Inspection on 04/05/05 for Charnwood Care Home

This inspection was carried out on 4th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Charnwood Care Home 23/06/08

Charnwood Care Home 28/06/07

Charnwood Care Home 01/06/06

Charnwood Care Home 01/09/04

Charnwood Care Home 20/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Charnwood Care Home 29 Station Road Carlton Nottingham NG4 3AX Lead Inspector Karmon Hawley Unannounced 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 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. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Charnwood Care Home Address 29 Station Road Carlton Nottingham NG4 3AX 0115 9404441 0115 9875008 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashbourne Health Ltd Mary Ledger CRH 88 Category(ies) of OP (81) registration, with number PD (4) of places TI (3) Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Physically Disabled clients to be aged 50 years and above. Palliative Care clients to include one aged 45 years or above. Date of last inspection 1st September 2004 Brief Description of the Service: Charnwood is a registered care home providing both nursing and personal care. The home is located in an inner city area of Nottingham, close to the local shops, general practitioners surgery and other amenities. The accommodation is a purpose built building, with two units offering a total of 88 beds, comprising of 60 single rooms nine of which are ensuite and 14 double rooms one of which is ensuite. All bedrooms are fitted with an alarm call system and are suitably furnished, however service users are encouraged to personallise their own rooms. There is one large lounge within each unit, incorporating a designated dining area. There is a pleasant garden access leading from patio doors. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place in one day, eight services users care notes and other relevant records with regards to their care and the environment were examined. Seven service users and three staff members were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Service user reviews would be more beneficial if developed to be more service user focussed and aimed at reflecting care and condition and service users expected outcomes rather than stating no changes. Minor attention is needed Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 6 to address two noted odour problems within both units. Staff supervision sessions need to be more structured so recognition and benefit is obtained which facilitate staff development. It is also recommended despite the good training plans in place that further recognised adult abuse training is undertaken. Despite staff stating communication is good and official handover period would increase dedicated time to allow for transfer of necessary information to ensure consistency of care is maintained. 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. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4 Both the statement of purpose and statements of terms and conditions of admission are easy to read and contain in depth information one would like to see if making an informed choice about staying in the home. The pre admission process is in depth ensuring all relevant equipment is available to the service users to meet their needs, it is felt that this process provides a good solid base ground to develop plans of care. EVIDENCE: Both the court and the house have the same statement of purpose format, each then being individualised accordingly. Both cover all the requirements of this standard and also offer further information. The terms and conditions of admission are kept in the service users notes, which were observed and cover all requirements of this standard. The manager, care managers or registered nurses visit prospective service users in the community prior to admission to ensure that identified needs can be met. Nursing determinations and relevant referrals were noted to be in service users notes and in depth preadmission information in place. A service user spoken with was able to substantiate that she had received the relevant paper work and she felt her needs are met. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 9 Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10,11 Assessment of service users needs and risk is considered to be thorough, with the exception of one identified shortfall so care received is as required. Care plans were personalised and reflected individuality enabling support for service users to make decisions with regards to their daily lives. However the changing needs of service users in some instances require attention to ensure these are service user focused and reflect personal outcomes EVIDENCE: Case files examined demonstrated that all relevant family contacts and multidisciplinary team contact were in place. There was also evidence of family involvement. Assessments covered the activities of daily living and various assessment tools were also used to identify risks. Necessary equipment required was documented and observed to be in use. Care plans were personalised, up to date and in depth with regards to complex needs. Funeral arrangements were noted in several files examined, as were contact details for advocacy services. Within the residential unit one file examined was noted not to have an assessment and relevant care plan in place, on discussion this was noted to be due to the service user refusing to co operate, this had not been documented. This issue was addressed and resolved during the inspection. With regards to Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 11 reviews these were in place but were not in all cases service user focused to reflect condition and outcomes. The manager carries out statistics on several areas within the home, such as falls, weight and training. These assist in monitoring and actioning required deficits or concerns. Specialist services were noted to be visiting the home or service users visiting the community to access services. One service user was able to substantiate that the district nurse visits to do her dressings and a relative stated they are kept informed and can request a general practioner if they feel the need. Staff training covers the required mandatory and additional subjects to assist in staff development. Nine members of staff have attained the National Vocational Qualification level 2 and one has attained level three. With regards to dying the manager stated that everything that can be done to facilitate the service user and relative is. The palliative care team is accessed and liaises frequently with the home, as are other relevant services. Resources to learning have been updated to facilitate staff’s knowledge in this area. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 Staff actively work towards exploring service users requirements and preferences and offer adequate activities to meet needs. From statements made it is felt that in general most service users are happy within the home and satisfied with the lifestyle and care they receive. Visitors are welcomed into the home and their input obviously valued. EVIDENCE: Within case notes examined there was evidence of in depth assessments, personal profiles and social and recreational requirements so as to meet specified needs. There are also two activities coordinators employed and notices of arranged events were displayed. This included fayres, coffee mornings and various others. Service users spoken with were able to substantiate that activities do take place and most stated their need are met, however one service users stated she was afraid to speak out in case she was shouted at, this issue was discussed with the manager who is acting upon this. An open visiting policy is employed and relatives are welcomed into the home, two relative spoken with felt they could visit at any time and did so daily. The new smoking arrangement frees ups the main entrance area so service users may receive visitors with more privacy or they may use their own rooms or the managers office if required. Information with regards to advocacy services was available. There are currently no volunteers working within the home, however student nurses do a secondment here and assist in facilitating activities. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 13 There were varying comments with regards to food offered, some service users enjoyed their meals whilst others did not, however there is a kitchen area available within each unit with microwave facilities should a service user wish to use it. Staff were able to discuss boundaries and maintaining privacy and dignity whilst delivering good care, however one service user spoken with was unable to confirm that staff knocked on her door. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home takes all concerns seriously and endeavours to remedy these within recommended time scales. Adult abuse training has been accessed and the home covers this within its own training sessions, which is good practice, however further recognised training is required. EVIDENCE: The complaints procedure is clear and accessible. Complaints and concerns are recorded and acted upon within stated timescales and outcomes noted. The regional manager to ensure action to remedy concerns is taken oversees these. There is a satisfactory policy in place for adult abuse and whistle blowing in place and staff also have access to a free telephone help line. Several staff have undertaken abuse training and are currently cascading information to other staff until further training is accessed. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,24,26 The home is generally well maintained, clean and tidy. The changes in the garden will prove beneficial to those more ambulant service users. As some service users remain unsettled with the changes in the environment additional support to facilitate adaptation would prove beneficial. EVIDENCE: There are sufficient washing and toilet facilities to meet the needs of service users within the home. The home was clean, tidy and free from offensive odour with the exception the smoke room and one bedroom. The smoke room in the house section has been divided from the main lounge and has an extractor fan, however this smelt strongly of stale cigarettes and full ashtrays were evident. Laundry facilities cover the required standards and sluice and hot wash facilities are available, this area was particularly clean and tidy. Specialist equipment and adaptations were noted to be available. Service users rooms were personalised and service users may have a key to their room if they wish, however no risk assessments were in place with regards to this. The gardens are pleasant and a pathway is being built to enable ease of access. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 16 The main communal area has recently been altered to provide a more conducive space; this has caused a little upset with service users despite a meeting being held to discuss this. On speaking with them most had adapted to the changes and felt the layout was in fact better. Whereas another felt that smokers now had the monopoly over the patio area within the court as this area had been divided also. In making the smoking areas this has allowed other areas to be used as more private settings. All double rooms have screening in place. The manager stated that service users rooms are kept locked if the service user is away from the home. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Staffing within both sections of the home is considered satisfactory, however staff views must be considered and this explored further. Recruitment procedures are satisfactory, however to ensure the further protection of service users photographic identification is required. Staff receive extensive training to assist in the delivery of a good standard of care. EVIDENCE: Staff file examined contained all relevant information and required checks. Staffing levels within both homes were observed and sufficient staff were available, however care staff in the court felt that they would benefit from additional staff in the morning. The manager works supernumerary and the two care managers also work supernumerary one day a week. Staff training records are maintained and cover all mandatory areas plus additional areas relevant to the service user group. There is no hand over period allocated between shifts; therefore staff come in ten minutes early to do this. The home has its own induction programme linked to the Training Organisation for the Personnel Social Services, an initial induction day is provide where the routine and policies of the home are covered they then commence on a three month probationary period. All training is paid for. Staff have not received copies of the General Social Care Council code of conduct, staff were able to substantiate this. Staff receive long service awards, evidence of which were in staff files. Photographic identity was not available within all staff files. On Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 18 discussions with service users they stated they are kept informed of things happening within the home and staff are always available and are efficient. Staff stated they received lots of training, which they feel assist them in delivering good standards of care. They expressed that communication within the home was good and confirmed they had had the relevant recruitment checks. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36,38 The manager is able to demonstrate good knowledge and understanding of the service user group, thus enhancing quality of life within the home, inclusion and participation of service users. Staff are currently supervised as a group, however alternatives may be explored to enable staff development supporting the ethos of the home. EVIDENCE: The manager is a registered nurse and is currently completing the National Vocational Qualification (NVQ) level four management award. She is also a NVQ assessor thus facilitating others training. She remains up to date with mandatory training and by attending courses relevant to her nursing qualification and the service users which she cares for. She has twelve years experience in this field and has held her current position for three years. She manages both sides of the home and floats between them both. She also Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 20 carries out spot visits, which are recorded to ensure care standards are being maintained in her absence. The manager stated that supervisions take place during team meetings and are held on a one to one basis if required, however one member of staff spoken with stated that she did not have supervision sessions. Staff development is not discussed during supervisions as this is dealt with during appraisals. With regards to health and safety all certificates and checks were observed and were satisfactory. Relevant policies and procedures are in place, which includes a free phone number should staff wish to discuss and abuse or whistle blowing issues. Staff spoken with stated that the manager was approachable and the home was well run, service users stated that they felt listened to. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 x x 3 3 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 2 x 3 Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 15 Requirement Service user reviews are required to be service users focused to reflect care, condition and outcomes. The issues of odour in the smoke room in the house and the one stated bedroom in the court are required to be addressed. All staff are required to have photographic identification witin personnel files. Records of staff supervisions must be available for inspection. Timescale for action 30th July 2005 Immediate 2. OP26 16 3. 4. OP29 OP36 19 Schedule 2 18 30th July 2005 30th July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP7 OP18 OP20 OP27 OP36 Good Practice Recommendations staff to sign service users assessments to demonstrate who has completed them Further recognised abuse training is obtained. Those service users who remain anxious with regards to the room layout change have additional support offered Take in to account staff views with regards to staffing levels within the home Supervision sessions are carried out at least six times a C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 23 Charnwood Care Home year. Charnwood Care Home C53 C03 S26425 Charnwood V225790 040505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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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