Random inspection report
Care homes for older people
Name: Address: Dove Court Nursing Home Albert Street Kettering Northants NN16 0EB two star good service 26/05/2009 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: Rajshree Mistry Date: 2 8 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Dove Court Nursing Home Albert Street Kettering Northants NN16 0EB 01536484411 01536484410 dove.court@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) care home 58 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 28 1 58 10 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 10 Dove Court Nursing Home is registered to provide personal care with nursing for male and female service users whose primary care needs fall within the following categories:- Old age, not falling within any other category (OP) 58 Physical disability over the age of 35 years (PD) 10 Physical disability over the age of 65 years (PD)(E) 10 Dementia over the age of 65 years (DE)(E) 28 No persons falling within the categories of PD or PD(EO are to be accommodated at Dove Court Nursing Home when there are 10 persons faling within these categories
Care Homes for Older People Page 2 of 11 residing at the home No persons falling within the category of Dementia DE(E) are to be accommodated at Dove Court Nursing Home when there are already 28 persons falling within this category residing at the home Persons with dementia should only be accommodated on the ground floor at Dove Court Nursing Home The maximum number of persons to be accommodated at Dove Court Nursing Home is 58 To accommodate the person named in application reference number V34452 under the category MD(E) Date of last inspection Brief description of the care home Dove Court Nursing Home is a large modern, purpose built home situated close to Kettering town centre. It is registered to provide both nursing and residential care. There is car parking to the front of the home. Accommodation is over two floors. Access to the upper floor is via a passenger lift. All the bedrooms are single with en-suite facilities and there are additional assisted bathing and toilet facilities. There are several lounges and dining areas and an enclosed garden and patio area, which is accessible to people who use wheelchairs. There is a qualified nurse on duty at all times. The Peripatetic Manager provided us with the range of fees, which are £355.00 to £650.00 per week. There are additional charges for personal expenditure such as hairdressing and personal toiletries. People considering using Dove Court Nursing Home should contact the Acting Manager or the home directly to discuss individual needs and requirements. Full details for Dove Court Nursing Home and any specific requirements can be obtained in the form of a Statement of Purpose and a Service User Guide. The latest inspection report from the Care Quality Commission is available at the home or accessible via our website: www.cqc.org.uk 2 6 0 5 2 0 0 9 Care Homes for Older People Page 3 of 11 What we found:
We as it appears in this Random Inspection Report refers to the Care Quality Commission (CQC). This Random Inspection of Dove Court Nursing Home took place to review the progress practice within the service following a number of concerns brought to our attention. These concerns related to health, safety and well-being of people who use the service and the management of the service. We were assisted by the Peripatetic Manager and the newly appointed Acting Manager during the site visit. Dove Court Nursing Home looks after people requiring support with their personal care needs and nursing care needs. The home is divided into four units and people are supported by a team of care and nursing staff. We found the home environment to be clean and tidy. Individual bedrooms were personalised to create a homely ambiance. Specialist equipment was provided where people have been assessed as requiring them. People were seen relaxing or resting in their room, sat in the lounge watching television, reading or receiving visitors. We spoke with several people who use the service requiring both personal care and nursing care. People said they felt they were well cared for and looked after by the registered nurses and the care staff. We looked at the care files for four people who live at the home, all having different health, nursing and personal care needs, which included a person diagnosed with dementia. We found the care files contained comprehensive assessments of care needs detailing individual history of their health, medication, reason for the admission, their physical needs, mental health needs and mobility. Individual preferences and daily life routines were known including family and professionals involved in their well-being. We found care plans were comprehensive, detailing the level of support and care required to meet their individual needs. We found assessments were carried out to ensure people were able to make important decisions about their life, which is part of the Mental Capacity Act to ensure peoples libertys and rights are promoted. We found daily records completed in full, reflecting the care provided and the persons well-being. We found care plans were reviewed regularly and care plans were updated as there were changes to individual needs. We observed the Acting Manager administer medication individually to people and in a sensitive manner. We found medication is prepared by the Pharmacist into blistered packs and stored in the medication trolley, which is stored securely. We checked the medication for three people against the medication records and found records were accurately completed. We spoke with care staff and the head of residential care with regards to administering medication. They told us that only registered nurses, trained manager and senior staff
