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Inspection on 27/05/10 for Pavilion Court

Also see our care home review for Pavilion Court for more information

This is the latest available inspection report for this service, carried out on 27th May 2010.

CQC found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Good assessments are carried out before anyone is offered a place in the home. This makes sure that their care can be properly planned and that they can be confident that their needs will be met. The assessment includes, where applicable, information from health professionals involved in the care of the person. Each person living in the home has a care plan which included a range of assessments used to identify peoples health and personal care needs and risks associated with the individuals vulnerability. Care plans were recorded to a good standard and matched with assessed needs. They were often sensitively recorded and indicated peoples preferences, though preference for gender of carer to assist with personal care was not always included. The plans were regularly evaluated and there is a plan in place for this to be developed further to include greater detail to show whether they were working towards achieving the stated goals and aims. Day and night staff maintain ongoing daily reports on each person and supplementary records such personal hygiene charts, body mapping of skin integrity and observation records were well completed. Charts relating to assistance with toileting to meet continence needs were not being consistently recorded and monitored to establish patterns. Care plans were in place for physical and mental health care needs and incorporated advice from health professionals. Professional visitor records showed people receive visits from general practitioners, district nurses, chiropodist, dentist, phlebotomist etc. Nutritional needs were monitored through assessment and care planning, recording food and fluid intake, and regular weighing. People are referred to dietitians if they experience weight loss or poor appetite and some people were prescribed nutritional supplements. Catering staff are notified of individual persons dietary needs and preferences. Special diets, extra calorific snacks and milkshakes are offered between meals and the cook routinely fortifies food. People living at the home spoke positively about the care and medical support they receive. They told us that staff are attentive, kind and friendly and said they are treated with respect. Staff spoken to were knowledgeable about individuals and their needs. Medication is administered by trained staff. Medication records have a front sheet profile with a photograph of the person and details of medical history and allergies. Handwrittendirections for prescribed medication were clearly recorded. The records examined were appropriately signed to verify that medication was given. Social profiles were recorded and people have care plans to address their social needs. Charts are recorded to show the activities that each person has participated in. A minibus that is shared between other care homes in the region was used to take people on regular outings. On the day of the inspection some service users went on a trip to Morpeth Park and the previous week there had been a trip to Beamish. Residents spoken to described the pleasure they had from the outings. One persons records examined had evidence of a mental capacity assessment being carried out and a care plan to address restrictions relating to deprivation of liberty. The home was comfortable and attractively decorated and furnished. The reception has been enhanced by creating a cafe, shop with tables and chairs and this area was well used by visitors and service users. People living at the home told us they were happy with their accommodation. One service user commented that she enjoys watching the sports that are played on the pavilion from her bedroom. There is a good process for recruitment and selection of new staff to the home. This is being followed by the Manager and the records show that she is being careful about selecting new staff to make sure that they will be suitable for the home. Staff records show that they receive training to give them the skills they need to carry out their role. There is a training matrix which is used by the manager to make sure that she can plan appropriate training for the staff in both health and safety and clinical areas. The number of staff who have received dementia training is low, however a senior member of staff has completed a `train the trainer` dementia course and is qualified to deliver this training to the staff team, this is being planned. The home Manager has been in post since November 2009 she was appointed to the home at a time when there were some issues around the quality of the service being offered. The Manager, Regional Manager and the staff have worked hard to make the necessary improvements and the quality of the care being provided ensures that the outcomes for people living in the home are good. The manager is in the process of applying to the Commission to be approved as the Registered Manager.

What the care home could do better:

On the day one inspector dined with people some of the residents. Menus were not displayed. The meal was steak pie, potato and vegetables or kedgeree, followed by fruit salad and cream. Tables were nicely set though the availability of condiments was variable. However, there was a significant delay in the food arriving and people became restless. Food was served from a hot trolley and the meals, including soft diets, were of good portion size and presented well. Staff offered choice to each person but did not show people the meals to help them decide until instructed to do so by a senior carer. Hot and cold drinks were provided and people were offered second helpings of food. One staff member sat with a service user and helped her with eating the meal. Some peopledid not receive sufficient support to cut up and manage food and assistance was not offered to use condiments. It was also noted that some people might benefit from having aids to help prevent food spillage and preserve their dignity. There were some discrepancies to the codes used for reasons why medication was not given and directions for one service users `as required` medication needed to be clarified. One service user was occasionally having a medication omitted due to being asleep and the manager agreed to follow this up. There was an odour of urine on entering one of the units and this was related to service users needing improved assistance with toileting to meet their continence needs. This was discussed with the Manager and a plan is in place to address this.

