Inspection on 10/11/05 for Appleby Court

This inspection was carried out on 10th November 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Appleby Court 23/01/08

Appleby Court 12/03/07

Appleby Court 11/05/05

Appleby Court 02/11/04

Appleby Court 22/06/04

Appleby Court 23/03/04

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Chirnside House

Keer Sands Residential Home

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Ruskin Lodge

Bushell House

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Langrigg House

Parkside

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Appleby Court Ellesmere Road Pemberton Wigan Lancashire WN5 9LA Lead Inspector Bernard Tracey Announced Inspection 10th November 2005 10:00 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 Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Appleby Court Address Ellesmere Road Pemberton Wigan Lancashire WN5 9LA 01942 215000 01942 215000 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) Mr Keith Lowe Mrs Sheena Thompson Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80), Physical disability (4), Terminally ill over of places 65 years of age (4) Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the total numbers of registered 80 OP places, up to 40 places can be used for OP nursing and up to 40 places for OP non-nursing. Within the total of 80 registered places there can be up to 80 OP, up to 4 PD and up to 4 TI(E) places 11th May 2005 Date of last inspection Brief Description of the Service: Appleby Court is situated on the outskirts of Wigan town centre close to shops and other amenities and is on the main bus route. The home is purpose built and accommodation is on two floors with a passenger lift available from the lower floor. Personal accommodation is provided in single rooms with en suite facilities. There are large communal lounges and separate dining rooms. The home provides nursing and social care to male and female service users aged 65 years and over. There are ample car parking spaces and the grounds have been landscaped and are well maintained. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. The Inspector spent 4 hours at the home. During this time he looked at care records to ensure that health and care needs were met. He also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training and how the manager collected information about residents views. The Inspector spoke to numerous staff members, the manager, owner and four visitors. The Inspector spoke at length to five residents and more during the tour of the home. Comment cards were received from eleven residents and four visitors. One relative also wrote a very complimentary letter to the Inspector before the inspection. What the service does well: What has improved since the last inspection? The dining rooms on the ground floor have been decorated and provided with new furniture. Redecoration of the personal accommodation has started and the home intends to carry this on as rooms become vacant. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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 Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 does not apply to the home) The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of three residents were examined and were found to contain full assessment information that had been obtained prior to admission, therefore ensuring that the home could meet these needs. Residents and their relatives confirmed that they had been involved in their assessment and were happy that their needs were being met by the home. The staff spoken to were well aware of the care needs of the individual residents and this was confirmed during the inspection through observations of the care practices being carried out. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 10 11 There is a clear and detailed care planning system in place that provides the staff with the information needed to meet the needs of the residents Personal support is given in the home in a manner that promotes and protects privacy, dignity and independence of the residents. EVIDENCE: Individual records are kept for each resident and contain comprehensive information relating to all aspects of health, personal and social care needs of the residents. From this information an individual plan of care is drawn up with the involvement of the resident or their relative to ensure that the care needs are met. Significant events had been recorded and daily entries made setting out the care given. Residents spoken to confirmed that they were involved in all aspects of their care and that the staff were very good and anything they wanted they only had to ask for. A relative spoken to during the inspection also confirmed that Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 10 they were kept informed of anything that affected the care and that the staff were very supportive and caring. During the inspection the Inspector observed the caring approach of all the staff towards the residents. A discussion with the residents identified that they feel their privacy is respected and that they are treated with kindness. Of the 11 questionnaires received all stated that their privacy was respected. Relatives and friends are encouraged to visit as often as possible and the home operates an open visiting policy, which is referred to in the Statement of Purpose and confirmed in discussion with residents and relatives spoken with during the inspection. Staff spoken to gave examples of how privacy and dignity were promoted. They also gave good practice examples of how they would care for a resident who was terminally ill. One of the Registered Nurses is a trained counsellor in the needs of the dying and those who have recently been bereaved. She provides help and support to residents, relatives and staff in the care of the dying. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Social activities are creative and provide daily variation and interest for people living in the home. The dietary needs of the residents were well catered for with a balanced and varied selection of food being served. EVIDENCE: The resident’s involvement in social activities varies greatly according to their abilities and nursing needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. The home employs an activities person who organises events and activities within the home as well as trips out to various places of interest. The programme of activities was displayed in the reception area and in other strategic places throughout the home, so that residents were aware of what was “going on”. Apart from details about games, quizzes and activities it also gave information about how often religious services would be held and when the mobile library would be calling at the home. There was also information about when the hairdresser and chiropodist would be visiting. