Inspection on 19/07/05 for Court Nursing Home

This inspection was carried out on 19th July 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

Court Nursing Home 17/04/09

Court Nursing Home 03/05/07

Court Nursing Home 06/09/06

Court Nursing Home 20/02/06

Court Nursing Home 04/03/05

Court Nursing Home 04/05/04

Similar services:

Sunny Bank (P.R.S.) Ltd

Chirnside House

Ashwood Court Unit 1

Thornton Lodge

Emmaus House

East Croft Grange

Craignair

Alfred House Residential Care Home

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

CARE HOMES FOR OLDER PEOPLE Court Nursing Home 644 New Chester Road Rock Ferry, Birkenhead Wirral CH42 1QB Lead Inspector Jeanette Fielding Announced 19 July 2005 9:15 am th 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. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Court Nursing Home Address 644 New Chester Road Rock Ferry Birkenhead Wirral CH42 1QB 0151 643 1162 0151 643 1162 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) Court Nursing Home Mrs Carol Lynne Owens Care Home with Nursing 31 Category(ies) of DE(E) Dementia - over 65 (31) registration, with number MD(E) Mental Disorder - over 65 (31) of places Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 4 named adults under 65 years of age. Date of last inspection 6/9/04 Brief Description of the Service: The Court Care Home is situated in a residential community and is close to all local amenities and is on a public transport route with easy reach to Birkenhead town centre. Accommodation for service users is provided on three floors. Communal space is situated on the ground floor and includes a lounge with access to the dining room. There is a serving hatch from the kitchen to the dining room. There is a non-smoking lounge and a separate designated smoking room. The dining room is accessed through the lounge. There is single and shared bedrooms on three floors. A passenger lift is available to service the first and second floor. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over a period of eight hours in one day. Discussion was held with management, staff and service users to obtain their views of the home and the service provided. Care records were inspected and were found to be comprehensive and informative. These have been improved considerably since the last inspection and now provide staff with all the necessary information for the appropriate level of care to be provided. Staff records showed that all documentation was in place and that all checks had been made to ensure the protection of the service users. A tour of the building showed that improvements continue to be made to the benefit of the service users and to provide them with a homely environment. A plan of further improvements was seen. Discussion with staff, and inspection of documentation within the home, provided evidence that a high level of training has been provided and that this training was relevant to the needs of the service users and benefited them. Some attention is required to the recording of medications entering the home and of those administered to service users. What the service does well: What has improved since the last inspection? What they could do better: The records relating to medications require to be more accurately held to clearly identify the amounts of medications entering and held in the home, and of those administered to service users. Some bedrooms were stark and bare and discussion took place regarding methods of personalising bedrooms to further improve the homeliness of these. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 6 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. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 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 Court Nursing Home F52 F02 S20944 Court NH V229040 190705 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) 1, 2, 3, 4, 5 Pre-admission assessments are undertaken to ensure that the home can meet the service users individual needs and ensure their protection. EVIDENCE: The home has prepared a Statement Of Purpose and a Service User Guide. These documents give full information about the home and the service provided. They are accessible to all service users and copies are available from the home on request. All service users are funded by the Local Authority who has issued contracts. These were seen to be held on service users files. Pre-admission assessments are undertaken on all service users to ensure that the home can meet their individual needs and to enable the home to obtain any necessary equipment and services prior to the service users admission. Information is gathered at the time of the assessment from the service user, their family, the Multi Disciplinary Team and any other professional involved in their care. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 9 The daily reports completed by staff are informative and given details of the specific care given to each individual service user. Changes in their care needs are identified to enable the plan of care to be reviewed as necessary. Some prospective service users visit the home prior to admission although it is generally their family or advocate as many prospective service users are unable due to hospitalisation or ill health. Prospective service users who visit the home are given the opportunity to view the rooms available and to meet with staff and other service users. These visits also provide staff with additional information to assist with the assessment of need. The home does not offer Intermediate Care. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 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, 9, 10, 11 The home has failed to ensure that service users medications are dealt with in a safe manner and has the potential for putting service users at risk. EVIDENCE: A plan of care is prepared for each individual service user. The initial plan of care is prepared based on the information gathered during the pre-admission assessment and is reviewed following the service users admission to the home. The care plans were found to be informative and gave all necessary information to enable the care staff to meet the identified care needs. Risk assessments are prepared and risk management plans are in place to remove or reduce any potential risk. The records provide evidence of all visits to and by GP’s and other healthcare professionals and give details of any additional care recommended. The advice of the Tissue Viability Nurse, the Multi Disciplinary Care Team and other specialist services are sought whenever necessary. Some attention is required to the recording of medications. Accurate information is required in relation to the amount of medications entering the home from the pharmacy. Records of daily amounts held for some Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 11 medications are made, however, some staff have failed to record this information accurately. All hand written entries on the medication administration record sheets should have two signatures to provide evidence of accuracy of the information recorded. Some staff have failed to sign the MAR sheets to indicate that they have administered the medications to the service users. All medications were seen to be stored safely and the storage areas were clean and organised. Personal care is given to service users in their bedroom or in the bathroom as appropriate. Screens are provided in shared bedrooms to ensure the privacy and dignity of both service users. Service users may meet with their visitors in their bedroom or in one of the communal areas as they wish. The home has a policy and procedure to be followed in the event of a service user dying. Family members are welcome to stay as long as they wish and the staff do all they can to provide support at this time. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 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, 14, 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Daily life within the home is quite structured as this has been identified as necessary to meet the needs of the service users. Individual preferences are met as much as possible within a risk management strategy and in line with the assessment of each individual. Service users spoken to confirmed that they were given every opportunity to make decisions, although some service users were not able to do this because of their mental health problems. The records show that individual preferences are respected in relation to how they wish to be addressed, the time that they go to bed and rise and the meals that they take. Visitors are welcomed to the home at any time some family members take their relative out. The staff encourage service users to take their meals in the dining room as this gives an opportunity to promote social interaction. Two sittings are held at meal times as the dining room is not sufficiently large for all service users to take their meal at the same time. The menu’s provide evidence that a choice of meals is offered and that a varied and balanced diet is served. Service Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 13 users who wish to take their meal in their bedroom or in the lounge may do so. Special diets can be provided on the advice of the GP or dietician or on the request of the service user. A nutritional assessment is undertaken on each service users and information on special diets and individual preferences is held in the care files. This information is also given to the cook to ensure that the service users needs and preferences are met. The kitchen area was seen to be clean and organised. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 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, 17, 18 Staff have a knowledge and understanding of Adult Protection issues which protects service users from abuse. EVIDENCE: The home has a comprehensive complaints procedure which is detailed in the statement of purpose and is also displayed in the home. The procedure identifies the person to complain to and the timescale in which the complaint will be investigated and responded to. The home does not deal with any of the service users legal issues. Relatives or advocates take responsibility for these. All staff have been given training in the different types of abuse, and of the action to be taken in the event of it being suspected. All service users are risk assessed to ensure that they are protected. Staff spoken to during the inspection were able to demonstrate that they were aware of the complaints procedure and of the action to be taken. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 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, 22, 23, 24, 25, 26 Recent investment has significantly improved the appearance of this home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: A programme of redecoration and improvements within the home continues to take place and considerable work has been completed since the last inspection. New laminate flooring has been fitted in the majority of the home to provide a bright and welcoming environment. Communal areas are appropriately furnished and discussion took place regarding the floor covering in the smoking lounge that has become damaged by cigarettes. The flooring in this room meets the standard required by Merseyside Fire Authority to ensure that the service users are protected. Furnishings in bedrooms is good and a programme of replacing the beds in the home continues. Some bedrooms were extremely stark as several of the service users do not have families to assist in personalising the rooms. The Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 16 home is advised to liaise with the service users with a view to providing personal items and pictures to enhance their rooms. The owner stated that plans are in place to repaint the exterior of the home but that