Inspection on 07/12/05 for Daisy Nook House

This inspection was carried out on 7th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Daisy Nook House 30/11/07

Daisy Nook House 26/09/06

Daisy Nook House 10/05/05

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

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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 Tameside OL7 9SX Lead Inspector Steve Chick Unannounced Inspection 7th December 2005 11:00 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 Nook House DS0000005566.V271273.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 Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Daisy Nook House Address Bamburgh Drive Ashton-under-Lyne Tameside OL7 9SX 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) 0161 343 1033 0161 343 8233 Tameside Care Limited Mr Ronald Henry Duke Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number 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 DS0000005566.V271273.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 40 DE (E) up to 10 MD (E) up to 39 OP and up to 39 PD (E) 10th May 2005 Date of last inspection 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 Nooks 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 Meridian Healthcare Ltd, a not for profit organisation, which operates several other care homes. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection four service users were interviewed in private, as were four relatives of service users. Additionally discussions took place with several members of staff on duty. The inspector also undertook a tour of the building and scrutinised a selection of service user records as well as other documentation, including equipment maintenance records. Comment cards were received from eight service users and seven relatives. This inspection was unannounced at it is recommended that this report is read in conjunction with the previous report of the 10th May 2005. What the service does well: What has improved since the last inspection? Areas of the building have been refurbished to a good standard. The gardens have been improved to enable service users to access them safely. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 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 DS0000005566.V271273.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 Nook House DS0000005566.V271273.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): 2,3,4 and 5. Service user’s copies of the terms and conditions do not always contain full information. Service users’ needs are appropriately assessed and they, or their representatives, are able to visit before a decision is made that the home is appropriate for them. EVIDENCE: A selection of service users’ files was scrutinised. All had a copy of the home’s terms and conditions. However not all were signed by the service user or a representative and not all had correct, up to date information (such as the room number). There was documentary evidence of service users having been assessed by an appropriate professional before moving to the home. There was also evidence of this assessment being complemented by the home’s own assessment process, - usually undertaken by the manager. Similarly there was documentary evidence that written confirmation was given to the service user Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 9 to confirm that the outcome of the assessment was that the home could meet their identified needs. It is the policy of the home to encourage service users to visit before making a decision to move in. Relatives spoken to confirmed that this policy was also the practice of the home. Daisy Nook does not offer intermediate care. Daisy Nook House DS0000005566.V271273.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): 7, 8 and 10. Written care plans were in insufficient detail. Service users’ health needs were appropriately met. Service users were treated with respect and their privacy was upheld. EVIDENCE: A selection of service users’ files was scrutinised. All had a copy of a care plan and, where appropriate the plan had been reviewed. There was a significant variation in the quality of the written plans. Some were lacking in detail and consequently gave inadequate advice to staff on how to meet the individual needs of the specific service user. There was similar inconsistency regarding evidence that care plans had been seen and agreed by the service user or their representative. Four service users and four relatives were spoken to during the inspection. All were satisfied with the care offered by Daisy Nook. One relative described the Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 11 quality of care as “excellent” and another described the home as “smashing”. A service user described the home as “very good. I can’t find anything wrong. I’m happy here.” This service user also confirmed that the way in which her care needs were met was done as she wished. There was appropriate documentary evidence of service users having appropriate access to medical and para medical services. This was also confirmed by service users spoken to. All service users spoken to reported positively on the way they were treated. All respondents to the ‘service user comment cards’ reported that they were well cared for, were treated well by staff and that their privacy was respected. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 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 and 15. The social activities provided do not meet the perceived needs of all service users. Appropriate alternatives to the main menu are not consistently available 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. Additionally activities take place within the home. These were described by staff who were spoken to as including ‘chair aerobics’, board games and dominoes, nail care and an outing to Blackpool. Service users spoken to were not critical of the activities program, with one saying “there are things to do, you just please yourself.” None the less, a significant number of service user comment cards stated that the home did not offer suitable activities. Similarly the Quality Assurance Monitoring undertaken by Meridian Healthcare Ltd in October 2005 only registered 57 satisfaction with social activities and events. Discussion with the manager following this inspection indicated that a relatives committee had Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 13 been set up with its main brief being to look at social activities. The first full meeting of this group had been planned for shortly after this inspection. Service users spoken to during the inspection expressed satisfaction with the food. However, the meal which was sampled at this inspection, which was the alternative to the main dish for lunch, was of poor quality and not what could be reasonably expected from the description. The senior member of staff on duty reported that the usual cook was on leave and the person covering for them was only able to produce a limited range of dishes, which did not include the alternative on the menu. