Inspection on 12/03/07 for Appleby Court

This inspection was carried out on 12th March 2007.

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 10/11/05

Appleby Court 11/05/05

Appleby Court 02/11/04

Appleby Court 22/06/04

Appleby Court 23/03/04

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Ruskin Lodge

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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 Lynn Sharples Unannounced Inspection 12 th March2007 09:30 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.V320708.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. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 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.V320708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 80 service users to include:up to 80 service users in the category of OP (Older People) up to 4 service users in the category of PD (Physical Disability under 65 years of age) up to 4 services users in the category of TI(E) (Terminal Illness over 65 years of age) 10th November 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. The fees for the home range from £353.44 to £520. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of the visit there were seventy eight people living at the home. The home did not know about the inspection and included a site visit to the service and it took six hours. Residents, 3 relatives, the manager and the care staff were spoken with; 19 surveys from residents and 12 completed comment cards were received from relatives. The files relating to the service users, staff and the home were read and the premises toured. The home has received two complaints since the last visit and the home has investigated these complaints and has provided evidence that these have been dealt with. One complaint has been made to the CSCI since the last visit; this related to the quality of care one resident was receiving. What the service does well: The homes Statement of Purpose and Service User Guide are detailed providing service users and prospective service users with details of the services the home provides enabling an informed decision about the admission to the home. Residents’ individual health, personal and social care needs are clearly recorded. This provides care staff with the information they need to meet the residents care needs. The medication at the home is well managed and promotes good health. Residents spoken with were happy with the care they received and some relatives confirmed this. One relative commented that the care is very good and that the “girls are good with my relative”. Residents have choice and flexibility how they spend their day in the home, and can pursue leisure activities according to their choice and preferences. This allows independence and individuality for each resident. Residents receive a balanced diet offering variety, which reflects the residents’ preferences The relatives spoken with confirmed that they were always welcomed and that the staff were “friendly and helpful”. The home has a satisfactory complaints system with evidence that residents feel their views are being listened to and acted upon. The home’s policy and training programmes for adult protection and whistle blowing ensure that the homes residents are protected from abuse. 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. The recruitment practices are adequate and appropriate checks are carried out; this ensures that the resident is not put at risk. The staff training provided Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 6 ensures that the staff are basically equipped to meet the needs of the service users. The home is well managed and run in the best interests of residents. What has improved since the last inspection? 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. Appleby Court DS0000005668.V320708.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 Appleby Court DS0000005668.V320708.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): 1,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service User Guide are detailed providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to the home. The home does not provide intermediate care services (Key Standard 6). This standard does not therefore apply. EVIDENCE: The Statement of Purpose is detailed and contains all the information a prospective resident and their representative would need to make an informed choice about whether to stay at the home. The Service User Guide is also available. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 9 The manager explained that new residents are visited in their own home or hospital. At the hospital the manager would speak with the nurse in charge to see if the home can meet the persons needs. The new resident is then offered the choice to visit the home usually the family visit. The home has a detailed needs assessment that is completed by the manager. This includes personal care and physical well-being, social interests and personal safety and risk. Some of the residents spoken with confirmed that there relative looked round the home before they moved in. Appleby Court DS0000005668.V320708.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ individual health, personal and social care needs are clearly recorded. This provides care staff with the information they need to meet the residents care needs. The medication at the home is well managed and promotes good health. EVIDENCE: The nine care plans that were looked at contained detailed and comprehensive care needs assessment that explains how best to support the resident with everyday living such as health, personal and social care needs. The plan is reviewed monthly with updates and changes recorded regarding the residents needs. The care plans contained risk assessments relating to prevention of falls, bed rails. The care plans included details of nutritional assessments, Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 11 weight, dietary supplements, continence assessments, personal cleansing and dressing, moving and handling, resting and sleeping and pressure sore assessments. All residents in the home can access their NHS entitlements, which includes dentistry, opticians and chiropody services. The residents spoken with confirmed that if they were unwell or they request it the home would call a doctor. There was evidence that residents had access to speech and language therapist, diabetes nurses and dieticians. Residents spoken with were happy with the care they received and some relatives confirmed this. One relative commented on the care is very good and that the “girls are good with my relative”. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). Personal care given by the staff was observed to ensure the residents dignity and privacy. Staff were seen knocking on residents doors. Some residents spoken with confirmed that they opened their own mail. During the inspection it was noted that the staff had a caring approach towards the residents and the residents and relatives spoken with confirmed this. One resident said, “ The girls know me well and what I like”. Appleby Court DS0000005668.V320708.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): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have choice and flexibility how they spend their day in the home, and can pursue leisure activities according to their choice and preferences. This allows independence and individuality for each resident. Residents receive a balanced diet offering variety, which reflects the residents’ preferences. EVIDENCE: The home employs an activities co coordinator who works full time five days a week. The co coordinator explained the variety of activities on offer, these included: - bingo, mental aerobics, music and song, quizzes, story telling and topical debate. There are also trips out to the theatre and restaurants. An entertainer visits once a month, the residents spoken with said that enjoyed this. In the care plans there is a section relating to social care and includes details of family history, favourite colour, past hobbies and favourite music, food and season as well as religious observance. There was evidence in the Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 13 care plans that residents attended various religious services. The activities co co-ordinator also keeps individual daily records as to how the resident coped or responded in the activity, and to their mood, emotions, physical dexterity. The recordings of the