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 12 Residents and relatives all praised the efforts of the activities person one said “she is a gem” Special events are celebrated such as Bonfire night and Halloween. Three residents chatted about the recent celebrations and said how much they had enjoyed them. In the reception area of the home the organiser had put together a display to commemorate Remembrance Sunday that had been well received by residents and their relatives. Visitors are made very welcome and the Inspector was able to observe a large number of visitors coming and going freely and the friendly way in which they related to the management and staff. One relative who visits daily spoke very highly of the staff and the care they provided. A choice of menu was available. The residents were asked what they would like to eat and alternative meals are available. The food was served from a hot trolley that was brought through into the dining room. The tables were nicely set with tablecloths, napkins and cruets. Hot and cold drinks were served. The residents spoke positively of the food provided. Of the 11 questionnaires received from the residents, all said that they liked the food all or some of the time. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents and relatives spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. There have been no complaints received since the previous inspection. The home has a procedure in place for dealing with allegations of abuse. The management and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff are encouraged to attend appropriate training course to help them understand all areas that could be seen as abuse. The home manager has recently attended the presentation of the new policy produced by Social services in respect of the Protection of Vulnerable Adults. Further training in the new procedures is planned. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely and safe environment. EVIDENCE: The home which is purpose built was found to be accessible, safe, maintained to a high standard and free from any offensive odours. Since the previous inspection the dining rooms on the nursing and residential units have been redecorated and provided with new dining room furniture. Some bedrooms have also been redecorated and it is planned to continue this programme as rooms become vacant. The carpets on the lower ground floor community areas are heavily stained despite recently being cleaned by the homes’ domestic staff. This was Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 15 discussed with the manager and it was suggested that a ‘heavy duty’ clean was necessary to bring them up to an acceptable standard. Aids are provided around the home to assist the staff with caring for the residents and also to encourage independence where ever possible. A passenger lift provides access between two floors and the inspector observed residents using this independently. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Staff are well trained to ensure they have the competencies to meet residents needs. The deployment of staff throughout the day is sufficient to meet the needs of residents. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: The Inspector examined staff files and found that they contained all the information required, confirming that the recruitment procedures had been followed. A newly recruited Registered Nurse was undergoing induction to the home and spoke about the content of the induction programme and the support she had received. The nurse felt the induction process was well organized and thorough enabling her to get to know the residents in the home as well as becoming familiar with the way the home was run. The Inspector examined the rotas and found that the staffing levels were sufficient for the number of residents in the home and to meet their needs. Training is high on the agenda and comprehensive records are kept of the training undertaken by staff. Staff spoken to informed the Inspector of the training that they had done. They stated that they are encouraged to attend courses and given the time and support to do this. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 17 Staff spoken to said that they were clear about their role and work well as a team to ensure the individual and collective needs of the residents are met. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 36 37 38 The home is well managed and run in the best interests of residents. EVIDENCE: The manager is a qualified nurse who has many years experience in caring for residents and possesses a management qualification. Throughout the inspection the Inspector was able to observe the professional, capable and approachable manner in which the manager undertook her role when dealing with residents, staff and visitors. Residents, relatives and staff spoke well of the management team and the care and support that they give. Staff said that the manager provided a clear sense of leadership. As part of the inspection residents and relatives were provided with questionnaires to complete it they wished. The comments received were very Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 19 positive and complimentary. One relative also wrote a letter to the Inspector, which was very complimentary about the care provided by the management and staff. The home has good systems in place to gather staff, residents and relatives’ views as part of the monitoring of quality. Staff spoken to had a clear understanding of their role and what was expected of them. The Inspector saw documentation that confirmed that staff received regular supervision and annual appraisal. Residents, relatives and staff spoke well of the management team and the care and support that they give. The Inspector was able to witness their approach to the residents and staff and confirm that comments made. Inspection of resident’s records found that they were comprehensive, well written, up to date and reflected the care being given. . Information provided by the manager and examination of the records, confirmed that all safety equipment is regularly serviced. The policies and procedures in the home ensure that the health, safety and welfare of the residents and staff are promoted and protected. Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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 X 9 X 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 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 3 3 3 3 3 3 3 Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP19 Regulation 23 Requirement A programme of decoration and refurbishment to all of the personal accommodation must be provided within the timescale stated. A programme of decoration and refurbishment to all of the corridors and communal lounges must be provided within the timescale stated Timescale for action 03/03/06 2. OP19 23 03/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 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 Appleby Court DS0000005668.V264879.R01.S.doc Version 5.0 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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