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 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 and 18. Service users are confident that complaints would be taken seriously. Service users are protected from abuse. EVIDENCE: At previous inspections the home was found to have an appropriate complaints procedure. It was reported that this had not been amended since last scrutinised. Documentation was not scrutinised at this inspection. One relative of a service user contacted the inspector after the inspection seeking clarification of the home’s complaints procedure. Similarly over 70 of the people returning relatives’ comment cards indicated that they were unaware of the home’s complaints procedure. Whilst the procedure is available at the home and in documentation produced for service users, these comments suggest the home may wish to consider being more proactive in publicising the procedure. All service users, relatives and staff who were asked during the inspection were confident that any complaint would be listen to and treated seriously. One service user commented that if there was “ anything wrong you can talk to them. [They are] nice girls.” Another commented “if I’ve had a query I could ask and [the staff] would deal with it.” Daisy Nook has appropriate procedures to minimise the risk of service users being abused or exploited. Staff who were spoken to during the inspection Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 15 demonstrated an understanding of the need to be vigilant about protecting the service users. All service users and visitors spoken to, and all returned service user ‘comment cards’ indicated that service users felt safe at the home. One service user commented that she felt safer at Daisy Nook than she had done at home. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 16 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): 19,20,23,24, 25 and 26. The building is well maintained and offered a safe environment with the exception of some unprotected central heating 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. Other than some unprotected central heating pipes no matters were identified for remedial action. Since the previous inspection some areas of the building had been refurbished. This work presented as being of a good standard, offering an improvement to the communal facilities. The grounds had also been significantly improved, Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 17 although some further work was reported as being planned. Staff and one visitor confirmed that service users had been able to use the gardens in the summer. Service users’ bedrooms presented as clean and tidy, with appropriate evidence of ‘personalisation’. Appropriate bathing and toilet facilities are available. Communal areas presented as clean and tidy. Visitors and service users spoken to during the inspection confirmed that this was the usual state of the building. One service user commented that it was “always clean and tidy, I wouldn’t like to feel I’m in a dump.” Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 18 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): 28 and 30 Staff are supported in achieving appropriate NVQ’s. Staff training is provided appropriately. EVIDENCE: It was reported by the manager that seventeen of the twenty five care staff held an NVQ II or higher. This is 68 of the care staff. It was additionally reported by the senior on duty during the inspection that eight staff were working towards NVQ II and two were working towards NVQ III. It was also reported that twenty staff had a current first aid certificate. Documentary evidence of these statements was not sought at this inspection. Discussion with staff indicated that the organisation’s commitment to staff training was being maintained. Service users and relatives spoken to were predominantly very positive about the attitude and competence of the staff team at Daisy Nook. Service users’ comments included … “the staff are very nice”; “very good, I can’t find anything wrong”. Relatives said “[staff have been] very very helpful”, “staff are wonderful”. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 19 At the last inspection the motivation of a small minority of staff had been identified as an issue needing attention. Discussion with the manger indicated that this was being addressed through the supervision system in operation at the home. At this inspection this issue seemed to be less significant than previously, but had not been entirely resolved. One relative recognised an improvement but still believed they could tell who was on duty by their relative’s attitude. Another relative spoken to believed that the key worker system did not always work to their relatives advantage if the key worker was unavailable. They reported that other staff could be reluctant to step in, for example, to bath their relative. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33,35 and 38. Good management is provided by an appropriately qualified and experienced person. Quality Audit systems are in place, but require some additional work. Service users’ financial interests are safeguarded. The health and safety of service users is maintained. EVIDENCE: The registered manager holds an appropriate qualification and has several years experience of running care homes. Discussion with staff and service users indicated that the manager gives a clear sense of direction and an Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 21 appropriate value base. Service users, visitors and staff confirmed that the manager’s style is to be open and approachable. Meridian Healthcare Ltd had undertaken a Quality Audit in October 2005. This involved questionnaires being sent to service users and relatives. The questionnaire responses have been analysed and a report produced. While there was some evidence that the findings of this exercise were being acted on, this did not present as being undertaken in a structured way. No written action plan was available at the time of the inspection. A selection of records relating to money held by Daisy Nook on behalf of service users was scrutinised. They presented as being appropriately maintained and included receipts for items purchased on behalf of service users. Discussion took place with the home’s ‘handyman’. He confirmed that all required Health and safety checks were undertaken. However these were not always recorded. A selection of records relating to the routine maintenance of fire detection and alarm systems and other mechanical equipment was examined. These presented as being appropriately maintained. Staff who were asked, confirmed the availability and mandatory use of disposable gloves and aprons to reduce the risk of cross infection. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 22 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 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 2 3 STAFFING Standard No Score 27 X 28 4 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? yes 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 OP2 Regulation 5 Requirement The registered person must ensure that each service user has a copy of the homes terms and conditions which is complete and up to date. The registered person must ensure that every care plan in sufficient detail to inform staff how to deliver the necessary care to that individual. The registered person must ensure that the program of activities is monitored to ascertain that it is meeting the needs of the service users. The registered person must ensure that an appropriate choice of meals is available at each meal time. The registered person must ensure that, subject to a risk assessment, all hot water pipework is appropriately insulated. The registered person must ensure that quality audits include an action plan which identifies how areas for improvement are to be addressed. DS0000005566.V271273.R01.S.doc Timescale for action 13/02/06 2 OP7 15 13/02/06 3 OP12 16 (m) 13/02/06 4 OP15 16 (2)(i) 01/02/06 5 OP25 13 (4)(a) 13/02/06 6. OP33 24 13/02/06 Daisy Nook House Version 5.0 Page 24 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 OP7 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 appropriate. Daisy Nook House DS0000005566.V271273.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs 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 DS0000005566.V271273.R01.S.doc Version 5.0 Page 26 - 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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