Inspection on 19/02/08 for Palm Nursing Home

This is the latest available inspection report for this service, carried out on 19th February 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Palm Nursing Home 17/02/06

Palm Nursing Home 09/05/05

Palm Nursing Home 20/01/05

Palm Nursing Home 22/09/04

Palm Nursing Home 17/03/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Palm Nursing Home 79 Glengall Road Woodford Green Essex IG8 0DP Lead Inspector Janet Pitt Unannounced Inspection 19th February 2008 11:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palm Nursing Home Address 79 Glengall Road Woodford Green Essex IG8 0DP Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 505 4577 0208 504 0747 palmnursing@btconnect.com Palm Nursing Home Ltd Mrs Marie Lilette Ebrahimkhan Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (20), Terminally ill (20) of places Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th August 2006 Brief Description of the Service: Palm Nursing Home is a privately owned care home with nursing for up to twenty residents. It is registered to provide nursing and personal care and accommodation for both younger adults (18 to 65 years) and older people (65). The property is an adapted detached house, situated in a residential area of South Woodford, in the London Borough of Redbridge. The home is approximately 1/2 mile from shops, public transport and other community facilities. Accommodation is provided on 3 storeys, with lift access to all floors. Bedrooms include single and double rooms. Several of the single rooms have ensuite showers and toilets. One of the proprietors, Mrs Ebrahimkhan is also the registered manager. On the day of the inspection the fees for the home were between £450.00 and £800.00 per week. A copy of the Statement of Purpose and Service User Guide is made available to both the resident and the family. A copy of the most recent inspection report is available on request. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. One inspector undertook this unannounced inspection. The home had provided an Annual Quality Assurance Assessment (AQAA); information from this document is included in the report. A site visit was undertaken which lasted six hours. Observations were made of staff interaction with people who live in the home and a mealtime. Staff files relating to training and recruitment were examined. Care plans and medications records were examined. The inspector spent time talking with the owner and two members of staff. Three people who live in the home were spoken with during the site visit. A tour of the premises was undertaken. What the service does well: What has improved since the last inspection? Requirements relating to medications have been met. There has been significant improvement in activities provided and the environment, which the owner aims to continue. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have their needs assessed prior to moving into the home. The assessments detail what needs they have and are individual to the person. The assessments are routinely reviewed and any changes in need are noted and actioned. EVIDENCE: People who live in the home are assessed prior to and on admission. Examination of the care records showed that comprehensive assessments are in place. There was information on preferred routines and a person’s normal daily activities. Details of the person’s medical history were also present. Information on same gender care was available. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 9 Assessments undertaken on admission to the home are routinely reviewed to make sure that changing needs are addressed and recorded. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in the home can be confident that their medications are handled and administered safely. Care plans lead from the assessments of the individual. Care must be taken to make sure that all risk assessments clearly detail why actions have been taken. Work is continuing on making care plans person centred and detailing their wishes on End of life Care and relationships. EVIDENCE: One questionnaire received by the home said: ‘On each visit made [the person] always had very nice things to say about the staff. [They] always looked clean, warm and comfortable. Thank you very much for all your care.’ Each person has an individual care plan that leads from assessments. Each plan has a clear index detailing dates for evaluating the plan. There was good Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 11 information on how health needs are to be met and includes details of personal preferences. Risk assessments relating to issues like skin integrity and manual handling contained good information on the person’s condition. However, it was noted that some people had bed rails in place and there were no clear indications of why the rails were in use. It is necessary to make sure that there are clear reasons why bed rails are use; to make sure that peoples rights are protected. Information on social history and interests could include more information to enable staff to gain more knowledge on the person. For example one person who lived in the home had had a career in acting, but there were no specific details of work they had done. The owner reported that she plans to address ‘sexuality’ for people who use the service. She plans to do this by accessing appropriate courses for staff and developing individuals care plans accordingly The AQAA indicates that future work is needed on End of Life Care. People’s care plans will be developed to detail people’s wishes. Staff have attended palliative care training to make sure that they are aware of how to address this sensitive issue. People can be confident that medications are handled appropriately in the home and they are safe from harm. Examination of polices and procedures relating to medication have been updated to ensure compliance with good practice guidelines. Records of administration were found to be completed fully and contained details of known allergies. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People are able to choose how they spent their day. Links with family and friends are supported and maintained. Activities are starting to reflect the individuals’ preferences. Mealtimes are a relaxed sociable occasion and supported is given discreetly and only when necessary. EVIDENCE: The homes AQAA indicated that the home is able to access Local Authority transport to facilitate personal or group activities. The AQAA also acknowledges the need to continue to improve activities offered within the home. People’s plans indicated their choice of activity, such as television programmes and newspapers. One person was looking forward to watching a football match on the evening of the site visit. The owner reported that a physiotherapist visits weekly and an entertainer visits on Mondays. She also stated that there are plans to install a large white screen, in order that films can be shown, at the time of the site visit she was awaiting a public viewing licence. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 13 People are able to develop and maintained intimate relationships of they choice and their privacy is respected. It is recommended that training is given on sexuality to make sure that staff have an awareness of an individual’s holistic needs. Lunchtime was observed on the site visit. People had chosen to eat their meal from small tables, rather than use the dining table. Staff were seen to be attentive to peoples needs throughout the meal. Some people had jugs of water or cordial on their tables and hot drinks were served in mugs after the meal. The television was switched off during the meal. If a person needed assistance, staff made sure that they were seated to help the person. Appropriate crockery and cutlery was in use, however the majority of people had ‘bibs’ on. This was discussed with the owner and it is recommended that large linen or cloth napkins are use, to make sure peoples dignity is respected. Staff made sure that each person had had a sufficient amount to eat or drink prior to removing used plates. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in the home can be confident that any concerns they have will be heard and acted upon. Individuals are supported to participate in elections and their legal rights are protected, Staff are aware of Safeguarding Adults procedures and have received training on this. EVIDENCE: No concerns or complaints have been received by CSCI regarding this service at the time of the site visit. The home’s AQAA indicates that there is a complaints policy, which is accessible. At the site visit copies of the policy were seen. People have commented in surveys sent by the home that they have no concerns. The owner reported that each person is registered to vote via the postal system and there were photographs of visits made by local members of parliament. Staff are giving training on Safeguarding Adults when they commence employment, this was evidenced by examination of staff files. The owner reported that training had been booked for staff to learn about the Mental Capacity Act and its impact on the service provision. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Palm Lodge offers a homely environment to live in. There is a planned redecoration programme in place and people are encouraged to chose décor. The home is clean and tidy and maintained. EVIDENCE: The home has an ongoing redecoration and refurbishment programme. Areas that have been redecorated have been done to a good standard. The manager reported that the hall and stairways would be recarpeted soon. People who live in the home are able to personalise their rooms of they wish and there was evidence of personal photographs, small items of furniture and ornaments. The home has suitable communal areas for people to use. The main lounge has been divided into two areas. This enables socialisation. At the time of the Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 16 site visit there were no separate dining facilities. The manager reported that she has tried to encourage people to use a dining area set up in the conservatory, but people preferred to sit in the lounges and use small tables. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in the home are cared for by a trained, competent staff team. Recruitment procedures are satisfactory and protect individuals form harm. Staff are regularly supervised and encouraged to develop their skills. EVIDENCE: The home states in its AQAA that there is a good recruitment procedure in place; this was confirmed by examination of staff files. Appropriate checks had been carried out and references had been obtained. There was evidence in staff files of regular supervision and training. Training included wound care, nutrition and dysphasia and manual handling. There are plans for nursing staff to undertake assessor’s courses to enable them to facilitate student nurses. At the time of the site visit there were adequate numbers of staff available to meet the needs of people who live there. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. A proactive owner and staff team supports people who live in the home. Surveys are routinely sent out to gather people’s views on the service. People are enabled to manage their own finances when appropriate. There are no health and safety issues within the home. EVIDENCE: The owner who manages the home has many years experience in the care sector and is a qualified nurse. The other owner is also a nurse and qualified tutor. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 19 It was noted that some people are subject to guardianship orders, but the majority of people have assistance with managing their financial affairs form their next of kin. An annual survey is sent to stakeholders each year and information from these is acted upon when necessary. We found that information received at the last survey was positive about the running and organisation of the home. We did not find any issues with health and safety in the home. Routine checks are made on equipment in the home and records are maintained. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 13 (7) & (8) Requirement There must be a clear risk assessment in place of why bed rails are used. This assessment must be reviewed at least monthly in line with good practice guidance. This will make sure that people’s rights are protected and they are not restrained. Timescale for action 30/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP15 OP14 Good Practice Recommendations It is recommended that cloth or linen napkins are used at mealtimes; to make sure peoples dignity is respected. It is recommended that staff are given training ‘sexuality’, in order that they are aware of the holistic needs of people. Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Palm Nursing Home DS0000025958.V358919.R01.S.doc Version 5.2 Page 23 - 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. 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