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Inspection on 16/08/05 for Churchfield Care Centre

Also see our care home review for Churchfield Care Centre for more information

This inspection was carried out on 16th August 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.

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

What the care home does well

The home provides a therapeutic environment for residents following assessment of their abilities and capacities. Each resident receives a timely and responsive management of their condition by staff that are skilled in the support required to manage their care. All areas are clean and well maintained. The manager has worked hard to improve the standards at the home.

What has improved since the last inspection?

The new manager has provided the stability and guidance to staff, which has ensured best practice in the management of care at the home. Staff spoke of feeling more supported and felt the quality of care provided was greatly improved. There has been a marked improvement in the care planning, documentation and record keeping since the last inspection. The staffing levels are now appropriate to the needs of the residents and ensure that each person receives appropriate care.

What the care home could do better:

The manager must ensure his application to register with the Commission for Social Care Inspection is submitted. There could be improvement in the management of medicines by recording all medicines received into the home.

CARE HOMES FOR OLDER PEOPLE Churchfield Care Centre Churchfield Drive Rainworth Nottingham NG21 0BJ Lead Inspector Mary OLoughlin. 2nd Inspector Steve Keeling Unannounced 16 th August 2005 - 10:00 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. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Churchfield Care Centre Address Churchfield Drive Rainworth Nottinghamshire NG21 0BJ 01623 490109 01623 795060 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) Southern Cross Care Homes No2 Ltd Care Home with Nursing 60 Category(ies) of Old age registration, with number of places Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Registered Manager must be 1st Level Nurse and full time,with full time supernumery hours of work. 2 Assistant Manager (Head of Care of Residential Unit) to have at least 2 days Supernumery hours of work. 3 Administration support for at least 25 hours a week 4 Residential Unit to allow 22 service users of residential category (older people) only. 5 Five Clients, in the category OP, over the age of 60 Date of last inspection 10/11/04 Brief Description of the Service: Churchfield Care Centre provides two units on the same site. The Nursing unit provides 38 places for Older People requiring Nursing care. The residential unit provides 22 places for Older People requiring personal care. The registered provider has recently merged with another company and has yet to provide its trading name. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by two inspectors over 2.5 hrs and was unannounced. On this occasion the Nursing unit was inspected. The main method used to inspect was to look at the records of the residents ensuring that their care needs were assessed and met by the home Residents were spoken with and all were happy with the care they received. The manager was on annual leave at the time of the inspection. The deputy manager was in charge of the home. What the service does well: What has improved since the last inspection? The new manager has provided the stability and guidance to staff, which has ensured best practice in the management of care at the home. Staff spoke of feeling more supported and felt the quality of care provided was greatly improved. There has been a marked improvement in the care planning, documentation and record keeping since the last inspection. The staffing levels are now appropriate to the needs of the residents and ensure that each person receives appropriate care. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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 Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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) 3-6 Prospective residents receive a full assessment of their needs prior to the home agreeing admission and ensure that residents and their families are confident that the home will meet their individual needs. EVIDENCE: The records of the most recent admission to the home contained a record of a pre-admission assessment that had been undertaken by the home manager. The records contained a comprehensive assessment of the person’s needs and had been done with the involvement of the allocated district nurse. There was evidence of specialist nursing assessment and guidance contained within the records to ensure best practice in the care of the specific medical /nursing needs of the resident. A care plan had been drawn up at the point of the admission and contained a full and comprehensive guide of the person’s care needs to enable staff to deliver appropriate care. Intermediate care is not provided by the home. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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 standard(s) 7-8-9-10 Regular assessment and review of care planning ensures that each resident receives appropriate care and that as far as possible their wishes are respected and their views are taken into account. Medicines are safely managed. EVIDENCE: Four care plans examined contained a comprehensive assessment of the person’s needs and provided the basis for care to be delivered. Records also contained evidence that residents are encouraged to participate in the drawing up and review of their care plans. The plans were reviewed by staff at least monthly and as the residents needs changed. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 10 All care plans set out in detail the actions that staff needed to take to meet the health, personal and social needs of the resident. Plans meet relevant clinical guidelines and include risk assessment with particular attention to the prevention of falls. Two of the residents case tracked were at risk of developing pressure sores, the actions taken by staff in regular assessment of the risk and the implementation of preventative measures ensured that the risk was appropriately managed There was evidence that for those people requiring pressure -relieving equipment such as seat cushions and special mattresses, these had been obtained and were in place for the resident. Each resident has their nutritional needs assessed monthly and from discussion with the residents and kitchen staff it was clear that they received the appropriate diet. Health checks included monthly weight, blood pressure and pulse records. Where residents required intensive support and monitoring this was in place and records held of external specialists involved show excellent inter-agency working to maintain the optimum level of physical and psychological wellbeing of the resident. There was also excellent practice observed in the management of care needs, plans contained up to date information obtained to manage difficult conditions and ensured that staff had access to up to date information on evidenced based practice. Medicines were safely managed and inspection found appropriate records in place demonstrating that residents received their medicines as prescribed. The most recent admission to the home did not have their medicines recorded into the home, which would be best practice and ensure an appropriate audit trail. Residents confirmed that staff respected their privacy and maintained their dignity at all times. Care plans contained information to staff on how to maintain the residents privacy whilst carrying out care tasks. All care plans demonstrated that the resident receives appropriate and timely care. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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 standard(s) 12-13-14-15 Residents receive an organised social life according to their preferences and expectations. Support for those that require assistance in engaging in activities is provided ensuring that all residents receive care in a therapeutic environment. EVIDENCE: Relatives and residents spoken with confirmed that they were very happy with the care they received and that they were supported by staff to maintain their contact with family and friends. There is an activities worker employed and a varied activities programme is in place. Residents were seen to walk into the courtyard and sit in the sun with their families or independently during the inspection. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 12 For those people that were unable to participate in activities due to their condition, care plans recorded information to staff on how they could provide stimulation and variation to the person’s day. Residents had a range of mobility equipment that enabled them to get about without help. Residents said they were happy with the meals provided. The kitchen has been re-fitted and there are plans to provide a menu for each dining table ensuring that residents are aware of choices at mealtimes. The dining room was spacious and provides good access for those in wheelchairs. Residents requiring help with feeding were being assisted sensitively by staff during the inspection. Residents were dressed in their own clothes that had been nicely laundered and care had been taken to ensure that each person was appropriately dressed, including suitable footwear. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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 standard(s) 16-18 An open culture in the home allows residents and relatives to feel confident about making suggestions or making complaints, and can be done without fear of victimisation. EVIDENCE: Relatives spoken with were aware of how to raise any concerns they may have and moreover felt that all the staff were approachable. The manager has initiated one adult protection investigation in 2005, which is not concluded at this time. Staff have received adult protection training from the home manager in 2005. The complaints procedure ensures that residents are informed of how to complain and what to do if they are unhappy with the response received by the home. The Adult Protection policy informs staff of what they must do if they suspect that abuse may have taken place . Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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 standard(s) 19-24 The home is accessible, safe and well maintained. EVIDENCE: The Nursing unit that was inspected on this occasion was very well maintained throughout. The location and layout of the home is suitable for the residents accommodated. There is a programme of routine maintenance of the building and evidence of work being carried out to improve the facilities. Resident’s rooms were fitted with a range of good quality furniture and many people had their own personal possessions with them. The home was clean throughout and there was no malodour. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 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 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- The home provides sufficient numbers of staff to meet the needs of the residents. The home’s recruitment practice safeguards the residents from harm. EVIDENCE: The home records the numbers of staff on duty and their position. Records of duty reflect that the home is appropriately staffed and has suitably trained staff at all times. Records of staff recruitment practice demonstrated good practice and residents can be assured that the appropriate safeguards are in place to ensure that any person unsuitable to work with vulnerable adults is not employed. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 16 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) EVIDENCE: These standards were not assessed on this occasion. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 17 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 18 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 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. 1. Refer to Standard 9 Good Practice Recommendations The Registered Person should ensure that the medicines of all new admissions are recorded into the home to provide an audit trail. Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Churchfield Care Centre C03 C53 S24635 Churchfield Care Centre V244641 160805 Stage 4.doc Version 1.40 Page 20 - 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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