Care Home: Dyneley House

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What the care home does well The manager wrote in the AQAA: We have a good staffing structure with an effective supervision programme. Staff are suitable qualified and trained to a very high standard. We ensure staff are safe and suitable to work with vulnerable people. We provide excellent choice of food all home cooked. Visitors are welcomed at any time and refreshments and meals are offered. Residents are able to follow their own religion and have the right to meet clergy of their chosen denomination at any time. We have developed our own individual care plans, which provide very detailed information to staff on how to deliver care based on each individuals needs and choices. Key worker reviews are held on a monthly basis and give a very good account of how the care plan is still meeting the resident`s needs. We receive excellent support from our GP and District Nurses to help us ensure our residents health care needs are being met and only qualified staff administer medication. We have an excellent social activity programme and our own mini bus for outings. The home aims to provide its resident`s with a secure, relaxed, and homely environment in which their care, well being and comfort are prime importance." The home is well established with a stable and consistent workforce. People are able to spend their time in the way they want with the correct support from staff. Care documentation is very detailed and means that staff have all the information about how to look after people properly. Staff are well trained and knowledgeable about the people they care for. People settle quickly into the home as the admission process is very well managed over a period of time when people can visit and stay at the home to help them adjust to moving into care. People said: very content and settled "right from the start" "We are delighted with the home. The staff are friendly and welcoming and the whole ethos of the home is one of genuine caring." "Dyneley House is a home from home with qualified and caring staff." What has improved since the last inspection? The manager wrote in the AQAA: "We have developed our own separate social activity care plan. We have made improvements to our nutritional assessment and records. Several bedrooms have been refurbished and the lounge, dinning room and TV room have been redecorated and new curtains fitted. We have only one member of staff without an NVQ level 2 in care. 9 staff achieved Dementia Care level 2 training which has improved their knowledge and awareness when delivering care to the residents suffering from dementia ." The manager continues to develop the services and facilities at the home with the support of a stable workforce. What the care home could do better: The manager wrote in the AQAA: "We aim to have 100% of care staff NVQ level 2 qualified We plan to refurbish some more en-suite facilities." The manager is clear about how to continue to improve services. There are plans underway for the continued development of the care records to make sure staff have a consistently high level of information about people and about their care needs. Key inspection report Care homes for older people Name: Address: Dyneley House 10 Allerton Hill Leeds West Yorkshire LS7 3QB     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: Catherine Paling     Date: 0 8 1 2 2 0 0 9 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) 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 Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Dyneley House 10 Allerton Hill Leeds West Yorkshire LS7 3QB 01132681812 01132667356 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Greendown Trust Limited care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Dyneley House is owned by Greendown Trust and is a registered charity. The home provides care, without nursing, to 21 people of both sexes over the age of 65. It was originally set up to provide care and support specifically to members of the Christian Science Church, but now people of all faiths are welcome. The home is set in mature well-tended gardens, and is situated in a suburb of Leeds, close to local shops, and restaurants. There are 21 single bedrooms, all with an en-suite facility, and spacious communal space includes a lounge, dining room and 2 conservatories. There is a no smoking and no alcohol policy in the home. The current fees range from four hundred and ninety five pounds to five hundred and twenty five pounds. This information was provided at the December 2009 inspection. The home should be contacted directly for up to date information about charges. 0 Over 65 21 Care Homes for Older People Page 4 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 the people who use this service experience excellent quality outcomes. This was an unannounced visit by one inspector who was at the home from 10:00 until 16:45 on 8th December 2009. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who live there and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. A number of documents were looked at during the visit and all areas of the home used by the people who lived there were visited. A good proportion of time was spent talking with the people at the home as well as with the manager and the staff. Care Homes for Older People Page 5 of 24 An Annual Quality Assurance Assessment (AQAA) had been completed by the home before the visit to provide additional information. This is a self-assessment of the service provided. This was well completed and gave us all the information we asked for. Survey forms were sent out to the home before the inspection providing the opportunity for people at the home, visitors and health care professionals who visit to comment, if they wish. Information provided in this way may be shared with the provider but the source will not be identified. A small number of surveys were returned by the time of this visit. Comments received appear in the body of the report. The last visit to this service was 24th January 2007. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: The manager wrote in the AQAA: We aim to have 100 of care staff NVQ level 2 qualified Care Homes for Older People Page 7 of 24 We plan to refurbish some more en-suite facilities. The manager is clear about how to continue to improve services. There are plans underway for the continued development of the care records to make sure staff have a consistently high level of information about people and about their care needs. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission process is very good and whenever possible includes introductory visits and short stays. Peoples needs are properly assessed and met by well informed and knowledgeable staff. Evidence: The manager wrote in the AQAA, We ensure that all the residents have an accurate assessment of their needs before admission. We offer short stay visits to the home before the resident makes a decision to move in. We provide written information about the home and our facilities to all residents before admission. A trial period is always agreed. Staff spend time with new residents settling them in to their new surroundings. Everyone has their needs assessed before they are admitted to the home by the manager or other senior staff. People admitted to the home can therefore be sure that their needs can be met. Information we received in our surveys indicated that people Care Homes for Older People Page 10 of 24 Evidence: felt that they had enough information. The organisation also provides sheltered housing and people are able to move into the home from the sheltered housing complex as their care needs increase. The admission process is very well managed. We spoke with one person who had recently moved into the home permanently. People planning to move into the home are able to spend time there including overnight stays over a long period of time, as this person had done so. This meant when they did move in, they knew staff well and staff were also familiar with their care needs. They told us that they had been very settled and content right from the start. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans contain detailed information about care needs which means that staff have all the information they need to know how to look after people properly. People are treated with respect and are protected by safe medication procedures. Evidence: The manager wrote in the AQAA, We have developed our own individual care plans, which provide very detailed information to staff on how to deliver care based on each individuals needs and choices. Key worker reviews are held on a monthly basis and give a very good account of how the care plan is still meeting the residents needs. Residents, families and key workers all contribute to the monthly reviews. We receive excellent support from our GP and District Nurses to help us ensure our residents health care needs are being met. Staff induction and training is ongoing and of a very high standard only qualified staff administer medication. Risk assessments are in place for those residents that self administer medication. Staff record on the MAR sheet the amount, date and time the medication is handed over to the resident that self medicates. Completing the (CHESS) Care Home End of Life Support Services programme. This has improved staff confidence, awareness, knowledge and Care Homes for Older People Page 12 of 24 Evidence: understanding when delivering care to residents in their last stages of life. All residents now have an advanced care plan in place identifying their personal choices and preferences regarding their end of life care. We looked in detail at the care of a small number of people living at the home. The detail about care seen in the care plans covered every aspect of care. this means that care staff have access to all the information they need to understand how to care for someone. We saw clear records about health care and visits from other health care professional, including the General Practitioner(GP), district nurse, optician, dentist and chiropodist. We saw that a range of risk assessments were completed and reviewed for everyone for such things as the risk of falling and to help identify those at nutritional risk. We saw clear evidence of detailed monthly reviews being held between staff and everyone who lives at the home on an individual basis. These were informative and very good practice. Information in our surveys indicated that people felt that they got the care and support they needed, when they wanted it. Comments from health care professionals: Friendly, efficient, no problems The home has very good support from their GP who visits the home on a weekly basis and also provides an out of hours service. The district nursing service provides nursing support where this is needed and are currently supporting the home in caring for a highly dependant person. This persons care plan provided clear evidence of the good standard of care he is receiving and he looked comfortable and well cared for. Staff involved in the administration of medication complete training beforehand. We saw clear and up to date records of administration. Information in the homes own quality assurance survey told us that people and their relatives are very happy with the care at the home: I am especially delighted that X is part of the Dyneley family and has lost the constant look of anxiety that she used to show The residents all seem so happy and well-cared for. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make their own decisions about their lifestyle. Family and friends are welcomed at the home. People are provided with a varied diet taking into account personal preferences. Evidence: The manager wrote in the AQAA, We have an excellent activity programme that is enjoyed by all the residents. They are consulted regarding our activity programme and we have our own mini bus with a tail lift for outings. Staff make every effort to spend time with the more depended residents on a daily basis. We provide excellent home cooked food with a choice of meals at lunch and tea. Visitors are welcomed at any time and refreshments and meals are offered. Residents are consulted on a regular basis regarding the menus. Residents can eat their meals in their rooms if they wish. Residents are able to follow their own religion and have the right to meet clergy of their chosen denomination at any time. If required, a private room is made available for such meetings. People told us that they spend their time in the way they choose. One persons care plan told us that they were a late riser and this was evident on the day of the visit. Care Homes for Older People Page 14 of 24 Evidence: More able people go out as they want to and visitors are welcomed at the home. People said: I am always made welcome Kind staff and drinks are always available The manager told us that she and her staff were in the process of developing individual social records. We looked at a small number of these and saw that they provide a personal history of the individual as well as serving as a record of how people spend their time, for example there were pictures in one file of involvement in outings as well as in house activities. This is good practice. There is a whole range of interesting and unusual activities arranged at the home. For example, a visit was arranged from an organisation with exotic animals including snakes and other reptiles. People thoroughly enjoyed this as well as a visit from a donkey! Photographs of these and other activities are displayed in the entrance area. We spoke with the cook and found her very knowledgeable about individual likes and dislikes. The food looked and smelt appetising and people said that they enjoyed the food. People are supported in pursuing their religious beliefs with regular readings taking place at the home. One person told us that they were regularly taken to the local Church of England service by staff. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident in raising concerns on a day to day basis and have access to a formal complaints procedure. People are protected by staff knowledge and understanding of safeguarding. Evidence: The manager wrote in the AQAA, We have a robust complaints procedure and residents are confident that complaints will be taken seriously. We have robust procedures in place to protect residents from abuse and whistle blowing procedures to protect staff. We ensure that all staff are safe and suitable to work with vulnerable adults. All staff are suitably trained and can recognise the different forms of abuse. People told us and information in our surveys indicated that people are confident in raising concerns and found good and helpful responses when issues had been raised. Staff have had training around the safeguarding of vulnerable adults. there are also plans in place to cascade training to staff on the Mental Capacity Act 2005 and the deprivation of liberties. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, comfortable and well maintained environment. Evidence: The manager wrote in the AQAA, We have very comfortable single bedrooms all with en-suite facilities. All staff have received training on Infection Control and staff hand washing facilities are in place in every bedroom. We have a high standard of cleanliness throughout the home and there are no offensive odours. Improvements over the last twelve months, We have decorated the lounge, TV room and dinning room. We have made a small area in the lounge for the residents that enjoy reading we have a bookcase with a selection of books. All the residents beds except one have been replaced with new profiling beds. Several bed rooms have been redecorated and new furniture and curtains fitted. New lighting has been installed throughout the home. The home is comfortable and well maintained. Redecoration and refurbishment is ongoing with plans in place for the coming year to make sure that people continue to live in comfortable surroundings. All the staff have had training in the control of infection and we saw good practices in place. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well cared for by trained and competent staff. People are protected by safe recruitment procedures. Evidence: The manager wrote in the AQAA, We have robust recruitment procedures to ensure staff are safe and suitable to work with vulnerable people. Staff training is of high priority and a new staff induction programme is in place. We have a very low care staff turnover Improvement in the last twelve months, New staff induction programme in place which is over and above what is required We have increased staffing levels and we have only one member of staff not yet qualified All our night staff have been promoted to senior members of staff and they have received the appropriate training this ensure that there is always a senior member of staff on duty at all times. There is a clear commitment to staff training and this means that staff have the knowledge they need to look after people properly. We saw that there are enough staff to meet the needs of the people living at the home and staff are well supported by clear lines of responsibility and communication. A lot of the staff have been at the home for a number of years and this means that there is continuity and stability for the people who live there. Care Homes for Older People Page 18 of 24 Evidence: All but one member of the care staff has a National Vocational Qualification (NVQ) in care at either level 2 or 3. The final member of staff is registered to undertake the qualification. This is good practice and exceeds the national minimum standard of 50 . We looked at the recruitment file of a recently employed member of staff and saw that all the required checks were complete. 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. The home is very well managed and is run in the best interests of the people who live there. Evidence: The manager wrote in the AQAA, We have a good staffing structure in the home with four team leaders and one administrator all supporting myself as manager. I have worked at the home for 21 years and I have achieved NVQ level 4 in care and the Registered Mangers award. I Undertake continuous training and development to maintain and update my knowledge, skills and management competence I have an open and transparent management approach and communicate well with my team. We have an effective supervision programme and staff turnover is very low. We have clear records of all residents money and we are subject to an external annual audit and the administrator produces management accounts to a board of Trustees every month. The interests of all the residents are very important to me and my staff we pride ourselves on the services we provide. Care Homes for Older People Page 20 of 24 Evidence: The manager is well qualified and has managed the home for a number of years providing clear leadership and direction for staff as well as stability and continuity for the people who live there. The views of the people using the service are very important to the manager and her staff. A recent innovation is the introduction of a monthly rolling programme of seeking the views about different areas of the service they provide. Where issues arise an action plan is developed.This is in addition to the annual questionnaires sent out to relatives and visitors to the home. There is an administrator who provides support to the manager and is responsible for handling peoples personal allowances. The finances of the home are subject to external audit. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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