Care Homes for Older People Page 4 of 11 are responsible for the administering medication. The Peripatetic Manager confirmed that a Pharmacist from the Primary Care Trust had visited and given advice with regards to specific management and administration of medication. This included the safe administering of medication for people who use a pegfeed and guidance detailed in the care plan for trained staff to follow. We found people who use the service have good access to health support such as the General Practitioner (GP), Chiropodist, District Nurse and Specialist Nurses. The care files we read contained record of visits and treatment given by health professionals such as the GP. The people we spoke with told us that they had seen the GP on several occasions when they were not well. This showed the service promptly seeks medical advice when required. We read the complaints folder and found Dove Court Nursing Home has received 6 complaints. Details of the investigations and actions taken are recorded. Five complaints have been investigated and concluded and 1 complaint in being investigated. The people we spoke with who use the service told us they were confident to complain directly to the staff or would tell their relatives. We found that residents and relatives meetings are held and the most recent meeting took place on 25th January 2010. This showed people who use the service and their relatives are informed about the changes within the home. The Peripatetic Manager told us they have provided the people who use the service and their family contact details for the home and the management: telephone number and email address to raise concerns; make a complaint or comment on the quality of the service. We spoke with four staff, which included a member of staff that was new in post and a member of staff that had been in post for over 10 years. We found that staff had attended training in safeguarding and confirmed this by checking the training records. Safeguarding means the protecting and promoting the well-being and safety of individuals from risk, harm and abuse. The staff demonstrated a good awareness of the types of abuse that could occur and their responsibility to report and record what they had witnessed or have been told. This showed staff were confident to recognise the various forms of abuse and protect people by following the procedures. We checked four staff files and found they all contained evidence that pre-employment checks were carried out. This includes the criminal records bureau (crb) checks and two satisfactory written references. The Peripatetic Manager confirmed that they are in the process of recruiting new care staff and registered nurses to stablise the staffing levels and reduce the use of agency staff. We looked at the training records and found staff recently had updates and refresher training in safeguarding adults, dementia awareness, moving and handling, infection control, health and safety, COSHHE and the Boots medication training for trained staff. We found displayed on the notice boards in the nurses station in each unit for staff, scheduled training events with dates. This indicated that training events are arranged and staff are made aware of them.
Care Homes for Older People Page 5 of 11 The Peripatetic Manager confirmed to us that over 50 of staff have attained the National Vocational Qualification (NVQ) level 2 and/or above. There are a number of staff who are in the process of completing NVQ 2 and NVQ 3; 2 staff are due to start NVQ 4; 2 staff are completing BSc Health and Social Work and 1 staff is completing BSc in International Nursing. We found staff have regular staff meetings, handover meetings at the start and end of each shift, supervisions and appraisals. The staff we spoke with told us they are kept informed about the well-being of the people who live at the home on a day-to-day basis. Staff said they receive information about changes that affects their work and training information and events. Staff said they have regular supervision meetings with the head of residential care and the deputy manager. We found staffing levels are maintained to meet the needs of the people who use the service. We found there are 2 registered nurses on duty in the day supported by care staff deployed in each of the units: nursing, dementia unit and residential unit. There is a registered nurse on duty at all times. The staff we spoke with told us staffing levels are sufficient and stable. Staff have clear areas of responsibilities and work in either the nursing units or the residential and dementia units. We found that there are monthly visits conducted by a representative of the Registered Person and reports produced from the visits. These monthly visits are known as Regulation 26 visits and are a legal requirement, demonstrating the internal management and monitoring of the service. We read the recent reports conducted, which showed the checks carried out and identified areas that required attention. We found that an Acting Manager has been appointed and has been in post for 3 weeks. We found that the Acting Manager has completed induction training and is working alongside the Peripatetic Manager to take responsibility for the management of the service. The Acting Manager confirmed that they are in the process of submitting an application to become the registered manager for the home. What the care home does well:
