Inspection on 21/07/09 for Daleside Nursing Home

This is the latest available inspection report for this service, carried out on 21st July 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Daleside Nursing Home 08/08/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Daleside Nursing Home 136-138 Bebington Road Rock Ferry Birkenhead Wirral CH42 4QB     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: Jeanette Fielding     Date: 2 1 0 7 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 25 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 25 Information about the care home Name of care home: Address: Daleside Nursing Home 136-138 Bebington Road Rock Ferry Birkenhead Wirral CH42 4QB 01516446773 01516646773FP debbieranken@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kate Armstrong-Shone,Margaret Armstrong care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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 categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 32 Date of last inspection Brief description of the care home Daleside nursing home is a three storey building situated in Rock Ferry, opposite Edgerton Park. The home provides accomodation in single or double bedrooms, some of which are provided with en-suite facilities. A lounge, a dining room and a conservatory are available on the ground floor, and a further lounge/quiet room is situated on the first floor. All floors are served by a lift. There is a car park at the front of the building and a secure garden to the side and rear. Daleside offers 24 hour registered general nurse care, and caters for a variety of nursing needs. The home benefits from being close to local shops and amenities, and is on a bus route. The fees Care Homes for Older People Page 4 of 25 0 Over 65 32 Brief description of the care home for the home are from 388.71 to 433.58 per week plus the assessed nursing fee. Care Homes for Older People Page 5 of 25 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: This unannounced key inspection was undertaken in one day over a period of seven and a half 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. The care files of five service users were case tracked to evaluate their care. Discussion took place with the registered manager, deputy manager, nurses, care staff, service users and visitors to the home. The manager completed an Annual Quality Assurance Assessment form prior to the inspection to give additional information regarding the home. Care Homes for Older People Page 6 of 25 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 7 of 25 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 8 of 25 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. Detailed information is available from the home about the services and facilities provided to enable prospective service users to make an informed decision regarding their care provider. Evidence: The home has produced a detailed statement of purpose and service user guide. These contain full information regarding the services and facilities provided by the home and are issued to all prospective service users and their families to enable them to make an informed decision regarding their care provider. The service user guide, statement of purpose and a copy of the contract are placed in each service users bedroom to provide them and their visitors with full access to information about the home. The brochure is displayed in the foyer together with pictures of the home, a copy of the menus and information on how to obtain a copy of the last key inspection report. Prospective service users and their relatives are encouraged to visit the home and to spend time with staff and other service users as well as giving them the Care Homes for Older People Page 9 of 25 Evidence: opportunity to view the home and the rooms available. Visits to the home also give the staff the opportunity to build on the initial assessment. All prospective service users are fully assessed prior to their admission. These assessments are undertaken by the deputy manager or one of the qualified nurses to establish the needs of the service user to confirm that the home can meet those needs. The preadmission assessments of service users recently admitted to the home were inspected and were found to be detailed and informative. Information is gathered from the service user, their family and healthcare professionals who have been involved in their care. A specific form is completed which includes information about health needs, abilities and social needs together with details about individual preferences. This information is used to prepare the initial plan of care which provides information for the staff team. Care Homes for Older People Page 10 of 25 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. Service users are provided with health and personal care in a way that shows respect for their privacy and dignity. Evidence: Individual care plans are prepared for each service user. These are prepared, initially based on the information gathered at the preadmission assessment, and then built on and updated as more information is gathered about the service user or as their care needs change. All care plans are reviewed on a monthly basis and whenever necessary. Regular audits of the care plans ensure that they are up to date at all times. Detailed information is recorded to inform staff of the care required and of more specific details about how that care is to be delivered. Information is also recorded regarding individual preferences such as preferred time of rising or going to bed, daily routines and likes and dislikes. Dietary preferences are recorded together with preferred gender of the person to provide personal care. Spiritual needs and preferences are recorded and any specific communication requirements. Detailed risk assessments are undertaken and comprehensive risk management plans are prepared to remove or reduce any potential risks. Moving and handling equipment, assisted Care Homes for Older People Page 11 of 25 Evidence: bathing aids and pressure relieving equipment are available in the home and are used following a detailed assessment of need. All staff have been given training in the use of equipment to ensure that service users are protected. Daily records are completed by the staff and provide evidence of the actual care provided. These records provide evidence that the