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Inspection on 02/08/05 for Daisy Bank Nursing Home

Also see our care home review for Daisy Bank Nursing Home for more information

This inspection was carried out on 2nd August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Health care awareness was evident, with the importance of any changes in health status, being continually monitored by appropriately trained, caring and diligent staff. Service users individual needs and wishes were well met, and service users were treated with dignity and respect. The home has a robust recruitment procedure. This was evidenced within staff records examined. Care plans viewed were clear, and up to date, enabling service users` needs to be met.

What has improved since the last inspection?

The Registered Person has introduced a Quality Assurance survey format, which has recently been sent out. The feedback obtained will feed into the home`s existing Quality Assurance system.

What the care home could do better:

Quality Assurance auditing is under way, and is being further developed. This will need to be collated, and will feed into the existing Quality Assurance system.

CARE HOMES FOR OLDER PEOPLE Daisy Bank Nursing Home C/O Jackson, Dyson & Blundell 17-19 Leek Road Cheadle Staffordshire ST10 1J Lead Inspector Pam Grace Unannounced 2 August 2005 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. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Daisy Bank Nursing Home Address C/O Jackson, Dyson & Blundell 17-19 Leek Road Cheadle Staffordshire ST10 1J 01538 750439 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) Classic Care Homes Ltd Mrs Ruth Anderson CRH 32 Category(ies) of DE(E) - 4 registration, with number OP - 32 of places PD(E) - 6 Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 8 March 2005 Brief Description of the Service: Daisy Bank is a care home providing personal care including nursing care for up to 32 elderly service users. This includes care for up to six service users over the age of 65 years with physical disabilities, and dementia care for up to four service users over the age of 65 years. A private company - Classic Care Homes Limited, owns the home. The home is located on the outskirts of the town of Cheadle, in the East Staffordshire district. There are no amenities within the immediate vicinity, but Cheadle town centre is approximately a tenminute walk away, where there are a choice of shops, public houses, banks and churches. The home was converted to a care home several years ago, from two large houses, and consists of two floors served by a passenger lift. There is ample car parking, and the gardens are accessible around the home to service users including wheelchair users. The accommodation provides for mainly single bedrooms, with six double bedrooms. There is ample provision of toilet and bathing facilities, and communal seating areas. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place over a period of 6 hours by one inspector. The home’s Registered Person and Care Manager assisted the Inspector throughout the inspection. The inspector spoke with the Registered Person, several staff members, visiting relatives, and many service users during the inspection. Service users spoken with were very positive about the care they were receiving, there were also service users who were unable to communicate, the inspector noted that they appeared well cared for, and were happy in their surroundings. The inspection undertook a tour of most areas of the home, and a number of records and documents were examined. Conditions in the home were determined by direct observation, and sampling other services provided, such as provision of activities, and aspects of health and safety measures. There were no requirements and one recommendation made as a result of this unannounced inspection. What the service does well: Health care awareness was evident, with the importance of any changes in health status, being continually monitored by appropriately trained, caring and diligent staff. Service users individual needs and wishes were well met, and service users were treated with dignity and respect. The home has a robust recruitment procedure. This was evidenced within staff records examined. Care plans viewed were clear, and up to date, enabling service users’ needs to be met. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 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. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 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 Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 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) 2,3,4,5 Service users have a written contract/statement of terms and conditions. Service users and or their representatives are assured that the home would be able to meet their assessed needs. Prospective service users are invited to visit the home and to move in on a trial basis, to enable a decision to stay. Unplanned admissions are avoided where possible. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 9 EVIDENCE: The manager confirmed that a full pre-admission assessment is undertaken with the prospective service user, and their relative/representative. Confirmation is then made in writing as to the home’s ability to meet the service user’s needs. The inspector examined service user care plans, spoke with service users, and the registered person. Service users receive a written contract and or statement of terms and conditions. The manager confirmed that prospective service users are able to move into the home on a trial basis. A decision to stay would be made, following a review. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 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) 7,8,10 The service user’s health, personal and social care needs are set out in an individual plan of care. Service users make decisions about their lives with assistance as needed. EVIDENCE: The inspector examined a random selection of service user care plans. They evidenced that individual health, personal and social care needs had been established, and were being met. Service users spoken with confirmed that their health, personal and social needs were being met, they spoke positively about the care and support that they received from staff at the home. The Inspector noted how well service users appeared, and how happy the atmosphere was in the lounge areas. Staff interacted appropriately with service users, respecting their wishes. Staff were seen to knock on service user’s bedroom doors prior to entering, and waited for consent to open the door. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 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 Service users can choose whether or not to take part in organised activities at the home, and can exercise choice in the routines of daily living. Service users maintain contact with family, friends, their representatives and the local community as they wish. EVIDENCE: The inspector observed service users undertaking appropriate activities in the dining room, and had the opportunity to speak with the activities co-ordinator. She confirmed that she uses activities that are age appropriate, and fun to do. Service users spoken with confirmed this, and were very satisfied with what is provided by the home. The inspector noted during the inspection that crafts, and armchair exercise can be accessed by service users on Tuesdays and alternate Wednesdays. Other service users spoken with confirmed that the quality of food they receive is very good, nutritious, and well presented. One service user said that they had received a delicious home baked birthday cake, baked by the cook, and provided by the home a few weeks previously. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 12 There was evidence from talking to service users and visiting relatives that contact is maintained with family and friends on a regular basis. There were no restrictions placed on visiting times, and the home provides a relaxed and friendly environment. Visitors were seen arriving and leaving the home during the course of the inspection. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 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 standard(s) 16,18 Complaints and concerns are listened to and resolved. The home’s policies, procedures and staff training protect service users from abuse. EVIDENCE: The inspector spoke with staff and service users. Service users spoken with said that they felt safe and secure in the home. Staff spoken with confirmed that they had received training in regard to abuse/vulnerable adults. This was undertaken during their TOPSS/ induction course, staff stated that they were also aware of the whistle blowing policy and the procedure for the reporting of abuse. The manager confirmed that staff had undergone appropriate CRB and POVA checks prior to employment at the home. Staff spoken with confirmed that any complaints and concerns are always listened to, and acted upon. They are usually resolved straight away. The home has a clearly written complaints procedure, which is readily available to service users, their relatives and or representatives. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 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 standard(s) 19,20,22,23,24,25,26 The location and layout of the home is suitable for its stated purpose. Service users live in a safe, clean and comfortable environment, which has been adapted to suit their lifestyle, and individual needs. EVIDENCE: The inspector undertook a tour of the home, which included all the communal areas. The home was found to be clean and well presented throughout. Bedrooms had been adapted to suit the needs of the service users and there was evidence of personal effects in bedrooms. Various aids and adaptations were in place including assisted baths, mobile hoists and other equipment used for moving and handling of service users. There was a nurse call bell in operation, which was heard to be working at the time of the inspection. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 15 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 Staff members are present in sufficient numbers and have the necessary skills, competencies and experience to care for the service users. Staff members are appropriately recruited to work at the home, and service users are protected by the home’s recruitment policy and practices. EVIDENCE: At the time of the inspection there was a total of 31 service users resident in the home, duty rotas were examined. Staffing levels were seen to be appropriate to the number of service users in residence at the home. The manager confirmed that existing staff members try to cover shifts that other staff would be unable to undertake, due to sickness or holidays. As well as nursing and care staff, the home employs ancillary staff consisting of housekeeping and laundry assistants, cook and kitchen assistant. There is also a maintenance person. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 16 The inspector spoke with staff members, and examined staff recruitment/training records. Staff spoken with confirmed that they had received appropriate training. This included in house induction training and TOPSS related courses. Records viewed showed that staff had received training on fire safety, health and safety, and food hygiene. A random selection of staff recruitment files was examined, and there was evidence of a thorough and robust recruitment procedure including 2 written references, CRB and POVA check. All prospective employees are interviewed and employment history is obtained. The inspector was informed that some staff members had declined to undertake the NVQ 2 award. The manager confirmed that they were currently discussing this with those staff members, and looking into other options for training. The manager is aware of the need for the home to have achieved 50 NVQ 2 qualified staff by 2005. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 17 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) 31,32,33,38 The manager is appropriately trained and experienced to run and manage the home. Service users benefit from the way in which the home is managed, and the home is run in the best interests of the service users. The home’s existing Quality assurance system should be further developed to include survey feedback, which will feed into the existing Quality Assurance system. The health, safety and welfare of service users and staff are promoted and protected. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 18 EVIDENCE: The manager is very well qualified and experienced to oversee the running of the home. Her management style is open and transparent, and includes the views of staff and service users. The deputy manager is currently undertaking the NVQ 4 award in Management. Records relating to Fire alarm testing, detecting and fire fighting equipment were up to date, and had been appropriately serviced and tested. Records relating to the testing and maintaining of the emergency lighting were up to date and had been appropriately completed. Accidents had been recorded as required and audited on a regular basis. Evidence was seen of regular staff mandatory health and safety training including regular fire drills and the staff spoken with confirmed this. The inspector discussed the home’s existing Quality Assurance system, and recommended that the outcome of the new Quality Assurance survey should be shared with service users, and staff via staff and service user meetings. The outcome of the feedback from the overall survey undertaken should be recorded with a plan of action as appropriate Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 19 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x 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 x 3 3 3 3 x x x x 3 Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 20 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 Regulation Requirement Timescale for action 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 S33 Good Practice Recommendations The home’s existing Quality assurance system should be further developed to include survey feedback, which will feed into the existing Quality Assurance system. Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Daisy Bank Nursing Home E51-E09 S26944 Daisy Bank V241079 03.08.05 Stage 4.doc Version 1.40 Page 22 - 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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