CARE HOMES FOR OLDER PEOPLE
Colonia Court St Andrews Avenue Colchester Essex CO4 3AN Lead Inspector
Steve Boyd Paxman House Unannounced Inspection 10th March 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Colonia Court DS0000015331.V286025.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. Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Colonia Court Address St Andrews Avenue Colchester Essex CO4 3AN 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) 01206 791952 01206 794230 www.bupa.com BUPA Care Homes (CFHCare) Limited Harvey Newman Care Home 110 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number disorder, excluding learning disability or of places dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (30), Physical disability (3), Physical disability over 65 years of age (30) Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. Amber Lodge Persons of either sex, under the age of 65 years, who require nursing care by reason of Huntington’s Disease (not to exceed 20 persons) Persons of either sex, under the age of 65 years, who require care by reason of Huntington’s Disease (not to exceed 20 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of Huntington’s Disease (not to exceed 3 persons) Blomfield House Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 30 persons) Mumford House Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 30 persons) Paxman House Persons of either sex, aged 50 years and over, who require nursing care by reason of a physical disability (not to exceed 3 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 30 persons) The total number of service users accommodated not to exceed 110 persons 3rd November 2005 Date of last inspection Brief Description of the Service: Paxman House is registered to provide nursing care for up to 30 residents over the age of 65 and up to 3 residents over the age of 50, who require nursing care because of a physical illness or disability. Paxman House has 30 single rooms, all with en-suite toilet and basin. The home has wide range of communal rooms and is all on one level. Paxman House is one of four houses at Colonia Court Residential and Nursing Home. Each house is staffed on an individual basis and the central services include administration, laundry and kitchen. The home has a spacious car park and a guest flat available. Colonia Court is set in a residential area and is approximately one mile from Colchester town centre and two miles from the railway station. Buses run along St Andrews Avenue outside the home. Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place in one day in March 2006. The inspector spoke with four service users in private and others in general. Four members of staff were spoken with as was the home’s manager Mr Harvey Newman. A relative of a service user was spoken with in private, as was a visiting GP. A tour of the premises was undertaken and various service user and staff records were looked at throughout the day. In total sixteen National Minimum Standards were assessed most of which were met. What the service does well: What has improved since the last inspection?
The last inspection report listed a number of requirements. Many of these have been addressed at the time of this inspection including staff receive training in dementia care, that medicines with a limited shelf life are dated when first used and that verbal complaints and concerns are documented along with the actions taken to address them. It was clear that the home had made good attempts to make improvements though recognising that some still needed to be addressed. Colonia Court DS0000015331.V286025.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. Colonia Court DS0000015331.V286025.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 Colonia Court DS0000015331.V286025.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): 4 and 5 Some staff training still required to be undertaken by staff in order that service users can be satisfied the home can meet all their needs. Service users and their representatives have an opportunity to visit and assess the home prior to moving in if the are able. EVIDENCE: The previous inspection report highlighted the need for staff to receive training in the management of challenging behaviour. This has been partially achieved in Paxman House and it was understood from the acting senior sister this should be fully complete in the next month. One relatively new service user spoken to had entered the home straight from hospital. They couldn’t recall whether their relatives had visited the home prior to their admission. However, it was clear from records that staff had visited the resident in hospital to assess their condition prior to admission. The service user was very complimentary about the way she had been helped to settle into the home by staff. Colonia Court DS0000015331.V286025.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): 7,8,9 and 10 Service users’ health, personal and social care needs are set out in individual plans of care. Records indicated service users’ healthcare needs are met. The home’s medicines system was generally working well and service user’s right to dignity and privacy was generally seen to be in good evidence. EVIDENCE: The previous inspection report had made observations about the care plans lacking content in respect of residents’ social care needs. These had largely been taken on board at the time if this inspection with daily reports being seen to be linked to the care plans service users sampled. Plans were seen to be regularly reviewed. Written records and discussion with service users indicated that their health needs were being met appropriately. Evidence was seen of appointments having been made and taken up with various health care professionals. The visiting GP on the day of the inspection indicated the care given to service users from his perspective was very good and he had no issues of concern to relay from his experience of Paxman House in the recent past. The home operates a monitored dosage system of medicine administration which was viewed at the time of inspection. This was seen to be working well although there was occasional signature gaps for medication
Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 10 that had been given or tests undertaken. Issues raised in the previous inspection report regarding the dating of particular medications with a short shelf life had been taken on board. On the day of the inspection service users were observed being treated in an appropriate manner with respect to their dignity and privacy. Service users’ comments regarding the way they were treated by staff were positive. The previous inspection report had highlighted some service user information being on display which would compromise their privacy . This has largely been addressed at this inspection although the inspector had noted some documents in the home’s bathrooms which should be held more confidentially. Colonia Court DS0000015331.V286025.