Care Home: Dundoran Nursing Home

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What the care home does well Care is provided by a well trained staff team who are positive in their approach to the service users. A high number and range of activities are provided to promote social interaction and stimulation for the service users. The home is bright and pleasant and it is evident that staff strive to provide a homely environment for the service uses. The home is managed to a high standard and the manager is well supported by the owners and staff. What has improved since the last inspection? Considerable investment into the home has been made. New furnishings and improvements to the fabric of the building have resulted in an extremely pleasant and safe environment for the service users. What the care home could do better: The home should continue to develop and improve to provide a homely environment for service users. CARE HOMES FOR OLDER PEOPLE Dundoran Nursing Home Vyner Road South Noctorum Birkenhead Wirral CH43 7PW Lead Inspector Jeanette Fielding Key Unannounced Inspection 29th September 2008 10:00 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 Dundoran Nursing Home DS0000071812.V367766.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. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dundoran Nursing Home Address Vyner Road South Noctorum Birkenhead Wirral CH43 7PW 0151 652 5481 0151 670 0459 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) Newbloom (Dundoran) Ltd Mrs Irene Qaisar Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Dundoran Nursing Home DS0000071812.V367766.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 with nursing - Code N 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: 39 Date of last inspection Brief Description of the Service: Dundoran is family owned by a company, Newbloom (Dundoran) Ltd and is managed by Mrs Irene Qaisar, who is a first level nurse with many years experience in caring for the client group. This care home is registered to provide nursing care for 39 older people, and three of the beds may accommodate clients who require personal care only. Dundoran is a converted three storey mature house situated in the quiet residential area of Noctorum, Birkenhead. The house is set in secluded mature gardens, with a car park to the front, which is surrounded by borders, shrubs and trees, and enclosed gardens to the side and rear. The home has three lounges, a dining room, conservatory, kitchen and laundry and all are located on the ground floor. A selection of single and shared accommodation is available on three floors and some have the benefit of en-suite facilities. Toilets and bathrooms are provided on each floor and assisted bathing facilities are available. A lift serves all floors. The fees for the home are £480.76 per week plus the assessed nursing element. Dundoran Nursing Home DS0000071812.V367766.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 3 star. This means that people who use the service experience excellent quality outcomes. This is the first inspection of Dundoran since the ownership was taken over by Newbloom (Dundoran) Ltd. There are no changes to the management or staff at the home. This unannounced key inspection was undertaken in one day over a period of six hours. As part of the inspection process, all areas of the home were viewed including many of the service users bedrooms. Assessments and care plans were inspected together with staff records and certification to ensure that health and safety legislation was complied with. Observation of the interaction between staff and people who live at the home provided further evidence of the actual care given. Five service users were case tracked to evaluate their care and obtain their views. Discussion took place with the manager, nurses, care staff, service users and visitors to the home. Discussion was held with one of the Directors of the company by telephone during the inspection. The manager completed an Annual Quality Assurance Assessment form prior to the inspection to give additional information regarding the home. What the service does well: What has improved since the last inspection? Considerable investment into the home has been made. New furnishings and improvements to the fabric of the building have resulted in an extremely pleasant and safe environment for the service users. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dundoran Nursing Home DS0000071812.V367766.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 Dundoran Nursing Home DS0000071812.V367766.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): 1, 3 and 4. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Service User Guide is comprehensive and provides prospective service users with full information regarding the home to enable them to make an informed decision regarding their care provider. EVIDENCE: The home has prepared a Statement of Purpose to provide current and prospective service users with full information regarding the facilities and services offered by the home. Copies of this are issued to all enquirers and additional copies are available from the home on request to enable prospective service users and their families to make an informed decision regarding their care provider. It can also be made available in any language, large print or Braille on request. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 9 Comprehensive assessments are undertaken on prospective service users prior to their admission to the home. These assessments are undertaken by the manager or deputy manager who is accompanied by one of the care assistants. This is to ensure that full information regarding the service users health, care and social needs together with any details regarding their cultural and spiritual needs and preferences are identified. This also enables the home to identify any specialist equipment that may be necessary and for the home to provide this prior to admission. The pre admission assessment form has been reviewed and revised since the last inspection to enable a greater range of information to be gathered. Arrangements are put in place for the care assistant who attends the assessment to be on duty at the time of the service users admission so that a familiar face is involved with the admission process and to provide any necessary care during the first few hours following the admission. The home does not offer intermediate care. Dundoran Nursing Home DS0000071812.V367766.