Care Home: High Dene Residential Home

Similar services:

• Claremont House
• Oak Ridge
• Coopers Mill Ltd
• Sun Court Nursing Home
• Ashville House
• Bramley Avenue (73)
• Paradise Lodge
• Bilney Hall

What the care home does well During the inspection it was noted that people looked well groomed and clean. One person`s care plan that was viewed showed how the person preferred to dress and that care should be taken to ensure that the colour of their footwear matched with their clothing, which showed that people`s preferences were sought and acted upon. The service user survey asked what the home did well and comments included `all the staff are kind and very friendly, always ready for a laugh and a chat`, `staff always friendly and helpful, I am cared for in everyday issues` and `being small the home has a feeling of a family, the residents know all the carers by name and they feel at ease with them, there is time to sit a while and chat`. A comment made in a staff survey was `cares for everyone well, treat all individuals for their different needs, likes and dislikes, we know and learn about each individual`s history`. Comments made in the health professional surveys included `I think the residents at High Dene get well looked after and are always clean` and `it cares for the residents with dementia with the right amount of laughter, love, personal care, tact and persuasion`. What the care home could do better: Whilst it was positive to note that the staff were aware of the support that was required by one person due to their deteriorating condition, staff needed to also be aware of how their behaviours may be of detriment to others that lived at the home and the support that they may need. At the inspection the areas for improvement that had been noted in people`s care records had been identified by the home`s management and actions were being undertaken to ensure that they were addressed. Random inspection report Care homes for older people Name: Address: High Dene Residential Home 105 Park Road Lowestoft Suffolk NR32 4HU one star adequate service 29/07/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Julie Small Date: 1 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: High Dene Residential Home 105 Park Road Lowestoft Suffolk NR32 4HU 01502515907 01502515909 highdene105@wanadoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Subhir Sen Lochun Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 15 Number of places (if applicable): Under 65 Over 65 15 1 15 dementia learning disability old age, not falling within any other category Conditions of registration: 0 0 0 One Service user in the category of LD (E) as detailed in the application received on 20/02/07 may be accommodated at the home. Date of last inspection Brief description of the care home High Dene is registered to provide personal care for up to fifteen older persons, all of who may have dementia, and one who also has a learning disability. The home is in an adapted Victorian house with an extension to the rear of the building situated in a residential area of Lowestoft and on a local bus route. It is near to shops and other Care Homes for Older People Page 2 of 11 2 9 0 7 2 0 0 9 Brief description of the care home community facilities and within walking distance of the sea. Accommodation consists of eleven single and two shared bedrooms, all with wash hand basins and approximately half of them with en suite toilets. Residents accommodation is on the ground and first floors, with shaft lift access. There is one bathroom on the first floor that is suitable for residents. On the ground floor there is a main lounge, a lounge/dining room and seating in the entrance hall. The second floor consists of office and staff rooms. There is a secure garden at the back of the property available for residents use. At the last key inspection 29th July 2009 the Service User Guide stated that the fees ranged from £495 to £550 per week. Care Homes for Older People Page 3 of 11 What we found: The unannounced random inspection was undertaken by Regulation Inspector Julie Small Monday 17th May 2010 from 10:15 to 15:15. Prior to the inspection the Annual Quality Assurance Assessment (AQAA) was sent to the home and they returned it to us within the required timescales. Surveys were also sent to the home and six service user, four staff and three health professional surveys were returned to us. During the inspection we tracked the care of two people who lived at the home, which included viewing their care records, we made observations of the work practice and we spoke with two people that lived at the home and two staff members. We also spoke with the homes provider who gave us the requested information promptly and in an open manner. Prior to the inspection the provider had advised us that the registered manager had left the service and that the provider was planning to make a registered manager application with us. The provider was spoken with and they told us that they worked at the home for a minimum of thirty hours each week and that they were supported in the managerial duties by the deputy manager, who was also spoken with during the inspection. The random inspection was undertaken to meet with the Care Quality Commission (CQC) inspection methodology and we had also received a concern about the care that was provided at the home and we had been advised of safeguarding alerts that had been made to Suffolk County Council Adults Services, which had not been resolved at the time of the inspection. However, we were made aware by the provider that Suffolk County Council Adults Services had visited the home the week before this random inspection. A safeguarding alert had also been made by the provider regarding a persons well being who had been provided with support from a health care establishment. This showed that they were aware of the actions that they should take if there were concerns about peoples well being. The AQAA stated the staff have a good working knowledge and understanding of their role in dealing with complaints and their role in POVA (protection of vulnerable adults)/adult safeguarding and are aware they have to contact Suffolk County Council Adult Social Services which is the lead agency to deal with any matters of abuse, all staff had training and refresher course in POVA and the manager and deputy manager both had recent training