Inspection on 10/05/05 for Daisy Nook House

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Daisy Nook House 30/11/07

Daisy Nook House 26/09/06

Daisy Nook House 07/12/05

Daisy Nook House 24/01/05

Daisy Nook House 03/09/04

Daisy Nook House 20/03/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Daisy Nook House Bamburgh Drive Ashton under Lyne OL7 9SX Lead Inspector Steve Chick Unannounced 10 May 2005, 10:30am 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 Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Daisy Nook House Address Bamburgh Drive, Ashton under Lyne, OL7 9SX 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) 0161-343-1033 0161-343-8233 Tameside Care Limited CRH Care Home 40 Category(ies) of Dementia - over 65 years of age (40) registration, with number Mental Disorder, excluding learning disability or of places dementia - over 65 years of age (10) Old age, not falling within any other category (39) Physical disability over 65 years of age (39) Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 40 DE (E) up to 10 MD (E) up to 39 OP and up to 39 PD (E) Date of last inspection 24 January 2005 Brief Description of the Service: Daisy Nook is a purpose built residential home offering accommodation to up to 40 older people in single rooms with en-suite facilities. The home is a detached property, all on one level. Day care is provided as part of Daisy Nook’s service, but this report only focuses on the residential care facilities. Daisy Nook is based around three discreet lounges. There is additional communal space in the form of one ‘quiet’ room and several pleasantly furnished areas around the building.Daisy Nook includes some gardens and an appropriately sized car park. It is located in a quiet residential area of Ashton under Lyne.The home is run by Tameside Care Group, a not for profit organisation, which operates several other care homes in Tameside. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection three service users were interviewed, as was one relative of a service user. Additionally discussions took place with the manager and two members of staff. The inspector also undertook a tour of the building and scrutinised a selection of service user and staff records as well as other documentation, including staff rotas, medication records ant training records. This inspection was unannounced and not all the standards were assessed. What the service does well: What has improved since the last inspection? The manager, having dealt with some pressing problems is pursuing the continuing improvement of care practice. This includes social activities and improved involvement of relatives in activity planning. The grounds are being improved to enable safe access for service users. Funds have been identified by the company to undertake a major refurbishment throughout the building. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 6 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 Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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 Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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) None of these standards were assessed during this inspection. EVIDENCE: Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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 standard(s) 7;8;9;10. Daisy Nook undertook the care planning process appropriately. The health needs of service users are appropriately met. Effective medication procedures are in place, including managerial overview which takes action when errors are identified. Service users are able to exercise their right to privacy and are treated with respect. EVIDENCE: All files which were looked at had a copy of a care plan which been reviewed on a regular basis. Service users who were spoken to reported positively on the way in which their care needs were met. There was documentary evidence that service users, or their relatives, were involved in the care planning process. In one example seen it was not clear why a relative, rather than the service user, had signed the documentation. Records of visits from Doctors and other medical personnel were seen. All service users spoken to confirmed that medical attention was appropriately sought for them. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 10 Medication presented as being appropriately stored and the medication administration records presented as being appropriately maintained. There was evidence from discussion with the manager and a complaint received by the Commission for Social Care Inspection that there had been occasional lapses in the required level of rigor while administering medication. However there was also evidence in supervision notes, that this had been identified and addressed by management. Training records indicated that all senior staff and nearly all night staff had received basic training in the administration of medication. At the time of the inspection no service user was administering their own medication, although it was reported by the manager that, subject to a risk assessment, service users could do so. All bedrooms were single and service users spoken to confirmed they could use their room at any time. One service user reported she preferred to stay in her room, only using the communal area for meal times, and that this choice was respected by the staff. Service users spoken to reported that they were treated with respect by the staff. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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;14 The home does not fully meet the social needs of all service users. There are no unreasonable restrictions on visitors and contact with the community. Service users are able to exercise personal choice within the restrictions of communal living. EVIDENCE: Daisy Nook has a Day Care facility attached to the main building with internal access between the two. Service users are able to participate in activities being undertaken in the day centre. These activities are publicised on the notice board in each lounge. The act of moving to a different part of the home, to participate in activities is likely to exclude all but the more highly motivated service users. A few activities take place in the lounges in the home and the manager reported one member of staff has recently taken responsibility for coordinating activities within the home. This was a recent delegation and had not been implemented for long enough to asses its effectiveness. Visitors and service users confirmed that there were no unreasonable restrictions on visiting the home. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 12 Service users spoken to confirmed that they were able to exercise personal choice over their lives, within the context of communal living. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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 The home promotes the effective resolution of complaints. The home provides appropriate safeguards to minimise the risk of service users being abused or exploited. EVIDENCE: The home maintained a log of complaints which presented as being appropriately maintained. Service users and visitors spoken to confirmed that if they raised concerns with the manager he responded appropriately and attempted to resolve any issues which were within his control. One complainant who contacted the Commission for Social Care Inspection did not share this view. The home has a whistle blowing policy and offers training to staff in connection with Adult Protection issues. Service users spoken to all expressed the view that they were safe in the home. They also confirmed that they had not observed any incidents where any staff had behaved inappropriately towards other service users. One service user pointed out to the inspector that if they did not feel safe they would have left. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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; 21; 23; 24; 25; 26. The building is well maintained and offered a safe environment with the exception of some unprotected hot water pipes. Service users’ bedrooms were appropriately personalised. The home was clean and tidy. EVIDENCE: A tour of the building was undertaken, including a sample of bedrooms, bathrooms and toilets. The building presented as being appropriately maintained, with no matters identified for remedial action. Work was in progress to improve the outside facilities to enable service users to benefit from access to the grounds. It was reported that a major refurbishment program inside the building was due to commence at the end of May 2005. This program should address the matter of unprotected hot water pipes identified at previous inspections. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 15 Toilets and baths were available in appropriate numbers and with the provision of equipment to assist people with restricted mobility. Bedrooms demonstrated a range of personalisation which presented as reflecting the choice of the occupant. No aspect of the building was seen which would compromise the health or safety of the service users or staff. The building was found to be predominantly clean, tidy and odour free. Service users spoken to confirmed that the home was consistently maintained this way. A small number of bedrooms did have an unpleasant odour. It was reported that this was as a result of continence management difficulties relating to the rooms’ occupants. The manager reported that new cleaning schedules had been introduced to ensure the maintenance of appropriate cleanliness. Adequate supplies of linen were seen on the premises. Service users confirmed that bedding was regularly changed. Domestic staff spoken to, confirmed the availability of appropriate equipment to minimise the risk of cross infection. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 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 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; 29; 30 An appropriate level of staffing is provided. Staff vetting was appropriately undertaken to help maintain the protection of service users. The home provided good training opportunities for the staff. EVIDENCE: The staff rota for the week beginning 2nd May 2005 was scrutinised and demonstrated that during the day (07:00 – 20:00) staffing was provided in line with the expectations of the previous registering authority. The night (20:00 – 07:00) rota for the whole of April 2005 was also scrutinised. This demonstrated that night staffing was maintained at three waking staff, other than on a small number of occasions. It was reported that these shortfalls were caused by staff phoning in sick but too late to arrange cover. Documentary evidence was produced to confirm the manager was ‘on call’ on these occasions, and that agency staff were employed when feasible. Domestic staff confirmed that they sometimes were needed to cover a ‘care’ shift, or to assist in the kitchen. They reported that they had received appropriate training for these tasks, and were never asked to mix a shift between domestic and care or kitchen duties. It was reported that only one member of staff had been recruited since the previous inspection. Scrutiny of the file relating to that staff member confirmed Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 17 that appropriate vetting procedures had been followed. It was reported that two other prospective staff were awaiting the completion of the vetting process. The manager demonstrated a good understanding of the required vetting process. Service users reported that they felt safe in the home. Service users and visitors reported that the majority of staff were very good. However they also indicated that a very small minority appeared to be less motivated. Service users received a lower quality of service from these staff than from the usual good standard provided by the majority of staff. Training records indicated a commitment to providing the staff team with continuing training. Thirteen staff held NVQ II or above and the remaining twelve staff were registered to undertake NVQ II. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36. The management of the home provides strong leadership with the intention of continuing to improve the experience of service users. Staff receive appropriate supervision to continue to improve their skills. EVIDENCE: Daisy Nook had suffered from a significant period of changes to the management until approximately six months ago when the current manager moved to the home. The manager has considerable management experience before he moved to the home. A visitor reported a noticeable improvement in the home since the current manager’s arrival. All service users and visitors spoke positively about the manger, with one describing him as “always available and responsive”. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 19 A meeting had been arranged by the manager with relatives, with a view to creating a forum where ideas could be generated by service users and their relatives about social activities. Staff received regular supervision from either the manager or a senior carer. Supervision records confirmed that this was used as an opportunity to identify areas where the member of staff could improve their practice. Service users spoken to were positive about the way in which their care needs were met. Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 3 x 3 3 2 3 STAFFING Standard No Score 27 3 28 x 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 x 3 3 x x 3 x x Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 25 Regulation 13 (4)(a) Requirement The registered person must ensure that, subject to a risk assessment, all hot water pipework is appropriately insulated. The registered person must ensure that a variety of strategies are employed to ensure that service users are able to engage in social activities Timescale for action 01/08/05 2. 12 16 (2)(n) 01/07/05 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 7 Good Practice Recommendations The registered person should ensure that service users personally sign to confirm that they are in agreement with their care plan unless there are documented reasons why this is not approriate. The registered person should ensure that staff who are percieved by servcie users as being poorly motivated are monitored and offered extra support through supervision. 2. 27 Daisy Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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 Nook House F54 F04 daisy nook U s5566 v226739 100505 stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!