this work would not commence until spring 2006 as the main priority had been to improve the interior of the home. Sufficient lounge space is provided and service users have a choice of areas to sit in groups or alone as they wish. Sufficient bathrooms and toilets are provided and assisted bathing facilities benefit those service users who have mobility difficulties. The home has been assessed by both the Occupational Therapist and the Physiotherapist to ensure that all necessary aids and adaptations have been provided to assist service users. Locks can be fitted to bedroom doors on the request of the service user subject to a risk assessment and appropriate safety measures being put in place. Every effort has been made to ensure the health and safety of the service users. The home is central heated and radiators are all fitted with low surface temperature surfaces. Radiators can be adjusted to provide each service user with the choice of temperature of their room. All windows can be opened and provide natural light and ventilation. Thermostatic valves have been fitted to all hot water outlets to remove the risk of scalding from hot water. The home was found to be clean throughout, and although one area of the home smelled offensive, appropriate measures are being taken to address this. Infection control policies are in place and all staff spoken to were aware of the procedures to be followed. Appropriate measures are in place for the disposal of general and clinical waste. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 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, 28, 29, 30 The staff have a good understanding of the service users support needs and work positively with them to improve their quality of life. EVIDENCE: The staff rota provides evidence that the home is fully staffed and that all shifts are covered. The number of staff provided meets the requirements of the registering authority and the needs of the service users. A high level of training has been given to staff since the last inspection. It is expected that all members of the care staff will hold NVQ at level 2 by the end of 2005. Several staff hold, or are currently working towards NVQ at level 3. Recent training undertaken by staff includes managing violence and aggression, dementia care, vulnerable adult protection, manual handling, heath and safety, food hygiene, basic life support, fire protection, infection control and drug awareness. Evidence of all training is held on individual staff files. All training is planned and follows a rolling programme of updates. Details of all planned training was displayed in the managers office. The staff records provide evidence that the homes recruitment policy and procedure is followed. All prospective staff are required to complete an application form prior to interview. Two references are taken and checks are made through the Criminal Records Bureau and Protection of Vulnerable Adults register to ensure the protection of service users. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 18 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, 33, 34, 35, 36, 37, 38 The manager has a good understanding of the areas in which the home needs to improve. Planning was in place and set out how this improvement was going to be resourced and managed. EVIDENCE: The registered manager of the home is an RMN who also holds a management qualification. She is experience in management and caring for elderly people who have mental health problems. The manager has an open door policy and is available for staff, service users and visitors to the home. Regular staff meetings are held to disseminate information and to gather the staff’s views of the home and the service users. Weekly meetings are held with the qualified nurses to give the opportunity to discuss the care needs of the service users and to identify changes in their plan of care. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 19 The home now holds the Investors In People quality award. Regular reviews of the home and the services provided are undertaken and changes are made as they are identified. Comprehensive records are held in relation to the small amounts of money held on service users behalf. The owner is looking to reviewing the systems for dealing with service users finances and is liaising with service users, their relatives and advocates and the bank to improve the service provided by the home. All staff are given regular supervision and annual appraisals, and evidence of this is held on the staff files. The owner of the home works within the home on a regular basis to oversee the day to day running and to deal with the business systems and the continued improvements that are taking place. Health and safety is the responsibility of a designated member of staff who has been given appropriate training, together with the manager and handyman. All safety certificates inspected were found to be in place and up to date. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 20 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 21 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 9 Regulation 13 Requirement The Registered Person must ensure that all staff follow the homes policy and procedure for the recording of medications administered to service users and those held in the home. Timescale for action 17th August 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. Refer to Standard 19 Good Practice Recommendations It is recommended that staff work more closely with service users to assist them in personalising their bedrooms. Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 3rd Floor, Campbell Square 10 Duke Street Liverpool L1 5AS 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 Court Nursing Home F52 F02 S20944 Court NH V229040 190705 Stage 4.doc Version 1.40 Page 23 - 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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