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): 12 and 14 Service users have more opportunities to pursue social and recreational interests than previously, though there is some work to be done in this respect. Choice and control for service users of their own lives is seen to be practiced at Paxman House. EVIDENCE: The previous inspection report highlighted that the home had a lot of room to develop activities and interests for service users. The “residents activity report” is now kept for each service user to link into social care objectives within their care plans. “Map of life” is being created for each service user which details amongst other things their interests. A number of these were seen to still need completed at the time of inspection. Details of activities that take place from Monday to Thursday were seen to be available but not posted on the resident notice board. Activities available included bingo, cards, dominoes, video afternoons, music, exercise, craft and painting. Residents have choice in matters of how to spend their time. For example, residents can choose where to eat either in the dining room or in their own rooms. Service users confirmed they can choose when to go to bed and when to get up, what to wear etc. Colonia Court DS0000015331.V286025.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 Service users and their relatives can be confident that their complaint will be listened to and acted upon. EVIDENCE: The previous inspection highlighted that not all concerns and issues raised by service users were documented along with the actions taken to address them. This appeared to have been addressed at the time of this inspection. No service users indicated they had any complaints or concerns to raise at the time of inspection. Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Service users live in a safe and well maintained environment that is generally clean, pleasant and hygienic. A tour of the premises indicated no obvious safety hazards. Service users rooms seen during the inspection were clearly personalised with evidence of their own interests and tastes such as pictures, photographs, ornaments, furniture and TV’s etc. Service users spoken with indicated they liked their rooms. EVIDENCE: An issue raised at the previous inspection about two small communal rooms being used for other purposes had been addressed at the time of this inspection. The home was found to be generally clean with no obvious unpleasant odours. Cleaning schedules were seen for Paxman House which indicated that regular cleaning took place in most areas of the home. One service user commented that their bed was not often pulled out so that the whole area of the room could be cleaned. This issue was pointed out to the manager and acting senior sister as an area to be added to the cleaning schedules lists.
Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Service users’ needs are being met by the numbers and skill mix of staff in Paxman House. The recruitment policy and practices followed by the home are appropriate. EVIDENCE: Paxman House has at least seven staff rostered on morning shifts, five on afternoon shifts and three awake members of staff during the night time period. There is a mix of qualified nursing staff and healthcare assistants. Service users comments re the staff team were very positive and staff themselves felt well supported. A number of staff files were sampled during the inspection and it was clear that staff were appointed following written job applications, interview, references being taken up and CRB checks being undertaken. Information on some staff files was difficult to access as there was no indexing of these files. The manager advised that this process was being addressed for all files and should be completed in the next months. Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 15 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, 35 and 38 Service users live in a home which is managed by an appropriately experienced and qualified manager. The health, safety and welfare of both service users and staff is generally well promoted as are service users’ financial interests although some improvements need to be made. EVIDENCE: Mr Harvey Newman is the registered manager of Colonia Court. He is suitably qualified and experienced to run a large nursing and care home with a number of units on site. Mr Newman presented as very professional during the inspection as did the senior acting sister of Paxman House. Records relating to financial matters of service users in Paxman House were seen during the inspection. In order to improve transparency to service users or their nominated representatives, period statements should be made available to them rather than them having to request reviewing this information. The previous inspection report had highlighted a number of training issues for staff
Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 16 in respect of health cand safety matters. A number of these had been addressed by the time of this inspection, though an up to date training matrix was not available to evidence what training had taken place and who had received the training. As indicated earlier in the report no obvious safety hazards were seen in the inspection. Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 2 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x 2 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 3 x x x 2 X X 2 Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 18 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 OP4 Regulation 18(1) c Requirement The registered person must ensure that all care staff receive training in the management of challenging behaviour. This is still partly outstanding from the previous inspection. Timescale for action not met. The registered person must ensure that care is always carried out in a manner that preserves residents’ privacy and dignity and ensures that personal information about residents is not on display in the home. This is still partly outstanding from the previous inspection. Timescale for action not met. The registered person must ensure that there is a sufficient range of activities to suit individual’s needs and ensure that activities are held on a daily basis. This remains partly outstanding from the previous inspection. Timescale for action not met. The registered person must ensure that the activity coDS0000015331.V286025.R01.S.doc Timescale for action 31/05/06 2. OP10 12 (4) a 30/04/06 3. OP12 16 (2) (m) (n) 31/05/06 4. OP12 18 (1) c 31/05/06 Colonia Court Version 5.1 Page 19 5. OP26 23 (2)d 6. OP38 13 (4) 7. OP9 13 (2) ordinator and care staff receive training in a range of activities appropriate for older people. This is a repeat requirement. The registered person must 31/05/06 ensure that standards of cleanliness are maintained at a consistent standard. This is still partly outstanding from the previous inspection report. The registered person must 31/05/06 ensure that all staff receive health and safety training. This is a repeat requirement from pervious inspections. Timescale for action not met. The registered person must 10/03/06 ensure all medications or medical procedures undertaken within the home are signed as having been completed at the time they are given or carried out. 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 Refer to Standard OP29 OP35 Good Practice Recommendations It is recommended that staff files are indexed for ease of access to information It is recommended that service users are given period statements of their financial position in respect of monies held on behalf of them by the home. Colonia Court DS0000015331.V286025.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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