Inspection on 20/02/06 for Court Nursing Home

This inspection was carried out on 20th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 19/07/05

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 Unannounced Inspection 20th February 2006 10:30 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 Court Nursing Home DS0000020944.V280268.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. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 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 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) Helmreal Limited Mrs Carol Lynne Owens Care Home 31 Category(ies) of Dementia - over 65 years of age (31), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (31) Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 4 named adults under 65 years of age Two named service users under 65 years Date of last inspection 19th July 2005 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 DS0000020944.V280268.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in one day over a period of seven hours. During the inspection, the records relating to the care required and given to service users were inspected and found to be detailed and informative. Staff records provided evidence that all checks were made on staff prior to them being employed, and also provided evidence of on going training. Medications were found to be dealt with appropriately. A tour of the premises found that the décor had now deteriorated to an unacceptable level. Only three bedrooms had been redecorated since the last inspection, despite assurances at the last inspection that this would be addressed. The home was not maintained in a clean condition. What the service does well: 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. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 6 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 Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 7 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): 1, 3 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. 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 DS0000020944.V280268.R01.S.doc Version 5.1 Page 8 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 DS0000020944.V280268.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, 10 The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: A comprehensive 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. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 10 A full review of the medications system has been developed since the last inspection. Medications are ordered by the manager on a weekly basis and are fully checked when they arrive at the home. A weekly audit of all medications is undertaken by the manager to ensure that they are administered and recorded accurately. Medications are now delivered to the home in individual containers as it was found that the use of blister packs on a monthly basis was not as efficient. Evidence of the weekly audit trail of the medications showed that the new system was effective and comprehensive records are now held. Medications are disposed of appropriately and a contract with a disposal company has been arranged. Some minor amendments are required to the medications policy to reflect the changes within the home and the manager has already made inroads into this. 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. Court Nursing Home DS0000020944.V280268.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, 13, 14, 15 A full programme of activities has been prepared to enhance service users social opportunities. 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. Activities take place every afternoon with a designated video afternoon being held each week. A large range of activities, games and craft equipment was held in the home to enable a choice of activities to be offered. Visitors are welcomed to the home at any time some family members take their relatives out. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 12 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 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. Fresh fruit and vegetables are used as much as possible and food stocks were seen to be good. The kitchen area was clean and organised. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 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 the following standard(s): 16, 18 The home has a satisfactory complaints system with evidence that service users feel that their views as listened to and acted upon. 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 complaints procedure also gives full information on how to contact CSCI. No complaints have been received by the home, or by CSCI, since the last inspection. Service users spoken to said that they were comfortable in raising any issues with the manager and felt assured that any concerns would be dealt with. 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 adult protection procedure and of the action to be taken in the event of it being suspected. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 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 the following standard(s): 19, 26 The standard of the décor within this home is extremely poor with little evidence of improvement. The home does not, therefore, present as a homely and comfortable environment for service users. EVIDENCE: A programme of refurbishment is currently underway but is moving extremely slowly. New flooring has been fitted throughout the home including all communal areas and bedrooms, with the exception of one. Plans are in place for the exterior of the home to be repainted and this work is due to commence in April 2006 and will take eight weeks to complete. Three bedrooms have been redecorated, but only one has been provided with a mat at the side of the bed to enable the service user to put their feet on to a warm surface. All other rooms require that service users place their feet on the cold flooring. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 15 The décor in all other areas of the home is now extremely poor and have reached an unacceptable level. The corridors are stark and bare with no colour or homeliness. The flooring in the smoking area has now extremely damaged from cigarettes and should be replaced with suitable covering as a priority. The home was not maintained in a clean condition. Walls and paintwork were dirty and stained and require to be thoroughly cleaned prior to redecoration. One bedroom was seen to have what appeared to be the remnants of Christmas decorations hanging from the picture rail and cobwebs were evident. A programme of cleaning all areas of the home must be implemented with immediate effect. A discussion was held with the owner of the home subsequent to the inspection. The inspectors concerns had been expressed to him by the manager of the home. It was agreed that an additional decorator would be employed and that all areas of the home, including corridors and bedrooms would be redecorated within the next three months. A further visit will be made to the home in three months time to confirm that the work has been completed. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 16 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, 28, 29, 30 The home follows a robust recruitment procedure to ensure that service users are protected. 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. The manager is actively promoting training for all staff. The programme of NVQ training has fallen due to problems with the training company. Arrangements have now been made to address this and additional staff are due to commence training very soon. Two of the domestic staff have achieved NVQ qualifications in relevant subjects. The staff files were found to be detailed and organised. All necessary information, including evidence of training undertaken is recorded. The home has a robust recruitment procedure. All prospective staff are required to complete an application form prior to interview. Two references are taken together with Criminal Record Bureau and Protection of Vulnerable Adults registers checks. Gaps in employment history are explored and evidence of prior training and qualifications are required to be produced. A record is held of the interview and each applicant must reach the required score at interview to be considered for employment at the home. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 17 All nurses are required to be registered with the Nursing and Midwifery Council and their PIN numbers are checked with the NMC. A full induction programme is followed by all new staff and this is evidenced on the staff files. Regular supervision is given and annual appraisals held. Specific training opportunities are made available to the trained nurses and to the care staff according to their previous skills and experiences. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 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 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, 33, 35, 38 Some service users finances are not dealt with appropriately and has the potential for financial abuse. 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 DS0000020944.V280268.R01.S.doc Version 5.1 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. Small amounts of money are held in the home for a few of the service users at their request. The signatures of those service users who request their money from the home is to be made to ensure their protection. Each of the service users is billed each month for the cost of hairdressing, chiropody and toiletries. No agreement to pay this amount has been signed by the service users and discussion with the owner took place regarding this. The additional costs are not detailed on the contracts and new contracts must be prepared and service users billed only if they, or their advocate, agrees. Records relating to service users finances must be held in the home. The owner holds the money for some service users. This is not acceptable and individual accounts are to be held to ensure that service users money is protected and that service users receive any interest on their money due to them. The electrical wiring certificate was not available for inspection. Discussion with the owner confirmed that the electrical wiring within the home was due for inspection and that this would be arranged. A copy of the report, together with confirmation of completed work is to be submitted to CSCI within eight weeks of the date of the draft copy of this report being received by the owner. Evidence was seen of fire training for all staff, but there was a lack of evidence that the fire detection equipment had been adequately tested at appropriate intervals. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 1 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 3 X 2 X 1 X X 1 Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP19 Regulation 23(2)(d) Requirement The Registered Person must ensure that all corridors and bedrooms are decorated to a good standard. The Registered Person must ensure that all areas of the home are maintained in a clean condition. The Registered Person must ensure that service users personal money is held in their personal account. The Registered Person must ensure that service users money is not held in any account in connection with the care home. The Registered Person must ensure that all tests are made on fire detection equipment at appropriate intervals and duly recorded. The Registered Person must ensure that the electric wiring within the home is safe and provide evidence of this to CSCI. Timescale for action 20/05/06 2. OP26 23(2)(d) 03/03/06 3. OP35 20 17/03/06 4. OP35 20 17/03/06 5. OP38 23(4) 03/03/06 6. OP38 13(4) 21/04/06 Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 22 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 OP19 OP33 Good Practice Recommendations Mats should be provided at the sides of beds to prevent service users placing their feet on cold flooring when they rise. The home should be run in the best interests of the service users in respect of the décor. Court Nursing Home DS0000020944.V280268.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Local Office 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 DS0000020944.V280268.R01.S.doc Version 5.1 Page 24 - 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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