on MCA (Mental Capacity Act) and DOLS (Deprivation of Liberty Safeguarding). All senior staff will be completing the same as places become available. The AQAA told us that there had been no complaints received in the last twelve months and stated all prospective residents and their families are informed of our complaints procedure at the enquiry stage and again at the point of admission if they choose to take residence at the home and we deal with any form of complaint promptly, however trivial it may seem to others. Six service user surveys said that they knew who to speak with informally if they were not happy and five said that they knew how to make a formal complaint and one said Care Homes for Older People Page 4 of 11 that they did not. Three health professional surveys said that concerns were appropriately responded to. Four staff surveys said that they knew what to do if a person had concerns about the home. A requirement was made at the last key inspection 29th July 2009 regarding the record keeping for controlled medication. During this inspection we viewed the controlled medication book, which showed that the requirement had been met to ensure that people were safeguarded by the homes procedures and processes for managing controlled medication. Upon arrival to the home we observed that the provider was undertaking an audit on the medication storage and records. They showed us the book in which they recorded the monthly audits and spot checks. They explained how they routinely checked that the storage, receipt, returns, records and administration of medication was appropriately undertaken to ensure that people were safeguarded by the homes medication processes and procedures. We asked the provider if there were any people in the home were administered with their medication in a covert manner. They told us that one person was provided with their medication with their food and that the practice was to ensure the persons well being. We tracked the persons care records and it was noted that there was documentary evidence that showed that the issue had been discussed and agreed with the homes pharmacist and the persons doctor and mental health consultant. We had received a concern prior to inspection regarding the lack of peoples personal toiletry items. We asked a staff member about how peoples personal toiletries were purchased. They told us that peoples relatives or representatives were expected to provide peoples toiletries, however, if a person did not have relatives or representatives then they could obtain them from a stock of toiletries that were kept in the home. We looked in three peoples bedrooms and it was noted that their personal toiletries were on shelves in their bedrooms. We asked a staff member how people were supported to bathe and they told us that people were regularly offered with the opportunity to use the bath and those who could not use the bath due to limited mobility were provided with bed baths. The staff member showed us a book, which provided information of the personal care that had been provided to individual people, such as bathing, having a hair wash, having a bed bath, a strip wash and the book also identified where people had refused support with personal care. They told us that the home used an Apollo bath chair and that they had recently received a product alert which said that they should be fitted with a seat belt. They told us that they were waiting for the seat belt to be fitted and that they used slip mats to ensure that people were supported to bathe in a safe manner. The provider told us that the home was fully staffed at the time of the inspection, however, they had recently appointed four senior carers, all had achieved an NVQ (National Vocational Qualification) level 3 and that they were waiting for the results of their CRB (Criminal Records Bureau) checks before they started working at the home. The provider told us that there were always three care staff that worked on the days shifts and two carers during the night. They told us that they had not needed to use agency cover for several months. During the morning of the inspection we noted that the numbers of staff working were three carers, the provider, the deputy manager, a domestic staff member and the cook. On the afternoon of the inspection there were three carers, the provider, the deputy manager and the homes handy person. A staff member Care Homes for Older People Page 5 of 11 told us that there were sufficient staff on duty. A person that lived at the home told us that the staff assisted them when they needed help. The AQAA stated we maintain a good ratio of staff to residents. Staff are supported daily by at least one on site supernumerary manager for most of the day. We make sure residents are always in safe hands at all times and there is a minimum of three care staff on the floor during the day and two waking staff during the night. Additionally, there are ancillary staff to cover cleaning and cooking duties daily. Six service user surveys said that staff were available when they needed them and that the staff always listened and acted on what they said. Three staff surveys said that there were usually enough staff to meet peoples individual needs and one said that there sometimes were. We observed that staff were attentive to peoples needs and that requests for assistance were promptly addressed. Interaction between staff and people was respectful and professional. However, we had sat in the dining area of the home for part of the inspection with four people and there were no staff present in the room, it was noted that there was a staff member present in the lounge area that was across the hall. We observed another person come in and out of the dining room and they displayed aggressive and intimidating behaviour to two of the people who had limited verbal communication, following the incidents the staff member who had been in the lounge assisted the person who had been aggressive into the lounge, offered them a drink and spoke with them in gentle and supportive manner. However, the other two people were offered no support. We spoke with a staff member and they explained that the person had displayed aggression due to a recent illness and how the staff were supportive to them. We explained that whilst it was positive that the person was being supported and that the staff were aware of