Inspection on 06/09/06 for Court Nursing Home

This inspection was carried out on 6th September 2006.

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 20/02/06

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 Andrea Morris Unannounced Inspection 6th September 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.V303803.R01.S.doc Version 5.2 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.V303803.R01.S.doc Version 5.2 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.V303803.R01.S.doc Version 5.2 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 20th February 2006 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.V303803.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection. The inspector during the visit spoke with residents, staff, the manager and several visitors. A tour was made of the building and a selection of documentation was examined including resident care files, staff personnel files, training records, medication and certificates relating to Health and Safety. What the service does well: What has improved since the last inspection? What they could do better: Care files are in need of some work especially around implementing and reviewing care plans. Medication was generally managed satisfactorily however, some minor issues require addressing ensuring safe practice is maintained. All staff require training in adult protection to ensure residents are protected from potential harm. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 DS0000020944.V303803.R01.S.doc Version 5.2 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 Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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): 1, 2, 3, 4, 5, 6 Residents are only admitted to the home following a full assessment of their needs, this assists in ensuring residents care needs can be met. EVIDENCE: The home has an up to date statement of purpose and service user guide, it has not been changed since the last inspection but remains appropriate. All residents and/or their families receive a copy on admission, further copies are available upon request. All residents admitted to the home are in receipt of a written contract which clearly defines their terms and conditions of residency. The home manager completes pre-admission assessments prior to any resident being offered a place in the home, these on inspection where found to be detailed and contained all necessary information to make decisions on offering places to potential residents. All professional visitors are recorded in residents care files, wherever possible the visitor completes the form to demonstrate what care has been delivered and any further treatment required. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 Page 9 The home encourages potential residents and their families to visit prior to moving into the home, any potential resident can stay for a day to test the service if they choose at no extra cost. The home does not provide intermediate care. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9, 10, 11 Care plans must reflect the care required by each individual resident, this assists to ensure residents remain safe and care is delivered appropriately. EVIDENCE: A selection of care files were examined and found that on pre-printed care plans no individualisation had been made to those care plans. Thus in some incidences the care plan was not completely accurate. Information on the pre-admission assessment had not been recorded in appropriate care plans as required. Review dates on care plans and risk assessments did not provide sufficient detail to demonstrate when care had been reviewed and when it was to be reviewed again. A full date is required to be recorded to ensure regular review of care is being carried out. The homes medication is generally managed adequately however, it was noted that not all handwritten entries had the required two signatures recorded. Medication with a short life span i.e. eye drops did not have the date of opening recorded on the bottle. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 Page 11 The home must purchase a fridge for the storage of medication to ensure safety is maintained at all times. The home has a good system of recording homely remedies and each day a stock check is made of certain drugs. The home manager does complete a weekly audit to ensure stock control is appropriate. During the visit it was observed by the inspector that residents and visitors were treated with respect, residents were offered choices on how they spent their day, including what time they got up. All residents are able to receive visitors in private. The home has an adequate policy in care of the dying resident. Staff through their NVQ receive training in care of the dying. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15 Residents are offered a variety of activities, this assists in ensuring they lead socially stimulating lives. EVIDENCE: The home employs an activities organiser Monday to Friday each afternoon. The home encourages residents to participate in activities provided but respects their decision if they decline to join in. Activities provided include, bingo, art and crafts, board games, snooker and singing. Once a month a local organist visits to play for the residents. Communion is provided for those residents who wish to retain their right to practice their faith on a weekly visit. A clear recording system of activities participated in is maintained within the residents individual care file. The home tries to ensure that on a daily basis in good weather residents are given the opportunity to go into the local community for afternoon tea or for a walk, this is done on a regular basis offering all residents the opportunity to participate. The home operates an open visiting policy. Residents can receive visitors in private and at times convenient to them. Visitors who spoke with the inspector reported that they found the home was friendly and the staff helpful. They Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 Page 13 commented on the new décor and stated it had improved the feeling of the home. The homes menus are operated on a four weekly cycle, they are regularly reviewed to ensure residents are enjoying meals provided. Residents are able to receive an alternative if they choose to, residents who spoke with the inspector stated they enjoyed the food. The kitchen on the day of the inspection was found to be clean and well managed. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 the following standard(s): 16, 17, 18 All staff in the home must receive training in adult protection, this assists in safeguarding residents from any potential harm. EVIDENCE: The home has a comprehensive complaints procedure, it contains details on whom to complain to and the address of the Commission for Social Care Inspection. There have been no complaints made to the Commission for Social Care Inspection since the last inspection. A system to record minor concerns is required to demonstrate action taken in the case of a verbal concern being raised in the home. All residents entering the home are placed on the electoral role. The home will access advocacy agencies for resident who do not have immediate family to assist them in dealing with personnel affairs. All staff on induction are given instruction on the policy relating to adult protection, some staff have received training in adult protection but it is required all staff are trained in adult protection on a regular basis. The home is in receipt of the Wirral No Secrets (Adult Protection) Policy. There have been no incidences of Adult protection issues in the home since the last inspection. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The homes decoration has improved to a high standard, this must be maintained to ensure a safe and homely atmosphere is created for all residents living in the home. EVIDENCE: Since the last inspection the home has carried out a total redecoration of all residents’ bedrooms and the communal living areas. There are still further improvements to be carried out in the toilets and in some bathrooms to ensure the standard of safety and cleanliness is maintained throughout. Residents, relatives and staff all spoke about the improvement of the décor and commented that it was a much more pleasant environment for all to live and work in. The garden area is currently being addressed to ensure that it remains tidy and safe for those residents who choose to access the garden area. Further work is planned for September to develop the garden area. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 Page 16 The home cleanliness has also improved since the last inspection, currently the domestic staff are studying NVQ1 and are due to complete by the end of the year. The home has the use of two hoists to ensure residents are moved safely, staff receive regular training in moving and handling. Most residents rooms are personalised with their own effects, where residents do not have family, staff assist in providing suitable pictures to create a homely environment for each resident. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 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 operates a robust recruitment policy, this assists in protecting residents from potential harm. EVIDENCE: The staff rota was examined and found to contain sufficient staffing levels for the current resident group. The home does not use agency in general as sufficient staff are employed within the home. 66 care staff hold the NVQ2 or above in care, the remaining staff are currently studying for the award and are due to complete in future months. The staff-training file was seen, many staff have recently attended a variety of training events. Training is provided both in house and through outside training providers. Records of staff training are maintained to a good standard. All staff on commencement of employment receive a full induction which is documented and kept on file, all staff are in receipt of a copy of their job descriptions. A selection of staff files were examined and all found to contain the relevant information required. All staff are checked through CRB (Criminal Records Bureau) as well as appropriate references being sort prior to commencement of employment. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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, 32, 33, 34, 35, 36, 37, 38 The home is well managed and leadership is provided to all staff, this assists in promoting good standards of care for all residents. EVIDENCE: An experienced manager who is registered with the Commission for Social Care Inspection manages the home, she holds the NVQ4 certificate in Management. Staff and visitors who spoke with the inspector stated they found the manager to be fair and friendly. Staff acknowledged that the manager gave clear instructions as necessary. The home carries out its own internal audit system by sending out questionnaires to relatives to seek their comments on the homes performance. The home is also accredited with the Investors In People Award and has held it since February 2005. Staff receive regular supervision with the manager, records are maintained to a good standard. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 Page 19 The home reviews its policies and procedures on a regular basis. Policies are held in the manager’ office for staff to access if required. All certificates relating to Health and Safety were seen and all found to be in date and relevant. The home displays the certificate of Employers Liability and certificates from the Commission for Social Care Inspection in the main entrance area of the home. Residents finances were examined and all found to be recorded and correct, a new system has been introduced since the last inspection to ensure an adequate and safe recording and handling system is maintained. Restricted access to resident finances is maintained to protect residents from potential harm. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 4 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 3 3 3 Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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 OP7 Regulation 15(1) Requirement Timescale for action 01/10/06 2. OP9 13(2) 3. OP18 18(1)(c) The registered person shall prepare a written care plan as to how the resident’ needs in respect of his health and welfare are to be met. The registered person shall make 30/09/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. 1) Purchase of a medicine fridge is required 2) All handwritten entries must contain x2 signatures 3) All short life medication must have the date of opening on the packet to ensure only used for the 28 day period. The registered person shall 30/11/06 ensure all persons employed to work in the care home receive appropriate training in adult protection. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 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. Refer to Standard OP16 Good Practice Recommendations It is strongly recommended that all concerns received verbally into the care home are recorded along with the appropriate action taken. Court Nursing Home DS0000020944.V303803.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite 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. 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