Inspection on 07/02/06 for Carrington Court

This inspection was carried out on 7th February 2006.

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

Carrington Court 28/06/07

Carrington Court 13/10/05

Carrington Court 16/11/04

Carrington Court 05/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Carrington Court Darby Lane Hindley Wigan Lancashire WN2 3DU Lead Inspector Lindsey Withers Unannounced Inspection 7th February 2006 11.20 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 Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Carrington Court Address Darby Lane Hindley Wigan Lancashire WN2 3DU 01942 526220 01942 526260 carringtoncourt@schealthcare.co.uk 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) Southern Cross Healthcare Services Limited Ms Marie Wall Care Home 48 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (48), Physical disability (2), of places Physical disability over 65 years of age (5), Terminally ill over 65 years of age (5) Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 48 service users to include:up to 48 service users in the category of OP (Older People) up to 5 service users in the category of TI(E) Terminal Illness over 65 years of age up to 5 service users in the category of PD(E) Physical Disabilities over 65 years of age up to 2 service users in the category of PD Physical Disabilities under 65 years of age The service should employ a suitably experienced and qualified manager who is registered with the CSCI. One named service user (KB) in the category of PD (Physical Disability under 65 years of age) may be accommodated within the overall number of registered places. The Home’s categories of registration must revert back once KB reaches 65 years of age, or is no longer accommodated at the Home. One named service user (TD) in the category of DE (Dementia under 65 years of age) may be accommodated within the overall number of registered places. The Home’s categories of registration must revert back once TD reaches 65 years of age, or is no longer accommodated at the Home. 13th October 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Carrington Court is situated close to Hindley Town Centre, on the main road from Atherton to Wigan. The Home is close to shops, pubs, a library, a dance hall, and other community and social amenities. Carrington Court, part of the Southern Cross group of care homes, is registered to provide nursing and personal care services to male and female residents over the age of 65. Additionally, the home may accommodate 2 people under 65 years of age who have a physical disability, 5 people who are over 65 years of age who have a physical disability, and 5 people over 65 years of age who are terminally ill. The total number of people who can be accommodated is 48. Carrington Court is a purpose-built care home. Accommodation is provided over two floors. There is ample communal space. All private accommodation is provided on a single occupancy basis. All bedrooms have en suite facilities. Car parking for visitors is provided at the front of the home. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 2 hour period and was unannounced. The main focus was on those areas not assessed during the previous inspection, so that over both visits all key standards were looked at. The Manager was absent on leave so part of the time was spent with the administrator going through the paperwork that has to be kept to show that the home is being run properly, and in conversation with the home’s Regional Manager. Part of the time was spent observing practice in the main lounges and dining areas. The Inspector had good conversations with four members of staff and three residents. The Inspector spoke to other staff and residents over the course of the inspection. What the service does well: What has improved since the last inspection? Tasks that were identified in the last inspection report and that related to the kitchen had been completed quickly and without fuss. An additional member of staff has been recruited specifically to assist those more dependent residents at meal-times. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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 Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed on this occasion. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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): 9 The home has a robust policy and procedure for dealing with medicines. There are good links with GPs, consultants, the pharmacist, families, and staff at the home so that medication for residents is managed in their best interests. EVIDENCE: The medication records for 10 residents were looked at with the two RGNs who were on duty. A copy of the home’s policy and procedure is kept at the front of each record book. Each individual record has a photo of the resident attached to it along with details specific to the resident, such as allergies. Records were up to date. A satisfactory explanation was offered by the nurse for one gap in the recording. Staff were knowledgeable about the medication they handled, and were familiar with the home’s policy, their obligations under their registration with the Nursing and Midwifery Council, and the guidelines set by the Royal Pharmaceutical Society. The nurses said that there were very good links with GPs and hospital consultants. One person’s medication is currently under review. The review panel includes the consultant, the GP, the pharmacist, the home manager, and the person’s family. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 10 Both nurses said they were pleased with the new local pharmacy provider that they had just changed to, and described the several advantages they have found with the new system. They particularly emphasised that residents now have quicker access to the medication they need, when they need it. The new pharmacy supplier changes over all medication at one point in the month and replaces with new. The nurses said that this meant they never ran out and that stocks were always fresh. Medication is not handled by staff other than nurses, who have full responsibility for the management of medication in the home. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed on this occasion. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 12 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 and 18 The home has an effective complaints procedure that is widely advertised at the home. Complainants can be sure that their concerns will be listened to, and that appropriate action will be taken, about which they will be formally informed. Staff at the home are very familiar with the guidance on protecting people from abuse and what they must do if they see something they believe to be abusive practice. Residents at the home can be sure they will live in an environment where they will be protected from harm or exploitation. EVIDENCE: The home has a complaints procedure that is widely advertised. One complaint received at the home since the last inspection and the documentation was looked at. The home had taken a positive approach to the content of the complaint and had agreed changes that were satisfactory to the complainant and beneficial to the resident. Complaints are dealt with in the spirit of improving the service provided by Carrington Court, and are seen as part of the quality audit and quality monitoring system. Staff were very familiar with the home’s policy on protecting people from abuse and whistleblowing. Two members of staff said they had seen the most recent guidance from the local authority. A copy of the guidance was seen in a prominent position on each of the two floors at the home. Staff said that the Manager has an “open door” policy and that they felt able to approach her at any time. Similarly they said they could turn to the manager on their particular floor or the deputy manager at any time. Senior staff were Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 13 described as “approachable”. Staff said that they usually provide care for residents in a team of two, which they felt helped to minimise the opportunity for abuse to occur. Staff said that they discuss abuse and what form it can take during their regular supervision sessions. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 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): EVIDENCE: This section was not assessed on this occasion. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 15 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): 28, 29 and 30 The home follows a robust recruitment process so that only people who are suitable to work with vulnerable people in a care environment are employed. Staff follow a structured induction programme when they commence employment, and are encouraged to train and develop during their career with the home so they are competent to do the work they are employed to do. EVIDENCE: Since the last inspection, an additional person has been recruited specifically to assist residents during the morning (making sure they have mid-morning drinks, etc.) and at lunch-time, when she assists those residents who need some help to eat their meal. Staff have reported that this extra pair of hands has been beneficial to residents because there is more time to devote to their needs. This person has experience as a chef and her role may be extended – through training with the Speech and Language Therapy team – so that there is focussed help for residents with swallowing difficulties to ensure they take in sufficient nourishment. The records for the most recent recruits were well-maintained, and contained all the information required by legislation. Staff are not allowed to commence employment at Carrington Court without clearance from the Protection of Vulnerable Adults list and the Criminal Records Bureau. There is a structure to the interview process so that all the questions are relevant to making sure the Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 16 candidate would be appropriate to work in an environment where care is provided to elderly and vulnerable people. On commencement in employment, all staff undertake an induction. The induction records show that this is not a quick process; staff are given time to absorb information and then sign off the parts of the induction with their mentor. New staff are supervised until their mentor determines they are competent to work unsupervised. Training for staff is generally linked to the work that they do and to any qualification they may be studying, such as the National Vocational Qualification in Care level 2 or 3. Nurses attend seminars, workshops and courses in order to keep their professional knowledge up to date. The Manager is also keen to help staff develop in areas that are of particular interest to them, for example, palliative care or “active living”. A computerised record is kept of all training undertaken by staff. Certificates are displayed so that visitors to the home know how well the members of staff are doing. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 17 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, 33, and 35. The home is managed by a competent person who has a genuine interest in caring for the residents and in training and developing the staff team. The home has effective quality assurance and quality monitoring systems. There was good evidence to demonstrate that the home is run in the best interests of the residents. The home’s systems for managing residents’ monies are robust and are audited regularly. Residents can be sure, therefore, that their financial interests will be safeguarded. EVIDENCE: The Manager is a Registered General Nurse and has a certificate in health and social care from the Open University. She has considerable experience as a nurse working within the area of care of the elderly and understands the associated conditions and diseases that are encountered in that field of care. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 18 Her staff team is experienced and competent and those who expressed their opinion of the Manager said she was very approachable and easy to talk to. As one person said, “You can go to her about anything.” The information held about the home’s quality assurance and quality monitoring processes were looked at. Responses on satisfaction forms ranged from ‘good’ to ‘excellent’. One relative had remarked on the very high standards that were maintained at the home and the enormous effort made by staff to meet residents’ individual needs. Staff were described in satisfaction surveys as ‘polite’, and ‘caring’. One person said that residents and visitors were made ‘comfy’. The many ‘thank you’ cards that are displayed around the home is further testament to the appreciation felt by families for the good work that is done in the home. The finances held on behalf of six residents were checked and found to be in order. The records are kept on the computer and are audited regularly. The administrator said that residents’ families provide money when funds held at the home become low. Some families take full responsibility for financial matters on behalf of their relative and leave very little funds at the home. Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 19 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 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 X Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action 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 Carrington Court DS0000005675.V269893.R01.S.doc Version 5.1 Page 21 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. 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