healthcare needs of the service users are met. Specific charts are maintained where the needs of the service users identify these as necessary i.e. turning, fluid intake and dietary intake. Medications are administered to the service users by the qualified nurses. Service users may hold and administer their own medications subject to an assessment of ability and risk. Medications were seen to be dealt with in accordance with the homes policy and procedure. Medication administration record sheets were seen to be well maintained and up to date. Medications are securely held and all storage areas were clean and organised. Arrangements are in place for all unwanted medications to be disposed of safely and detailed records are held of medications entering or leaving the home. Specific forms are placed on the MAR sheets with regard to medications that are required on an as necessary basis. These are completed by the nurses and are reviewed and monitored by the deputy manager. Where these medications are required on a regular basis, the GP is requested to review the medications prescribed. Medications are audited on a regular basis and a record of the findings of the audit are held. Relatives spoken to during the inspection said that the care provided was very good and that the staff all knew what the needs of their relatives were. Observation of staff and service users at the time of the visit showed that staff spoke discreetly with service users when referring to personal care. Service users interacted with the staff and the staff were polite and professional at all times. The home provides a booklet to give bereaved relatives full information of the tasks to be undertaken and the people to contact. Names and addresses of relevant persons and offices are detailed. Care Homes for Older People Page 12 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The programme of activities shows that service users are given the opportunity to participate in stimulating and meaningful activities of their choice. Evidence: The home employs an activities co-ordinator for 24 hours each week. A planned programme of activities is displayed and service users may choose whether they participate or not. Group and individual activities are provided and a record of all activities is held. Photographs are displayed of recent social events and service users spoken to confirmed that they were free to participate, or not, as they wished and were given the opportunity to suggest additional activities. Relatives and friends are encourage to participate in the activities with their relative to further promote social interaction. A summer fair is planned for early August and service users spoken to said that they were looking forward to this event. Ministers visit the home each week and provide services for those who wish this. One service user attends a local Church. Trips out are arranged for service users who are able to enjoy these. The hairdresser visits the home and a designated hairdressing room has been provided for this purpose. A group of ladies were having their hair set on the day of the visit. Service users are encouraged to take their meals in the dining room to promote social Care Homes for Older People Page 13 of 25 Evidence: interaction but are free to take them in the lounge or in their own bedroom as they wish. A cooked breakfast is provided and the main meal of the day is served at lunchtime. A lighter meal is served in the evening and snacks and drinks are provided between meals and at supper time. A choice of meals is offered and special diets can be provided on the advice of the GP or dietitian or at the service users request. Dining tables are attractively laid and a selection of condiments and sauces are provided. The dining room is bright and decorated to a high standard to provide service users with a pleasant environment. Menus are displayed. The meals are prepared in the main kitchen and kitchen was seen to be clean and organised. Fresh goods are used in the preparation of meals as much as possible and a selection of fresh fruits were available for service users to choose from. The meal served on the day of the visit looked and smelled appetising. Service users spoken to said that the food was really good and one service user said that chef knew what she liked and made every effort to ensure that her meals were served as she liked them. Visitors are welcome at the home at any time and one relative said that she visited most days each week and was always treated in a kindly manner by the staff. Care Homes for Older People Page 14 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is good so people who live in the home are able to express their concerns and be listened to, their rights are protected and they are safeguarded from abuse. Evidence: The home has a robust complaints procedure which is displayed in the foyer. Information on how to make a complaint is also detailed in the service user guide which is placed in each of the bedrooms. A very low number of complaints have been made against the home and detailed records are held of the investigation and outcomes. Detailed risk assessments and risk management plans have been prepared to protect service users from potential harm or abuse. Service users spoken to on the day of the visit said that they had no concerns but would be comfortable speaking to the manager if there were any issues they wished to raise. One relative said that they were very happy with the home but would speak with the manager if there were any concerns. All staff have been given training in the protection of vulnerable adults and staff spoken to on the day of the visit were able to demonstrate that they were aware of the different types of abuse and of the action they would taken in the event of it being suspected. Records of training are held on the staffs individual files. Staff are required to be fully vetted before they commence work at the home to ensure that service users are protected. Staff are provided with information about the homes Care Homes for Older People Page 15 of 25 Evidence: whislteblowing policy to ensure that service users are protected at all times. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Continued investment in the home has resulted in service users being provided with a high quality, comfortable and safe environment. Evidence: The home has a planned programme of redecoration and refurbishment and work to improve the home continues. Since the last key inspection, some of the bedrooms have been redecorated and some fitted with new carpet. New furniture has been provided in communal areas and in bedrooms to provide service users with a high standard of environment. On the day of the visit, three bedrooms were having new carpet fitted. New carpets have been fitted in corridors and communal areas. Plans are in place to provide further bedrooms with en-suite facilities. Bathrooms have been refurbished and assisted bathing facilities have been provided to assist service users who have mobility difficulties. Profiling beds have been provided where it has been identified that these would be of benefit to the service users. New windows have been fitted to further enhance the home. All communal areas are decorated and furnished to a high standard and every effort has been made to ensure that service users have a pleasant and homely environment. Service users are encouraged to personalise their bedrooms with pictures, photographs and items of memorabilia. Bedrooms were seen to be bright and pleasant and personalised to reflect the wishes and lifestyles of the occupants. Plans are in place to replace the conservatory. Care Homes for Older People Page 17 of 25 Evidence: New linens, curtains and blinds have been provided throughout the home. A new nurse call system and fire alarm system have recently been installed and a new boiler for the central heating. At the rear of the home is a garden which is provided with ornate features, a patio and seating. The lawn is bordered by shrubs and trees and an array of colourful plants have been placed in pots. A new patio area has been developed at the side of the home with seating, flowerbeds and tubs with flowers in to give an alternative area where service users can spend their day. This patio is readily accessible from five of the bedrooms where patio doors provide easy access. All areas of the home were observed to be clean and fresh and there were no unpleasant odours. Infection control policies are in place and it is evident that staff follow procedures at all times. Laundry is attended to by designated laundry staff. The laundry provides two large washing machines and dryers and service users personal clothing was observed to be attended to carefully. Repairs and safety issues are addressed as soon as they are identified to ensure that service users and staff have a safe place in which to live and work. Care Homes for Older People Page 18 of 25 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. Service users are supported by a well trained, effective staff team who have gone through a thorough recruitment process, so that their needs are met and they are safe from possible harm or poor practice. Evidence: The home has a clear management structure with the owner registered as the manager. She is supported by a deputy manager, qualified nurses, senior care assistants, care assistants, domestic,catering, laundry and maintenance staff. All prospective staff are required to go through a robust recruitment process which requires an application form to be completed prior to interview. Two references are taken and checks are made with the Protection of Vulnerable Adults and Criminal Records Bureaux. A comprehensive induction training programme is followed and is recorded on their personnel file. Additional training is provided to further the staffs knowledge and understanding. The majority of staff hold or are working towards NVQ qualifications and domestic staff do an NVQ in hospitality. Three senior care assistants are working towards an NVQ in team leadership. Staff are provided with a contract, code of conduct, grievance policy, disciplinary policy and probation policy. Recent training events include infection control, fire safety, health and safety, moving and handling, first aid, food hygiene, personal care, protection of vulnerable adults, mental capacity act, catheter care, customer care, diabetes, continence, pressure area care, Care Homes for Older People Page 19 of 25 Evidence: nutrition, record keeping and communication. Training is provided each month and a training matrix is held to identify training undertaken or required. Staff files inspected were all found to be well maintained and up to date and certificates of training undertaken are held. Head of teams meetings are held each month and full staff meetings every three months. Supervision is given to staff every two months and annual appraisals are held. These meetings provide forums for staff to identify their training needs and care practices and to enable information to be disseminated. Care Homes for Older People Page 20 of 25 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 well managed to ensure that it is run in the best interest of the people who live there. Evidence: The owner of the home is also registered as manager. The manager and deputy manager work closely to improve the service and an open door policy provides opportunities for service users, relatives and staff to speak with them at any time. The home holds the Investors In People quality award. In addition, questionnaires are sent to service users and relatives and healthcare professionals to obtain their views about the home. The outcomes of these quality audits are detailed in the brochure. Regular meetings are held with service users and relatives on a one to one basis to provide them with the opportunity to discuss care and issues that they do not wish to discuss in open forum. The home does not hold any money on behalf of the service users and so relatives or Care Homes for Older People Page 21 of 25 Evidence: advocates take this responsibility. The home employs a maintenance person on a full time basis to attend to repairs and safety issues within the home. The home is maintained to a high standard. Tests and checks are made on the premises and all equipment within the home. Certificates of these tests are held in the home and those seen were found to be up to date. Tests are made on the fire detection equipment and recorded as required. All staff undertake updates on fire prevention training and of the action to be taken in the event of a fire. Regular fire drills are held and these are duly recorded. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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