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): 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans are prepared for each service user and are reviewed on a regular basis to ensure that the staff are informed of the individual care to be given. EVIDENCE: Comprehensive care plans are prepared for each service user to provide staff with full information regarding the care needs and individual preferences of each service user. The care plans of five service users were inspected and showed that their care needs had been identified and action plans set in place to address those needs. One plan was noted to have fifteen different plans to ensure that staff have full information regarding the service users specific needs to enable them to provide the appropriate level of care. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 11 Risk assessments had been undertaken and risk management plans put in place to reduce or remove those risks where necessary to ensure that the service users are protected from harm. Evidence of visits to and by GP’s, Chiropodist, Dentist, Tissue Viability Nurse Specialists, Dietician, Speech and Language Therapists and other health care professionals was seen, together with information given to the home by these professionals. The records completed by staff following these visits are detailed and informative and give full information and instruction for the staff team. Care plans are reviewed and updated on a monthly basis and more frequently if the service users’ needs change. Service users and/or their relatives are involved with the reviews and agreement with the change in plan is gained. Individual social preferences are recorded to enable an appropriate social and activities plan to be prepared. Daily reports provide evidence of the actual care given by the staff. These reports are detailed and informative. All records are clearly written by the staff. Medications are dealt with in accordance with the home’s policy and procedure to ensure that service users are protected. The records were found to be well maintained and up to date. All storage areas are clean and organised. Arrangements are in place for the disposal of unwanted or refused medications. Service users may meet with their visitors in one of the communal areas or in the privacy of their own bedroom as they wish. Staff were observed to knock on bedroom doors prior to entering. All bathrooms and toilets are fitted with locks which can be opened from the outside in the event of an emergency. Dundoran Nursing Home DS0000071812.V367766.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): 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A choice of meals is offered to service users and a balanced diet is provided to promote good health. EVIDENCE: The home employs an activities coordinator for 20 hours each week to provide activities and stimulation for the service users on five days each week. The coordinator is fully trained, having completed her training at the Countess of Chester Hospital. A programme of activities is prepared and displayed in the home. The activities include individual and group activities together with planned trips out. Records of activities that service users have participated in are held. Service users spoken to confirmed that they were given a choice of activities and were free to decline the offer to participate if they wished. Service users meetings are held regularly each month and provide a forum where they can comment on the service and the activities and make suggestions for change. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 13 Records are held of the issues discussed at the meetings together with information regarding the actions taken by the home. Recently, trips have been made to The Safari Park, a local farm, Blackpool and Liverpool. Service users are taken in groups or individually on shopping trips or to local pubs. In house activities include quizzes, jigsaws, quoits, art and craft, cake making and icing, skittles and knitting. Time is spent reading books and newspapers to service users who have visual problems. At present, service users are making Christmas cards, crackers and table centres. All programmes are subject to change depending on the weather at service users request. Personal life stories for individual service users are being prepared by the staff which involve gathering information about service users life in three stages – as a child, as an adult and now. Included in this is their hopes and wishes which has enabled the staff at the home to provide a more person centred approach to care and to lifestyle. Meals are served in the dining room, the lounge or the service users own bedroom as they wish. A four week menu is provided and is changed according to season or service users preferences. The dining room does not seat all the service uses at one time and so two sittings are provided for meals and are subject to risk assessment and service users needs and preferences. Dining tables are attractively laid with condiments and table centres. The menus provide evidence that a varied and well balanced diet is provided. Special diets can be provided to meet health or cultural needs or service users preferences. Meals are prepared in the main kitchen which was found to be clean and organised. Fresh products are used for the preparation of meals and the chef makes cakes, pies and desserts from fresh goods. Fresh fruit and vegetables are delivered to the home three times each week with additional purchases made as necessary. Since the last inspection, some new equipment has been provided for the kitchen including a refrigerator, blender, microwave cooker, toaster and beakers. Dundoran Nursing Home DS0000071812.V367766.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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a robust complaints procedure to ensure that service users are protected. EVIDENCE: The home has a detailed complaints procedure which is displayed in the foyer of the home and is also detailed in the Statement of Purpose. Two service users were spoken to and said that they were happy in the home but would be confident that any issued raised with the manager would be addressed. Since the last inspection, three complaints have been made and all have been dealt with appropriately and in a timely manner in accordance with the home’s policy and procedure. The majority of the staff team have been given formal training on the protection of vulnerable adults and the remaining staff are booked onto a training course. In house training has been given to all staff to ensure that service users are protected from harm or abuse. Staff spoken to during the inspection were able to demonstrate that they are aware of the different types of abuse and of the action they should take in the event of it being suspected. Dundoran Nursing Home DS0000071812.V367766.