Inspection on 08/08/06 for Daleside Nursing Home

This inspection was carried out on 8th August 2006.

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

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

Other inspections for this house

Daleside Nursing Home 19/07/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Daleside Nursing Home 136-138 Bebington Road Rock Ferry Birkenhead Wirral CH42 4QB Lead Inspector Lynn Sharples Unannounced Inspection 8th August 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Daleside Nursing Home Address 136-138 Bebington Road Rock Ferry Birkenhead Wirral CH42 4QB 0151 644 6773 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) Kate Armstrong-Shone Margaret Armstrong Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 32 beds nursing care (3 of which may be used for residential care) One named person under 65 years of age may be accommodated Date of last inspection Brief Description of the Service: Daleside nursing home is a three storey building situated in Rock Ferry, opposite Edgerton Park. There are nine single rooms and one double on the ground floor, with an extension leading onto the gardens. The first floor has two double and five single bedrooms, and there are a further four double and four single bedrooms located on the second floor. A lounge, a dining room and a conservatory are available on the ground floor, and a further lounge/quiet room is situated on the first floor. All floors are served by a lift. There is a car park at the front of the building and a secure garden to the side and rear. Daleside offers 24 hour registered general nurse care, and caters for a variety of nursing needs. The home benefits from being close to local shops and amenities, and is on a bus route. The fees for the home are from £341 £389.98. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home did not know about the visit and took five hours. The residents, relatives, the responsible individual, manager and care staff were spoken with. Files relating to the resident and the home were read and the premises toured. The home is under new management since February 2006. What the service does well: What has improved since the last inspection? The home now ensures that pre admission assessments provide full and detailed information. The care plans provide detailed information regarding residents’ care, medical, social and emotional needs including management plans. Residents’ medications are now securely stored with all medication being appropriately named and labelled. There is evidence that residents’ views are regularly sought and acted upon with regard to their every day lives and involvement in the operation of the home. The dining room floor has been Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 6 replaced. The crockery used to serve residents meals matches to provide a homely and attractive atmosphere for them to enjoy their meals. Complaints and concerns raised are acted upon in an open and proactive manner and that detailed records are maintained to this effect. There is adequate heating and hot water to provide a safe and comfortable environment for residents. The home is free of offensive odours. Adequate ventilation is provided with particular regard to all bedroom windows being able to be fully opened and closed into their rebates. A review of residents’ care and nursing needs is now undertaken to ensure the staffing levels in home meet all their assessed needs. 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. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5,6 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide provides sufficient information for prospective service users to be clear about the services the home provides to meet their needs. EVIDENCE: The statement of purpose and service user guide for the home has been updated and contains all current information and they are bright, clear, and easy to read documents. A copy is provided in each resident’s bedroom and further copies are available from the home on request. Both documents would be translated into other languages if requested. There are details of resident’s contracts on file detailing fees and terms and conditions of occupancy. The manager or one of the qualified nurses undertakes a pre-admission assessment on all prospective residents. A comprehensive assessment is completed to ensure that the home can meet the prospective residents Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 9 individual care needs and to enable any necessary equipment to be provided prior to admission. The assessment involves gathering information from the service users, their family, GP, hospital staff and any other person involved in their care, this includes likes and dislikes. The assessment also identifies any specific equipment necessary to meet the service users needs and enables the home to obtain the equipment prior to the service users admission where necessary. The assessments seen during the visit, of those residents recently admitted to the home were found to contain comprehensive information from which the initial plan of care is prepared. Prospective residents and their families are encouraged to visit prior to a move to the home. The home has a four-week trial period, before residents decide whether to move in permanently. The home does not provide intermediate care. