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Inspection on 20/12/05 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 20th December 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. Care plans viewed were clear, and up-to-date, enabling service users` needs to be met. Complaints had been dealt with appropriately and within timescales laid down by the home`s policy and procedure.

What has improved since the last inspection?

The home`s quality assurance system is now well underway, and continues to be developed. The system now includes feedback, through regular staff meetings.

What the care home could do better:

There was one requirement and no recommendations made as a result of this unannounced inspection. Care staff training must include Dementia Care, and the Management of Aggressive Behaviour.

CARE HOMES FOR OLDER PEOPLE Daisy Bank Nursing Home c/o Jackson, Dyson & Blundell 17 - 19 Leek Road Cheadle Staffordshire ST10 1JE Lead Inspector Pam Grace Unannounced Inspection 20th December 2005 10:00 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 Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 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. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Daisy Bank Nursing Home Address c/o Jackson, Dyson & Blundell 17 - 19 Leek Road Cheadle Staffordshire ST10 1JE 01538 750439 01538 750439 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) Classic Care Homes Limited Mrs Ruth Addison Care Home 32 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (32), of places Physical disability over 65 years of age (6) Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/08/05 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 DS0000026944.V272693.R01.S.doc Version 5.0 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 5 hours by one inspector. The home’s care manager and registered person assisted throughout the inspection. A tour of the home was undertaken and discussions were held with service users, visitors and staff. Discussions were also held with the manager of the home. Relevant records and documentation were examined. At the end of the inspection, feedback was given to the care manager and registered person, outlining the overall findings of the inspection. Service users and visiting relatives spoken with were very positive about the services that they were receiving. Conditions in the home were determined by direct observation, and sampling services provided such as the provision of activities, and aspects of health and safety measures. There was one requirement and no recommendations made as a result of this unannounced inspection. What the service does well: What has improved since the last inspection? Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 6 The home’s quality assurance system is now well underway, and continues to be developed. The system now includes feedback, through regular staff meetings. 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 DS0000026944.V272693.R01.S.doc Version 5.0 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 Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 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): Standards 3,4,5,6 Prospective service users have their needs assessed by the manager or deputy manager. 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. The home does not provide intermediate care. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 9 EVIDENCE: There was written evidence within care plans sampled that service users have had an assessment of his or her needs, carried out prior to admission to the home. The manager or deputy manager usually undertakes this assessment. This assessment may also involve the next of kin or representative providing information, which then feeds into the care plan. In some instances there has been an assessment by another professional such as a social worker. The prospective service user is then informed in writing that their assessed needs can be met by the home. The service users and visitors spoken to at the time of the inspection confirmed this. There was evidence of specialist advice and treatment contained within care plans seen. The home does not provide intermediate care. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 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): Standards 7,8,10 Appropriate arrangements are in place for identifying and meeting the health and personal care needs of service users in the home. Service users are treated with respect, and their privacy is upheld. 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 and visiting relatives spoken with spoke positively about the care and support that they and their relatives received from staff at the home. The Inspector noted how well service users appeared, preparations were in progress for Christmas festivities, and the atmosphere was relaxed and happy. 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 DS0000026944.V272693.R01.S.doc Version 5.0 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): Standards 13,14,15 Service users maintain contact with family, friends, their 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 and balanced diet, in pleasant surroundings. EVIDENCE: The quality and variety of food served at the home is of a good standard, and menus reflected the wishes of service users, as well as the changes in season. Service users spoken with confirmed that they enjoyed the meals at the home, and that they are consulted regarding their preferences. 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. Service users spoken with confirmed that they often discuss their preferences with staff, they feel listened to, and their requests are acted upon. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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 home had received two complaints since the previous inspection. One had not been upheld, and the second had been partly upheld. Both complaints had been dealt with in a sensitive and appropriate manner, and within allotted timescales. The inspector spoke with staff and service users. Service users spoken with said that they felt safe and secure in the home. 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 DS0000026944.V272693.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,22,24,25,26 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. The home was well decorated and prepared for the Christmas festivities. Bedrooms seen were personalised, and had been adapted to suit the needs of the service users. Wardrobes were either fitted, or fixed to the wall for safety. Bedrails were used following a risk assessment. Bumpers were used with these. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 14 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 seen and heard to be working at the time of the inspection. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 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 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): Standard 27,30 Mandatory training for staff continues to be undertaken. However, specific training must include Dementia Care, and the Management of Aggressive Behaviour. Staffing levels were appropriate to the number of service users in residence at the home. EVIDENCE: At the time of the inspection there was a total of 32 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. The inspector discussed staff training with the manager and registered person. Mandatory training continues to be undertaken, for example fire, moving and handling, health and safety. However, it is required that specific training with regard to dementia care and the management of aggressive behaviour is undertaken by all care staff. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 16 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): Standards 31,32,33,36,38 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 has been further developed by the registered person to include survey feedback, via regular staff meetings. The health, safety and welfare of service users and staff are promoted and protected. Staff supervision is in place, and is in the process of being further developed. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 17 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. Complaints had been listened to, dealt with sensitively, and within appropriate timescales. 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 was pleased to note that this now includes regular and constructive feedback from the registered person to staff. This includes an agreed action plan for outcomes. Staff supervision is in progress, and is being further developed for all care staff. Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 18 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 X X 3 3 3 N/A 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 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 X 3 Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 19 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 OP30 Regulation 18 Requirement Care staff should undertake specific training with regard to dementia care, and the management of aggressive behaviour. Timescale for action 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Daisy Bank Nursing Home DS0000026944.V272693.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Stafford Office 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 DS0000026944.V272693.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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