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): 19, 20, 22, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recent investment has improved the environment for service users to give them a bright, pleasant and homely place in which to live. EVIDENCE: The home provides accommodation in single bedrooms. Some double rooms are available but only used for shared occupancy on request. The programme of redecoration and improvements continues. The home has recently been taken over by new owners and considerable investment into the home has been made. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 16 The entrance to the home at the front has been provided with an extended ramp, with lighting, to give greater access to the home to people who require the user of a wheelchair or who have mobility difficulties. The area at the front of the home provides a car park and a small lawned area. At the rear of the home is a landscaped and well maintained garden with a walled area containing plants and flowers. Seating is provided at the garden at the rear of the home and at the front. The home provides three lounges which are each provided with a television and DVD player. Twelve new lounge chairs have been provided and all lounges are decorated to a good standard and provide service users with a pleasant area to spend their days. Service users can choose the lounge where they sit. The conservatory has been redecorated and fitted with new blinds. New furniture has been provided in the dining room. Bedrooms are decorated and furnished in a domestic style to a high standard and service users are encouraged to provide pictures, photographs and items of memorabilia to personalise their rooms. Bedrooms are redecorated and fitted with new curtains when they become vacant, and as needed, and service users are given a choice regarding the colour scheme of their room. Bedroom furniture is replaced whenever necessary. Some new beds have been purchased and pressure relieving mattresses provided where needed. A new hoist with slings has been provided to assist service users who have mobility difficulties and all staff have been given training in the use of the hoist. New shower rooms have replaced older bathrooms to offer greater choice of bathing facilities to service users. The home is clean and smelled fresh throughout. Infection control policies are in place and training is given to all staff to ensure that service users are protected. The home is maintained to a high standard and all staff are responsible for reporting maintenance issues to ensure that they can be speedily addressed. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by a staff team that is recruited and trained to support safe care practices in the home. EVIDENCE: The home employs a full staff team, many of whom have been at the home for many years and thereby provide a consistent level of care to the service users. 95 of the care staff now hold NVQ qualifications and the remaining member of staff is to commence NVQ training in January 2009. The home has a robust policy and procedure for the recruitment of staff which is in accordance with equal opportunities legislation. All prospective staff are required to complete an application form and then attend for interview. Two references are taken and checks made with the CRB and POVA and evidence of qualifications is required to be produced. The files for four members of staff were inspected and were found to contain all necessary information. Induction training is given to all new staff and records of this training are held on the staff files. Supervision is given to all staff on a regular basis and staff meetings are held to provide a forum for open discussion and the dissemination of information. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 18 Training opportunities are made available for all staff and the manager has prepared a training matrix to identify training undertaken and to trigger updates in training. Staff spoke positively about the home, the manager and the training opportunities and all expressed that they gave high quality care to the service users. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The views of residents, relatives and other healthcare professionals are sought on a regular basis to enable improvements to continue. EVIDENCE: The Registered Manager of the home is a qualified nurse who holds a management qualification at level 4. She has been the Manager of Dundoran for seven years and is qualified and experienced to run the home effectively. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 20 The home is accredited with the quality assurance British Standard ISO 9002 and was recently awarded the Investors In People accreditation for the second time. Internal audits are undertaken each month to ensure that the home remains complaint with its own and external quality assurance standards. Customer satisfaction surveys are undertaken twice yearly and the information is collated and used to further improve the service. These are sent to service users, relatives and other stakeholders. The home will hold small amounts of money for individual service users for personal use i.e. hairdressing, chiropody, toiletries and trips out. Receipts are held for all purchases made on service users behalf and comprehensive records are held. All checks are made on equipment within the home and certificates were in place and up to date. No business management meetings have yet been held with the new owners to discuss changes and proposals in the home. It is expected that these meetings will commence in the next few months and will become a regular event to ensure greater communication between the owners and the manager. The manager confirmed that she is well supported by the new owners and that their previous experience in care homes has ensured that the home has continued to run well with no negative impact as a result of the change in ownership. Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 21 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 3 X 4 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X 3 X 4 3 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 22 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 Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 Dundoran Nursing Home DS0000071812.V367766.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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