Standard accreditation status. All staff undergo training in end of life care and the manager stated that she feels this is one of the main strengths of the home. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14 and 15 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are supported to take part in the activities that meet their needs and interests. They are encouraged to get involved in activities in their local community and to maintain contact with their family and friends. The people that live in the home are provided with a varied and nutritious diet with plenty of choice of the meals they enjoy. EVIDENCE: A range of activities are provided in the home each day during the week. This includes games, crafts, cooking, singing and exercise sessions. One member of staff is allocated to arrange the programme of activities. Outings are booked several times per month based on the interests and requests of the residents. During the inspection a group of residents went out to a Christmas concert at a local school. People spoken with said they enjoyed the activities that were arranged. The activities coordinator makes a record each day of the activity provided, whom Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 13 took part and whether people enjoyed the session. This allows the manager and activity coordinator to monitor and review the activity programme to ensure people’s social needs are met. Some people were reading newspapers and those spoken with said that they were asked when they moved in if they wanted a daily paper and that these are delivered for them. One resident said there is a library of books available in the home. Staff said visitors are welcomed at anytime and a number of visitors were seen to be arriving throughout the inspection. Two residents spoken with confirmed that they could have visitors when they wish and could see them in private. People are supported to visit family and friends if they wish and have the opportunity to participate in activities in their local community. Evidence was seen in the care plans of how people are supported to make choices and decisions about their care. Their consent has been obtained for the use of bed rails where a risk assessment had identified this was required. The home has a four week menu that provides a choice of meals at each mealtime. Residents said that they always have a choice of hot and cold meals and are provided with tea, coffee and cakes in the afternoon. Everyone spoken with said they enjoyed the food and felt there was sufficient choice of the things they like. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People that use the service know how to make a complaint if they need to and feel confident that their concerns will be taken seriously. They are safeguarded from harm and abuse through robust recruitment procedures and training for staff. EVIDENCE: People are provided with a copy of the complaints procedure when they move into the home. There have been no complaints received by the home or the Commission since the last key inspection. People spoken with in the home confirmed that they knew how to make a complaint if they needed to and that they felt any concerns they have are listened to and taken seriously. The home had recently received a letter of compliment in which the person had commented “I would certainly award your home 100 ”. All the staff have received training in safeguarding adults and have read the policy relating to this as part of their induction. All staff employed in the home are required to have a Criminal Records check (CRB) that includes a check against the Protection of Vulnerable Adults (POVA) register. People spoken with said that the staff are kind and patient when supporting them and treat them with respect. The manager and deputy manager are booked to attend training with Surrey council on safeguarding adults in February 2009. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 15 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): Standards 19 and 26 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean, safe and comfortable and meets the needs of the people that live there. EVIDENCE: The home is clean and well maintained. Risk assessments have been completed to ensure there are no significant risks to residents in the home. The home has a homely and comfortable atmosphere with plenty of communal and private space for residents. People spoken with said they were happy with their rooms and the facilities available in the home. The home is able to meet the needs of people with mobility difficulties as there is a lift, hoists and adapted bathroom facilities. Downsvale DS0000013316.V373544.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): Standards 27, 28, 29 and 30 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People in the home are safeguarded by robust recruitment procedures for new staff. They are supported by sufficient numbers of trained and qualified nurses and carers to meet their needs. EVIDENCE: The home employs a manager, deputy manager and a team of nurses and care staff. There is also a team of catering and domestic staff and two maintenance workers. People that live in the home said that there are always plenty of staff around to support them and that the staff are pleasant and treat them with respect. Staff were seen to respond quickly to people’s needs during the inspection. The staff files for two staff members are were inspected. These contained evidence that appropriate pre employment checks had been made, including written references and a CRB check. The manager stated that agency staff are not used in the home, but that a bank of staff are available to cover in the event of annual leave and sickness. The home has a low turnover of staff, with the newest carer having been employed for a year. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 17 All except one member of the care team have achieved, or are working toward, the NVQ award. New staff complete the ‘skills for care’ induction and go on to complete a range of training courses including safeguarding adults, infection control, moving and handling, equality and diversity, food hygiene and health and safety. Additional training is provided dependant on the needs of the group of residents in the home, such as dementia care, communication and stroke care. The home has Investors in People accreditation. Downsvale DS0000013316.V373544.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): Standards 31, 33 and 38 People using this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent, qualified and experienced manager that ensures the service is run in the best interests of the residents. The health and welfare of the residents and staff are promoted and protected. EVIDENCE: The manager is a registered nurse and has completed the Registered Managers Award and an MSC in elderly care. She has undertaken various management courses and updates in relevant areas of care practice. Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 19 A quality assurance system called ‘Putting Service Users First’ is used to gather the views of the residents and their relatives about the service provided through surveys and meetings. Feedback is given to residents about the action that is taken to address any issues raised. An external agency is used carry out an annual health and safety and fire safety assessment. The manager confirmed that action had been taken to meet the recommendations made in the assessment reports. Risk assessments are in place for the general environment of the home and any risks that are specific to individual service users. All staff are trained in health and safety matters and the home has policies and procedures for the protection of staff and residents. Downsvale DS0000013316.V373544.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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 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 X X X X 3 Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Downsvale DS0000013316.V373544.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Downsvale DS0000013316.V373544.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. 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!