their condition, they must be more vigilant to ensure that the other people in the home were safeguarded and supported. It was not clear if the absence of the staff was due to our presence, if the home was short staffed, if the staff were deployed elsewhere or if there was a lack of knowledge about the actions of the person to other people. After we had discussed the issue with the staff member, it was noted that the two people were reassured by staff and a staff member remained in the dining area. One staff member started playing connect four with one of the people, however, it was noted that they left after ten minutes and the person was sat with the half played game in front of them. Upon our arrival to the home we observed that people were listening and singing along to music by Jim Reeves in the lounge and a person was enjoying a visit from their relative in the dining area. Later in the day people were observed to play skittles in the lounge and it was noted that there was laughter from the people who were playing. A person played with a pack of cards and a person handled a bucket and shells in the dining area of the home. A staff member read a magazine with a person and a staff member talked to a person about their memories of their previous job. We viewed the activities book, which showed that activities that people had participated in included church services, listening to hymns and music, watching films, reminiscence, movement to music and playing games. A person that was spoken with told us that there was plenty to keep them occupied. A staff member told us that a person that we had observed in the communal areas had previously preferred to stay in their bedroom each day and with encouragement from the staff that worked at the home they had started to participate in activities with other people, which improved their social well being. This was confirmed by Care Homes for Older People Page 6 of 11 the persons care plan that was viewed. The service user survey asked if there were activities that they could participate in, two answered always, one answered usually and three answered sometimes. The staff survey asked how the home could improve and comments included trips out maybe and more events. The AQAA stated we have reorganised our activities and we are providing activities on a one to one basis more often that group activities, although we have collective activities as well. During the inspection lunch was a choice of chicken stew or cottage pie and fresh vegetables and a choice of sweets. The meal looked and smelled appetising. Two people told us that they were provided with their choice of meal and that they had enjoyed their meal. A staff member told us that people made their choices before lunch. The service user survey asked if they liked their meals that were provided at the home, two answered always and four answered usually. We tracked the care records of two people that lived in the home, which included their care plans and risk assessments. The care plans identified the support that people required to meet their assessed needs. We had identified some areas of improvement, for example where people needed support with their behaviour, this needed to provide more details to ensure that the staff were aware of the types of behaviours that they displayed and the methods of providing support and where needs assistance was used, this needed to be expanded upon to ensure that the staff were aware of the specific support that people needed and preferred. We discussed this with the provider and the deputy manager during the feedback of the inspection and we were shown care plans that were in the process of being updated and the issues that we had noted were already identified and were included in the new care plans. The deputy manager said that once they were all updated, they would be introduced into peoples care records and to the staff team. The AQAA stated all staff are knowledgeable about the needs and support required by individual service users and have a clear understanding of peoples individual needs and the details of the support and needs are clearly written in their care plan. These details are extracted from various sources including the service user and with their permission from their significant others. We include risk assessments in individual care plans and identify possible risk factors on peoples day to day living such as moving and handling, transfer from bed to chair, dietary risks, eating, risks of fall, nutritional risks and how to minimise or avoid them. The service user survey asked if they were provided with the care and support that they needed, three answered always and three answered usually. Six service user surveys said that they were always provided with the medical support that they needed. The health professional survey asked if peoples social and health care needs were properly monitored, reviewed and met, two answered always and one answered usually. Three surveys said that the service always sought advice and acted upon it to meet peoples social and health care needs and improve their well being. The staff survey asked they were provided with up to date information about peoples Care Homes for Older People Page 7 of 11 needs, three answered always and one answered usually. Four staff surveys said that the ways that they shared information about people that lived at the home between staff usually worked well. Some of the peoples care records were kept in their bedroom, such as the hourly checks and fluid and food charts. A staff member told us that they needed to update them in each persons room throughout the day and they told us that when they made hourly checks on people who were in the communal areas, this could be time consuming. We discussed this with the area manager and they told us that the methods of completing peoples daily records was under consideration to ensure that staff were appropriately deployed. What the care home does well: 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 set out on page 2. Care Homes for Older People Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 11 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, 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 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. Care Homes for Older People Page 11 of 11 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!