Random inspection report Care homes for older people Name: Address: Pavilion Court Brieryside Cowgate Newcastle Upon Tyne NE5 3AB one star adequate service 24/11/2009 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: Suzanne McKean Date: Information about the care home Name of care home: Address: Pavilion Court Brieryside Cowgate Newcastle Upon Tyne NE5 3AB 01912867653 01912865794 pavilioncourt@cshealthcare.co.uk www.southerncrosshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross BC OpCo Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 75 Number of places (if applicable): Under 65 Over 65 0 75 dementia old age, not falling within any other category Conditions of registration: 75 0 The maximum number of service users who can be accommodated is: 75 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 - maximum number of places 75 Dementia Code DE, maximum number of places 75 Date of last inspection 2 8 0 1 2 0 1 0 Care Homes for Older People Page 2 of 9 Brief description of the care home Pavilion Court is a 75-bedded care home situated in the Cowgate residential area of Newcastle. The home opened in August 2005 and provides residential and nursing care to older people over two floors, including those with dementia care needs. All bedrooms are single and have en-suite facilities. There is a range of communal space including seven dining rooms and lounge areas. The home is attractively decorated and furnished. A range of aids and equipment has been provided. People who use wheelchairs can access all areas of the home. Off road parking is available and the home is close to local bus routes. Fees for the home vary. Further information about fees can be found in the homes statement of purpose and service user guide. A copy of the last inspection report has been appended to the service user guide a copy of which is available in the main reception area. Care Homes for Older People Page 3 of 9 What we found: An unannounced visit was carried out by two regulatory inspectors 27th May 2010, the visit was started at 9.30 and was completed by 16.00. During the visit we looked around the home, spoke to the residents and their visitors and spoke to the manager. We also looked at some of the records being kept including care plans and the Quality Assurance records. The requirements made at the last inspection on and none were identified as a result of this visit. What the care home does well: Good assessments are carried out before anyone is offered a place in the home. This makes sure that their care can be properly planned and that they can be confident that their needs will be met. The assessment includes, where applicable, information from health professionals involved in the care of the person. Each person living in the home has a care plan which included a range of assessments used to identify peoples health and personal care needs and risks associated with the individuals vulnerability. Care plans were recorded to a good standard and matched with assessed needs. They were often sensitively recorded and indicated peoples preferences, though preference for gender of carer to assist with personal care was not always included. The plans were regularly evaluated and there is a plan in place for this to be developed further to include greater detail to show whether they were working towards achieving the stated goals and aims. Day and night staff maintain ongoing daily reports on each person and supplementary records such personal hygiene charts, body mapping of skin integrity and observation records were well completed. Charts relating to assistance with toileting to meet continence needs were not being consistently recorded and monitored to establish patterns. Care plans were in place for physical and mental health care needs and incorporated advice from health professionals. Professional visitor records showed people receive visits from general practitioners, district nurses, chiropodist, dentist, phlebotomist etc. Nutritional needs were monitored through assessment and care planning, recording food and fluid intake, and regular weighing. People are referred to dietitians if they experience weight loss or poor appetite and some people were prescribed nutritional supplements. Catering staff are notified of individual persons dietary needs and preferences. Special diets, extra calorific snacks and milkshakes are offered between meals and the cook routinely fortifies food. People living at the home spoke positively about the care and medical support they receive. They told us that staff are attentive, kind and friendly and said they are treated with respect. Staff spoken to were knowledgeable about individuals and their needs. Medication is administered by trained staff. Medication records have a front sheet profile with a photograph of the person and details of medical history and allergies. Handwritten Care Homes for Older People Page 4 of 9 directions for prescribed medication were clearly recorded. The records examined were appropriately signed to verify that medication was given. Social profiles were recorded and people have care plans to address their social needs. Charts are recorded to show the activities that each person has participated in. A minibus that is shared between other care homes in the region was used to take people on regular outings. On the day of the inspection some service users went on a trip to Morpeth Park and the previous week there had been a trip to Beamish. Residents spoken to described the pleasure they had from the outings. One persons records examined had evidence of a mental capacity assessment being carried out and a care plan to address restrictions relating to deprivation of liberty. The home was comfortable and attractively decorated and furnished. The reception has been enhanced by creating a cafe, shop with tables and chairs and this area was well used by visitors and service users. People living at the home told us they were happy with their accommodation. One service user commented that she enjoys watching the sports that are played on the pavilion from her bedroom. There is a good process for recruitment and selection of new staff to the home. This is being followed by the Manager and the records show that she is being careful about selecting new staff to make sure that they will be suitable for the home. Staff records show that they receive training to give them the skills they need to carry out their role. There is a training matrix which is used by the manager to make sure that she can plan appropriate training for the staff in both health and safety and clinical areas. The number of staff who have received dementia training is low, however a senior member of staff has completed a train the trainer dementia course and is qualified to deliver this training to the staff team, this is being planned. The home Manager has been in post since November 2009 she was appointed to the home at a time when there were some issues around the quality of the service being offered. The Manager, Regional Manager and the staff have worked hard to make the necessary improvements and the quality of the care being provided ensures that the outcomes for people living in the home are good. The manager is in the process of applying to the Commission to be approved as the Registered Manager. What they could do better: On the day one inspector dined with people some of the residents. Menus were not displayed. The meal was steak pie, potato and vegetables or kedgeree, followed by fruit salad and cream. Tables were nicely set though the availability of condiments was variable. However, there was a significant delay in the food arriving and people became restless. Food was served from a hot trolley and the meals, including soft diets, were of good portion size and presented well. Staff offered choice to each person but did not show people the meals to help them decide until instructed to do so by a senior carer. Hot and cold drinks were provided and people were offered second helpings of food. One staff member sat with a service user and helped her with eating the meal. Some people Care Homes for Older People Page 5 of 9 did not receive sufficient support to cut up and manage food and assistance was not offered to use condiments. It was also noted that some people might benefit from having aids to help prevent food spillage and preserve their dignity. There were some discrepancies to the codes used for reasons why medication was not given and directions for one service users as required medication needed to be clarified. One service user was occasionally having a medication omitted due to being asleep and the manager agreed to follow this up. There was an odour of urine on entering one of the units and this was related to service users needing improved assistance with toileting to meet their continence needs. This was discussed with the Manager and a plan is in place to address this. 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 6 of 9 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 7 of 9 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 1 9 The recording of administration of medicines could be improved, to include the reason for when omissions have occurred this and how this is being managed. The organisation of mealtimes on the ground floor should be reviewed to ensure that people have a positive experience. 2 15 Care Homes for Older People Page 8 of 9 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. 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