Dove Court Nursing Home is a large care home with nursing that cares for people with a range of personal care, health and nursing needs. Each unit has individual bedrooms with en-suite facilities and a communal lounge, dining room and bathing and toilet facilities. Dove Court Nursing Home has four units, specifically caring for people with nursing and complex needs, dementia and personal care needs. Each unit has a team of dedicated care staff and registered nurses who are managed by the Head of Residential Care and newly appointed Acting Manager. Dove Court Nursing Home has been managed by the Peripatetic Manager, until the new Acting Manager completes the induction programme. The people who live at Dove Court Nursing Home are supported and cared for by trained staff and each have a named key-worker. People receive individual care and are involved in developing the care plans, reflective of their wishes and preferences. The care plans are holistic and personalised to ensure individual routines and preferences continue
Care Homes for Older People Page 6 of 11 to be supported. There is good clear guidance for staff to follow and care plans and risk assessments are reviewed regularly to ensure changing care needs are met. Record keeping is good in relation to the health and well-being of the people who use the service. The monitoring records were completed for people showing the care needs met as per the care plans. These were the fluid monitoring sheets and turning charts for people who are nursed in bed to ensure pressure care management. This also includes the daily records reflecting the well-being of individuals, record of health support provided by health professionals and management and assessments of risks carried out to ensure safety of individuals. The management, administration, storage and recording of medication is maintained accurately. Dove Court Nursing Home seeks advice and guidance from health professionals such as Primary Care Trust, Pharmacist, specialist nurses and experts working with people with dementia. Dove Court Nursing Home have staff trained in dementia awareness to support the people who use the service. Staff have been more creative in engaging with people with dementia, using small musical instruments and singing, dressing up items such as hats, shopping trolley with packaging that people may wish to use. The head of residential care continues to be keen and enthusiastic in promoting a better quality of life for people with dementia. The management team and senior staff have promptly sought advice and guidance to ensure the rights and well-being of people is advocated, where there are concerns about the individuals ability to make decisions. They have demonstrated that procedures have been followed in line the Mental Capacity Act 2005 and the Deprivation of Libertys. Dove Court Nursing Home has an activity co-ordinator, who is responsible to organising a range of activities in the home, both in small groups and individually with people. The activities co-ordinator liaises with the activities co-ordinators in the sister homes within the group to develop new ideas to stimulate people, maintain social interaction and their well-being. The management team and senior staff have worked with organisations such as the local authority, the Primary Care Trust and ourselves when concerns have been raised. They have been open and transparent with the issues raised and has demonstrated the actions taken to address issues. The Peripatetic Manager told us that they have made people who use the service and their relatives, aware and encouraged them to complete the comment cards expressing their views and concerns about the service. People can post the comment cards in the post box, accessible by the manager only or contact the home via e-mail or text messages. This showed the service is being creative in using different means of communication open to people and are keen to receive comments about the quality of service. The staff team continue to maintain their knowledge and skills through regular training updates, team meetings and supervisions. There is good communication between staff and good record keeping to ensure the health, safety and well-being of the people who use the service.
Care Homes for Older People Page 7 of 11 The staff are deployed to ensure individual needs are met and have clear roles and responsibilities. There are good internal monitoring and auditing systems in place. This includes the monthly visits conducted by a representative of the Registered Person, health and safety checks and the audits and reviews carried out with individuals and their care plans. Some of the comments we received from people who use the service, visiting relatives and staff: The meals are better Dont have any complaints We had a residents meeting this week and they tell us whats happening and we can ask questions New manageress seems nice - shes only been here 3 weeks or so My son visits every evening and brings me a newspaper. I prefer to read and do puzzles or crosswords, keeps me mentally active although not physically Care has been very good here Theyve really managed my changing needs well and now Im just waiting for an assessment and hope to go home soon Cant fault the carers, staff and facilities If I had to choose a home now, I couldnt go elsewhere, Im happy and well cared for here The head of care and deputy have been really supportive and kept things going 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. 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 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!
