Inspection on 15/09/05 for Coniscliffe Rest Home

This inspection was carried out on 15th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Coniscliffe Rest Home 14/01/08

Coniscliffe Rest Home 11/09/06

Coniscliffe Rest Home 16/01/06

Coniscliffe Rest Home 13/10/04

Coniscliffe Rest Home 29/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Coniscliffe Rest Home 37-43 Grosvenor Place Jesmond Newcastle Upon Tyne NE2 2RD Lead Inspector Deborah Haugh Unannounced 15 September 2005 9:30 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. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Coniscliffe Rest Home Address 37-43 Grosvenor Place Jesmond Newcastle Upon Tyne NE2 2RD 0191 281 2553 0191 281 8690 coniscliffe@highfield-care.com Southern Cross Home Properties Limited 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) Mr Terence Lillico CRH 43 Category(ies) of DE(E) - Dementia - Over 65 (12) registration, with number OP - Old Age (31) of places Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 13 & 14th October 2004 Brief Description of the Service: Coniscliffe is a care home that provides personal care to 43 older people and older people with dementia. The Home is located in Jesmond, a residential area of Newcastle upon Tyne and is a conversion of five large terraced houses. There is a range of local shops and amenities within walking distance and the area is well served by public transport. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 15/9/05 at 9.30am and lasted until 3.15pm. At the time of this inspection the Registered Manager, Mr Terry Lillico was on duty. There were 33 service users at the time of the visit and staffing levels were appropriate to meet the needs of the service users. Time was spent looking around the home to check the cleanliness, maintenance and decoration. Service users shared their views about the home. Time was also spent observing the contact between service users and staff. Staff were asked for their views. Lunch was shared with the service users. Three Care Plans for service users care were examined. The home’s Fire Log and Maintenance book were checked. Arrangements for the administration and management of medication were audited. What the service does well: All of the service users spoken with spoke highly of the care which they receive at Coniscliffe. Comments covered the positive relationships which service users have with the manager and staff in the home as well as the activities. ‘Staff are very good’ ‘Always go out’ ‘I’m alright, this is my home.’ ‘It’s nice here.’ ‘I like the trips.’ Service users and staff spoke highly of the support of the manager Mr Lillico and the other seniors. Mr Lillico encourages service users and staff to fulfil their potential. The care plans are positive and look at a range of service users needs. Links with other professionals are in place. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 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 Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 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 Service users who move into the home have their needs assessed by a care manager and the home. EVIDENCE: Three service users records were inspected and 2 people have been recently admitted. There was evidence of assessments of the person’s needs by care managers and the home. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 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 - 10 Care plans are in place and staff have the information to meet service users needs. Staff demonstrated that they know the service users needs and wishes and have good relationships. The health needs of service users are met and multi disciplinary working is taking place. The arrangements for the administration of medication are satisfactory but some areas need addressing. Resident’s dignity is respected with one exception. EVIDENCE: A sample of service user’s care records were examined. Care plans look at a range of needs based on ‘Activities of Daily Living’. These are updated on a monthly basis. Risk assessments and risk management plans are in place. Supplementary reports and charts are also recorded. There is a system of initial and six monthly reviews of service users care. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 10 Service users have access to a range of health professionals. Assessments are in place for pressure sore management, nutrition, falls, moving and handling and continence. An audit of the medication arrangements was undertaken in the presence of the deputy manager and 3 areas need addressing see Requirements. Some care staff carry combs in their uniform pockets and it was confirmed that these are used to ‘tidy service users hair.’ The communal use of combs must stop. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 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 &15 Community contact and relationships with family and friends are good. Service users are able to join in a variety of activities. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices as well as special dietary needs. EVIDENCE: Service users spoke about the many trips they have enjoyed to Belsay, St Mary’s Lighthouse and the Tall Ships on the Quayside. Other activities are entertainers, singers, arts and crafts and chairobics. Visitors are welcome any time and a relatives support group can meet monthly. A recent summer fair was enjoyed by those who attended and the newsletter provides good information about all aspects of the home. Service users spoke highly of the food and the lunch meal was attractively served. Staff sat with service users who needed help during the meal. The lunch- time menu was belly pork, roast potatoes, cabbage with sago or ice cream for dessert. The alternative was a jacket potato and various fillings. Service users were offered more alternatives through the meal such as soup and an omelette. A variety of drinks were available including milkshakes. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 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 standard(s) 16 & 18 The home has a satisfactory complaints system in place. Systems are in place to protect service users from harm. EVIDENCE: Service users said they would tell the manager if they were unhappy about anything. The manager is proactive in obtaining the views of service users, visitors and staff. Staff spoken with are clear about reporting any concerns to the manager. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 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 standard(s) 19, 21, 24 & 25 The standard of the environment within this home is good providing service users with a safe, clean and homely place to live. EVIDENCE: A tour of the premises with the manager found the home to be clean, well maintained and decorated. The manager plans to develop the rear garden for the benefit of the service users. Adequate numbers of bathrooms and toilets are provided for the current number of service users living in the home. However a walk-in shower would be of benefit to service users in the interest of choice and personal hygiene. The bathroom in question has a bath which is cracked and requires repair or replacement. Several bars of soap were found in the middle floor bathroom and the manager said he would remove them. Bedrooms are comfortable and personalised. However one bedroom had a strong odour and the manager is dealing with this. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 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 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 & 30 Staffing numbers are appropriate to the assessed needs of the service users, size and layout and purpose of the home at all times. Service users are not being moved and handled appropriately. EVIDENCE: The home maintains the level of staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the residents currently living in the home. At the time of the inspection there are 5 care staff on duty during the waking day and 3 waking nights. Several service users were observed to be moved inappropriately using a ‘drag’ lift. Moving belts are not available but are to be supplied according to the deputy manager. Some staff were also observed to walk ahead of service users too quickly when supporting them. The deputy said that some staff have received refresher training but the concerns observed remain. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 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 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, 37 & 38 The Manager is experienced and is supported by the senior staff in providing clear leadership throughout the home, with all staff demonstrating an awareness of their roles and responsibilities. The safety of service users and staff are protected but two areas must be addressed. Records are maintained appropriately however the handover book does not. EVIDENCE: The manager has completed the Registered Managers Qualification and is awaiting his result. Mr Lillico has also completed D32 and D33 NVQ Assessors Award. Service users spoke highly of the manager and said they would raise any concerns with him. They were observed to be relaxed and familiar with Mr Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 16 Lillico. Staff also spoke of the open style management and support which they receive. Mr Lillico supports service users and staff to reach their potential such as art competitions, craft hobbies, training and awards. One service user has entered a calendar competition by the Company. A carer was awarded the ‘Carer’s Commitment and Achievement Award’ in November 2004 within the Company. The home records confidential information about service users in a Staff Handover Book. The record should refer to the service users individual care record for staff to read. At lunch time the inspector sat with two service users and one person was interested in the electric switches below the table. A cover should be considered to prevent potential hazards. Moving and handling of service users must improve as mentioned NMS 30. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 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 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 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x 3 3 x STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 4 x x x x 2 2 Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 18 yes 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 9 Regulation 13(2) Requirement Medication issues must be addressed ie - Covert administration of medication must cease until the Royal Pharmaceutical Society Guidelines 2003 6.2.2 are followed. - Allergies must be recorded on Medication Administration Records. - Retain medication for 7 days after a service user has died. Confidential information must not be recorded in the Staff Handover Book The cracked bath on the ground floor must be repaired or replaced (see Recommendation 1) The identified electric socket in the dining room must be made safe from potential hazards. Staff must receive training and equipment for the safe moving and handling of service users Timescale for action 16/9/05 2. 3. 37 21 17 23(2) 23/9/05 30/9/05 4. 38 & 30 18(1) & 13(4) 31/10/05 Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 19 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. Refer to Standard 21 10 Good Practice Recommendations Consider providing a walk in shower as a replacement for the damaged bath on the ground floor. Communal combs must not be used for service users hair. Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Coniscliffe Rest Home B53-B03 S437 Coniscliffe V241124 150905 Stage 4.doc Version 1.40 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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