Care Home: Durban House

What the care home does well The home is well managed and the staff are well trained and supervised to help them carry out their roles effectively. The staff are committed to providing good care and are well aware of the individual needs of the people they care for. The health needs of the people living in the home are monitored by the staff and appropriate action is taken if there are any concerns. The staff were observed to be treating people with dignity and respect. Good relationships were apparent between the people living in the home and the staff on duty. The food is home cooked and people said they enjoyed the meals that were served to them. Choice is always available. Visitors are welcome at any time and encouraged to take part in any events that are taking place. The atmosphere in the home is relaxed and friendly. A good selection of activities are offered in both groups and on an individual basis. The staff are constantly looking for new activities to introduce to the home and support people to visit facilities in the local community. What has improved since the last inspection? At the last inspection it was suggested that the main lounge area should be made into separate units in order to provide a calmer environment and to meet people`s individual needs. This has now been carried out so two separate lounges and dining areas have been created. What the care home could do better: The management must ensure that there are sufficient staff available at all times to meet people`s needs and help to protect their health and safety. The carpets in one corridor should be clean to ensure the area is free from offensive odours. Key inspection report Care homes for older people Name: Address: Durban House Hodgsons Road Blyth Northumberland NE24 1PN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Anne Brown     Date: 2 4 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Durban House Hodgsons Road Blyth Northumberland NE24 1PN 01670354181 01670362236 durbanhouse@schealthcare.co.uk www.schealthcare.co.uk Exceler Healthcare Services Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Dementia Code DE, maximum number of places: 45 Date of last inspection Brief description of the care home Durban House is a two-storey building of traditional brick and tiled roof construction. It has a car park to the front of the building, which allows level access to the main entrance. The home is situated in a predominantly residential area with easy access to the centre of Blyth town with its shops and other public amenities. It is also on a main bus route being only about one mile from the main bus terminal. The home is registered to provide care to a maximum of forty-five people with a dementia who Care Homes for Older People Page 4 of 24 Over 65 0 45 0 9 1 0 2 0 0 8 Brief description of the care home have nursing and social care needs. The home provides information about the service through the service user guide and a copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit we looked at:Information we have received since the last key inspection on 3oth August 2008. Care Homes for Older People Page 6 of 24 How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives. Surveys returned by two members of staff. An unannounced visit was made on 24th March 2010. During the visit we:Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the manager what we found. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given good information about the home and assessments are carried out prior to them moving in. This helps ensure the home can meet their individual needs. Evidence: The homes statement of purpose and a guide for service users were openly displayed in the foyer. They contained good information and about the home and the services offered. These documents were also placed in each bedroom. The care records of four people living in the home showed that assessments had been completed about each persons needs prior to them moving into the home. These assessments included mental health, social, nutrition, continence, moving and handling, falls, oral health etc. People are able to spend time in the home to help them decide if their needs can be met, prior to moving in on a permament basis. One person had been receiving respite care in the home and has now moved in permamently. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported by the staff and there are good arrangements in place to help ensure the health needs of the people living in the home are met. Evidence: Four service users care records were looked at. Risk assessments are carried out and regularly reviewed to determine the risk of falls, pressure ulcers, oral health, continence, malnutrition etc. The information from these assessments was used to draw up comprehensive care plans. One case record contained information from a specialist team on how to deal with challenging behaviour. The staff had been asked to keep a record of any episodes which took place to help improve the care provided. The staff on duty were respecting peopleis dignity and dealing with their needs in a caring and sensitive manner. The medication records were up to date and appropriately signed. Medications are administered by qualified nurses and the system is audited by the manager on a regular basis. Care Homes for Older People Page 11 of 24 Evidence: Two files did not include information on end of life preferences. The manager was aware that more work needs to be carried out to gain this information. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are provided with a wide range of activities and a good choice of food. Evidence: Social assessments are developed which give a history of each persons life and their likes and dislikes. A social care facilitator is employed for 30 hours per week and an activities programme is produced each month. Staff are also responsible for arranging some of the activities. Activities include arts, crafts, carpet bowls, flower arranging, darts, pool, reading club, manicures, gardening, baking etc. The staff said the people living in the home could choose what activities they took part in. If people are unable to take part in group activities they are offered one to one activities which are more suitable to their needs. The staff also arrange birthday parties, themed evenings, pie and pea suppers etc. Care Homes for Older People Page 13 of 24 Evidence: People are also supported to visit local shops, cafes etc. The home has a mini bus and regular outings are offered to local places of interest. Entertainers are booked to perform in the home on a regular basis. Family and friends are encouraged to join in any events which take place. They can visit at any time and people living in the home can see their visitors in private if they wish. The people living in the home were choosing whether they wanted to join in the activities taking place and where to spend their time. Each person living in the home has their nutritional needs assessed and this information is fed into the menu planning with the chef. Lunch was being served during the inspection. A choice of two main meals are always available. Alternatives can also be requested and these are displayed in the dining room. Finger food is also made available for those people who need this option. The atmosphere was relaxed and unhurried and staff were meeting peoples needs in a sensitive manner. The chef visits each dining room during mealtimes so he can observe what people have enjoyed. Drinks are available throughout the day and night. The tea trolley offers a variety of drinks and snacks. People who were able to comment said they enjoyed the food served to them. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected from abuse and there is an effective complaints procedure in place. Evidence: The complaints procedure was displayed in the home. It is also referred to in the service user guide which is available in each bedroom. A complaints book is maintained to record any complaints received and the outcome of the investigation. Six complaints had been received since the last key inspection. These had all been investigated and satisfactorily resolved. The manager also records any concerns that are raised so this information can be used in the quality assurance system. Complaints are analysed on a monthly basis and a report is sent to the companys headquarters so it can be monitored. The manager is aware of the need to report any safeguarding issues to the local authority so appropriate action can be taken. Staff are given training on safeguarding vulnerable adults. The staff on duty were aware of the procedure to follow if they observed any bad practice in the home. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a comfortable and hygienic place to live and specialist equipment is provided to meet their needs. Evidence: Access into the home is good and meets the needs of the people living there. Specialist facilities are provided e.g. bathing facilities, handrails etc. A recommendation was made at the last key inspection to separate the communal areas and give a more structured space for people to spend their time. This has been carried out and there are now two lounges an dining rooms. There is a redecoration programme in place and when rooms become vacant they are redecorated. The person occupying the room is consulted with regard to the colour scheme. A handyman is employed to carry out routine repairs and maintenance. The communal areas are decorated with pictures and activity boards which can be touched and have different textures and items to stimulate and add interest to the environment. Care Homes for Older People Page 16 of 24 Evidence: Each person living in the home has their own bedroom. People are encouraged to bring personal belongings and to individualise their rooms with small items of their own furniture. There was an unpleasant smell in one corridor and the commode in one bedroom was rusty. The manager said these issues would be addressed as soon as possible. Apart from the above issues all other areas were comfortable, pleasantly decorated, clean and fresh. There are pleasant gardens which are accessible to the people living in the home. Garden furniture and planters are available. In the summer months some people enjoy planting flowers etc. Staff have completed training to help prevent the spread of infection and protective clothing was readily available. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust recruitment policy and procedure in place to help protect people living in the home. The staff are competent, skilled and committed to meeting individual needs. Evidence: On the day of the inspection the following staff were on duty:Manager Qualified Nurse Four Senior Care Assistants Two Care Assistants Three Domestic Assistants Chef Kitchen Assistant Social Care Facilitator Administrator Twenty nine people live in the home at the present time. Four staff files were examined. Criminal Records Bureau (CRB) checks had been carried out and two written references obtained before staff are employed in the home. This helps to protect the people living in the home. The kitchen staff, domestic assistants and maintenance person have achieved an National Vocational Qualification (NVQ). There is a programme in place to ensure all care staff achieve NVQ Level 2. There are nineteen care staff employed in the home and fifty three percent have completed this Care Homes for Older People Page 18 of 24 Evidence: training. There are programmes in place to ensure mandatory health and safety training is kept up to date and a training matrix is maintained. Specialist training is provided to meet the individual health needs of the people living in the home, e.g. tissue viability, diabetes etc. The company has its own training package for caring for people with dementia known as Tomorrow is another day. One member of staff has been identified to complete the three day training course which will then be cascaded to the rest of the staff team. The staff on duty said they received good training and this is discussed with them at their formal supervision sessions. The written records confirmed this. Three members of staff were on duty in each lounge. It was noted that there were times when one care assistant was left in one of the lounges as staff were attending to people in other parts of the building. It was difficult for this carer to attend to peoples needs and actively supervision another person who displays behaviour which is challenging. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is very well run and managed for their benefit and health and safety is promoted. Evidence: A new manager has been appointed in the home since the last inspection. She has experience in managing care homes and is committed to providing good care to the people living there and putting their needs first. She promotes an ethos amongst the staff and people living in the home of involving them in the decision making process. The staff on duty confirmed that she is very approachable, supportive and listens to any suggestions they may have. Regular meetings are held in the home and minutes are recorded. A residents/relatives meeting had been arranged for the following day. Activities, meals, care standards etc. are discussed to help ensure the home is run in the best interests of those who live there. Care Homes for Older People Page 20 of 24 Evidence: A newsletter is produced each month to inform people of events that are arranged and any other issues. Good relationships were observed between the manager, staff on duty and people living in the home. There is a quality assurance system in operation and regular audits of the systems are carried out. Surveys are given to people living in the home and their relatives/representatives. This information is collated and used to make any necessary improvements. The administrator deals with personal allowances held on behalf of the people living in the home. The records held showed the dates money was deposited or withdrawn/spent and what it had been used for. Receipts and appropriate signatures are maintained. Up to date evidence was in place of maintenance/safety checks on the fire systems, lift, gas system and moving and handling equipment. A programme is in place to ensure formal staff supervision sessions are carried out. The staff on duty confirmed that they receive regular supervision. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 12 There must be sufficient 31/05/2010 staff on duty in each lounge to supervise and care for the people living in the home. This will help ensure peoples health and safety. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 11 26 Ensure information is kept on end of life preferences for the people living in the home. Ensure the unpleasant odour is eliminated from one corridor in the home so people are provided with a fresh smelling environment. Ensure the rusty commode is replaced in the interests of hygiene. 3 26 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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