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. There is clear, consistent care planning system in place to provide staff with the information they need to meet resident’s needs. The lack of risk assessments regarding restraint leaves the residents at risk of harm. The health needs of residents are met with evidence of multidisciplinary working taking place on a regular basis. The medication at this home is well managed promoting good health. EVIDENCE: The seven files that were looked at contained care plans that included an assessment of needs for daily living. The files contained comprehensive care plans giving full information regarding the service user health, care and social needs, together with detailed information on how these needs will be met. Risk assessments were in place together full information on how the risks will be reduced or eliminated. However, two residents have a seat belt to ensure that they are safe, family and health professional have agreed this, but no risk assessment has been completed placing the residents at risk of harm. The Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 11 manager agreed with this and implemented a risk assessment. The care plans include information regarding the service users individual preferences and choices to enable staff to meet the service users specific requests. Information is also held on the files of visits made to and by GP’s and other health care professionals. Details of action to be taken following these visits are recorded and appropriate changes are made to care plans as appropriate. The home also keeps a record of communications with family members and other relevant persons. Medications were found to be ordered, stored, administered and recorded in accordance with the home’s policy and procedure. The storage area was seen to be clean and organised and no unnecessary or unwanted medications were held. Appropriate disposal arrangements were in place for unwanted medications. The home has specified spaces for each resident where their mail is kept and opened by the resident or relative. If the person has no relative the post is opened with the resident. Residents may use their own bedroom or in one of the communal areas as they wish. The office can be made available for private meetings. The staff team were observed to knock on doors and to wait for an answer prior to entering. Screens are provided in shared bedrooms to ensure that privacy and dignity are protected. The home is now using the ‘Integrated Pathway for the dying’ to keep comprehensive records for those residents who are accommodated in the end stages of their illness. This document involves the recording of a more specific plan of care and is completed by the staff at the home, doctors and any other care professional involved. The home has prepared a useful booklet to give information to families following bereavement. The booklet is called ‘At This Sad Time’ and provides full information on persons to contact and actions to be taken. It also provides essential contact numbers and addresses to assist the families. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. Residents have some opportunity to exercise their choice in relation to leisure and social activities. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices. EVIDENCE: Residents in the home are asked on admission, about their lifestyle, choice of foods, and choices and preferences of the social activities they would like to participate in. The home employs an activities coordinator 20 hours a week. There is a list of the activities engaged in including music, television, games, outings, hair craft and exercises. However when residents participate in social activities, it must be recorded in their daily health record sheet. This is to ensure that there is recorded evidence of how the resident coped/responded in the activity, and to reflect their mood, emotions, physical dexterity. The recordings of the resident activities helps to complete a “full picture” of the resident’s progress, or even identify developing care needs. Resident spoken with said that would like the staff to talk with them more. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 13 Visitors are allowed in the home at any reasonable time of the day and residents may entertain their visitors in the communal lounges, or in their own bedroom. During the day visitors where seen in the home. The home does not deal with any of the resident’s finances and so family members or an advocate is advised to act on their behalf. Residents have some choices including what to wear and eat. Some of the residents are not able to verbally indicate their choices. This would be greatly improved if photographs were used with residents to enable them to exercise choice and control over their lives. Residents spoken with said that they enjoyed the food at the home and relatives said that the food looks good and their relatives had no complaints about the food. On the day of the visit there was two choices of hot meals or sandwiches. The cook said that they would also prepare alternatives if the resident wanted something that was not on the menu that day. The menus looked at indicated that the food is nutritious and varied. The lunchtime was observed to be unhurried with residents given sufficient time to eat. To assist with choices a file containing photographs of meals would help all the residents choose what to eat. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The home has a documented complaints procedure to ensure residents’ views are listened to and acted upon. Systems are in place to ensure residents are safeguarded from abuse and harm. EVIDENCE: A complaints procedure is in place and information on how to make a complaint is detailed in the Statement of Purpose. One complaint has been received and resolved by the home, the CSCI has received no complaints. The home gives all residents, relatives and visitors the opportunity to compliment the home as well as to complain. Residents and relatives spoken with confirmed that they knew how to complain and would be confident in speaking to the manager or owner in the knowledge that their concerns would be addressed. Policies and procedures are in place to ensure the protection of the service users. All staff are required to sign to indicate that they have read, understand and will comply with these. Training has been given to all staff on the different types of abuse and of the action to be taken in the event of it being suspected. Evidence of this training is held on the staff files. Qualified nurses have been given training on the Nursing and Midwifery Councils’ Code of Professional Conduct. The staff spoken with were able to demonstrate their knowledge of Adult Protection issues. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 15 Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 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): 19,20,21,22,24,25,26 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The recent investment has improved the appearance of the home creating more comfortable environment for those living there and visiting. EVIDENCE: The home has fitted double glazed windows in all but three windows in the home and fitted with blinds to ensure privacy. Carpets have been fitted in the ground floor and all corridors on the other floors and rooms have been redecorated. There is an ongoing maintenance and renewal of the fabric and decoration of the premises. The residents and relatives said that the home is much more comfortable and homely to live in and are pleased with the recent improvements to the home. There is a large communal lounge and a smaller quiet room and a conservatory on the ground floor. The furnishings of these rooms are domestic in character and of good quality. The garden at the rear is accessible through Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 17 the conservatory; these exits should be assessed to ensure that people in wheelchairs and sensory impairment could safely exit the building. There are five bathrooms and each resident has a toilet near their bedroom. The bathrooms are part of the redecoration programme. The sluices are separate from the resident’s toilets and bathrooms. There is a lift between the floors and grab rails in corridors, bathrooms and toilets. Aids, hoists are installed which meet the assessed needs of service users. Wheelchairs are stored on the ground floor near a fire exit and hinder the exit of residents and could place them at risk, the manager immediately addressed this and moved the wheelchairs. All the bedrooms are going to be redecorated; eight bedrooms have been completed to date. They have been redecorated; have new carpets, furnishings and new beds. The rooms do not have locks as residents and relatives do not want this and this is recorded in their care files. In shared rooms have appropriate screening to maintain a level of privacy. The rooms have been personalised with individuals’ possessions. The home employs two full time domestics and a laundress. The laundry room is going to be redecorated. The home was clean and free from malodour on the day of the visit. Infection control policies are in place and it was evident that staff follow all procedures. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 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): 27,28,29,30 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The staff training provided ensures that the staff team are equipped to meet the needs of the residents. EVIDENCE: The staff rota provides evidence that the home employs and deploys staff in sufficient numbers to meet the needs of the service users. A qualified nurse is on duty at all times, supported by care staff who have all been given training in the care of elderly people. The residents and relatives said that the staff were caring and supportive. The staff were observed interacting appropriately with the residents. Eight staff have the NVQ level 2 and one staff has the NVQ level 3, four staff are currently completing the NVQ 2 and one staff is completing the NVQ 3. The remaining staff will be offered the NVQ programme. An examination of a sample of staff records indicated that most staff had two references, enhanced Criminal Records Bureau checks, statements of terms and conditions on their personnel file. Some staff have worked at the home twenty years and do not have two references on their file. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 19 All staff have received induction training and since the new owners have taken charge all the staff have received four days training on fire, manual handling, infection control and basic food hygiene. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 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): 31,33,35,36,38 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The record of self-review by the registered provider is good and provides the home with adequate quality assurance. EVIDENCE: The manager has several years experience as a manager and a registered provider. They have the NVQ 4 in management. The staff said that the manager was supportive and approachable. The home is having a resident survey held at the end of the month. The responsible individual visits daily to oversee the overall running of the home. Staff meetings are held regularly and minutes are taken. Group staff meetings are held and also specific staff meetings i.e. qualified staff, care staff, ancillary Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 21 staff. Policies and procedures are in place to protect the interests of each service user and these have recently been reviewed and updated. The home does not deal with any of the service users finances. Secure facilities are provided to store valuables and accurate records are held of these. Supervision is given to all staff every two months and annual appraisals are undertaken to provide staff with the opportunity to review their own professional and career development and to identify training needs. All staff have been given training on health and safety and are required to read the policies and procedures relating to these. Individual residents records are secure up to date and are maintained and secure as in accordance with the Data Protection Act 1998. Certificates of maintenance and worthiness for machinery, hoists, gas and electrical installations, fire equipment, lift were viewed. All certificates were in date and valid. The fire drill records indicated that all staff have received at least one fire drill this year. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 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 3 X 3 X 3 3 X 3 Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 Requirement The registered person must ensure risk assessments are completed for residents who are subject to restraint. The registered person must ensure that communication aids are made available to service users to assist with the decision making process. Timescale for action 29/08/06 2 OP14 12 05/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations It is recommended that the exits to the gardens are assessed to ensure that they are safe for residents to use. Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Daleside Nursing Home DS0000066725.V298236.R01.S.doc Version 5.2 Page 25 - 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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