resident activities helps to complete a “full picture” of the residents progress, or even identify developing care needs. This is good practice. Some residents prefer to spend time in their rooms reading newspapers and watching television. Their records also indicate that the activities co coordinator visits these residents regularly and spends time talking with them; one resident confirmed this. Special events are also celebrated and the home is preparing for Saint Patrick’s Day. The residents spoken with said they enjoyed the activities and the activities co coordinator was “lovely”. Some residents and relatives said that they would like more trips out; this was discussed with the manager who said that they would discuss this at the next residents meeting. Residents explained that they are able to see visitors in private and the home operates an open door policy. Visitors were seen coming and going during the inspection and were observed to interact with the staff in a friendly manner. The relatives spoken with confirmed that they were always welcomed and that the staff were “friendly and helpful”. The resident’s bedrooms contained personal possessions. The menus looked at offered a varied, wholesome and nutritious diet. Several alternatives were provided if a resident wished to have something that was not on the menu. Residents spoken with said that they could have alternatives and that they enjoyed the food. The lunchtime meal was observed to be served in a relaxed unhurried manner. Appleby Court DS0000005668.V320708.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): 16,18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that residents feel their views are being listened to and acted upon. The home’s policy and training programmes for adult protection and whistle blowing ensure that the homes residents are protected from abuse. EVIDENCE: The home has a complaints procedure that is included in the Statement of Purpose. The home has received two complaints since the last visit and the home has investigated this complaint and has provided evidence that these have been dealt with. One complaint has been made to the CSCI since the last visit about the quality of care received at the home. The residents spoken with said that if they had any concerns or complaints they would talk to either their relative or the manager. The relatives spoken with said that they had “ no complaints” but said that if they did they would raise this with the manager. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 15 Some of the staff have received training in Protection Of Vulnerable Adults training, through the National Vocational Qualification (NVQ). The staff spoken with were able to demonstrate an awareness of the different forms of abuse and how to act as an alerter in terms of adult protection. The home must ensure that the remaining staff have received up to date training regarding adult protection. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. 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 premises are maintained to a good standard, both inside and out. The grounds were tidy and accessible. There is a programme of renewal of the fabric and decoration of the home. Residents said that the home was clean. On the day of the inspection the home was free from malodour. Some areas in the home are in need of redecoration, the carpets in some of the dining rooms are stained and need replacing, some of the doors require Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 17 painting. This was discussed with the manager, to ensure that the home is maintained to an acceptable standard. The laundry facilities are located on the lower floor and consist of washing machines and driers. The washing machines have the specified programming ability to meet disinfection standards. The staff were observed to wear protective aprons and gloves for specific tasks. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment practices are adequate and appropriate checks are carried out; this ensures that the resident is not put at risk. The staff training provided ensures that the staff are basically equipped to meet the needs of the service users. EVIDENCE: The rotas indicate that there are sufficient care staff on duty to meet the residents needs. The home is split into four units and on the day of the visit there were enough staff on duty to meet residents care needs. There is usually four staff on duty in the morning, 4 in the afternoon and two waking night staff on each unit. Some of the staff has worked at the home for many years this provides continuity. There are also an administration assistant cooks, domestic assistances and laundresses. Of the 53 care staff, 20 have the NVQ level 2 and 10 have the NVQ level 3; currently 10 staff are completing the NVQ level 2 and 4 staff are completing the level 3. Some staff are to begin the NVQ level 2 later this month and this was confirmed by some of the staff who will be attending the course. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 19 An examination of a sample of staff records indicated that all new staff had two references, enhanced Criminal Records Bureau checks, statements of terms and conditions on their personnel file. The manager views training as important and the records indicate that staff have received training in several areas. Staff confirmed that they had received several days training and that if they see a course they want to attend the home will attempt to ensure that the member of staff can attend. The inspector spoke to a new member of staff who was currently undergoing a thorough induction programme. The induction programme had recently been updated and is comprehensive. Staff spoken with indicated that they were clear about their roles and responsibilities and all enjoyed working at the home. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 20 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): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of residents. EVIDENCE: The manager is a qualified general and mental health nurse who has many years experience in caring for residents and has a management qualification. During the inspection the manager was observed to conduct themselves in a professional and approachable manner when dealing with residents, staff and visitors. Residents, relatives and staff confirmed that the manager was approachable and supportive. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 21 The home has regular residents meetings and has systems in place to gather staff, residents and relatives’ views as part of quality monitoring. The owner nominates an individual to provide quality assurance. The manager confirmed that they visit every month, but could only produce one report. They must ensure that they visit every month and write a report on the conduct of the home and that these reports are available to be viewed. The home is not appointee for any of the residents and the home has a policy and procedure to ensure that residents’ money is kept safe. The care staff receive regular recorded supervision and the staff spoken with confirmed that they had received formal supervision in the last year. The care staff also receive an annual appraisal with their line manager. In the care files it was noted that all accident, injuries were appropriately recorded or reported. The home has current certificates in respect of electrical and gas safety. Staff have attended regular fire drills. 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.V320708.R01.S.doc Version 5.2 Page 22 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 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 3 X 3 Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 23 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 corridors and dining rooms must be provided within the timescale stated to ensure that the residents live in a comfortable and safe environment. Timescale for action 12/06/07 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 Refer to Standard OP33 Good Practice Recommendations The nominated quality assurance person should ensure that they make their monthly reports available. Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 24 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: 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 Appleby Court DS0000005668.V320708.R01.S.doc Version 5.2 Page 25 - 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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