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Inspection on 14/04/05 for Daneside Court Nursing Home

Also see our care home review for Daneside Court Nursing Home for more information

This inspection was carried out on 14th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

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

The care residents receive is of a good standard and all the people spoken with were satisfied with the care that they, or their relative, were receiving. Visitors are made welcome, residents` relatives are kept well informed and are involved in their care. There is a stable staff group who know the residents well. Staff were seen to work well with the residents and the atmosphere in the home is cheerful and friendly. Regular meetings are held with residents and relatives to find out what they think of the way the home is run and action is taken to address any concerns. The home has a competent and experienced manager.

What has improved since the last inspection?

The appearance of the dining room on the ground floor has improved since the last inspection. There are now enough dining chairs for all of the residents to eat there and staff no longer take their meal breaks there.

What the care home could do better:

Care plans must be drawn up for residents to make sure that staff are aware of their needs. These should be reviewed and changed when a resident`s needs change. Staff must ensure that oral hygiene/mouthcare is offered as appropriate. The procedures for giving out and recording medicines need to be improved, particularly on the ground floor of the home. A requirement about this was made at the last inspection but has not been met.Staff need to be guided to respect the fact that the home is for the residents. They must ensure that if they bring their children into the home, they are supervised at all times. The lounges are for residents to sit in and should not be used for other purposes by staff.

CARE HOMES FOR OLDER PEOPLE Daneside Court Nursing Home Chester Way Northwich Cheshire CW9 5JA Lead Inspector Helena Dennett Unannounced 14 April 2005 08:30 th 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. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Daneside Court Nursing Home Address Chester Way, Northwich, Cheshire, CW9 5JA 01606 40700 01606 40621 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) Southern Cross Healthcare Services Limited Susan Clacy Care Home 64 Category(ies) of OP - Old age (64) registration, with number of places Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 64 service users in the category of OP old age not falling within any other category. 2 The registered provider, must at all times, employ a suitably qualified and experienced manager who is registered with the Commission For Social Care Inspection. Date of last inspection 01/12/04 Brief Description of the Service: Daneside Court is a purpose built care home and can provide both personal and nursing care for up to 64 older people. It is owned by Southern Cross Healthcare, a copany which operates care homes throughout the country. The home was purpose built in the 1990s and provides single bedroom accommodation on the ground and first floors. there is access into the garden which has seating and tables. The home is situated in the centre of Northwich within walking distance of local shopping facilities, public houses, bus stops and open park areas. It is well established wihtin the local community. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit to the home took place over 8.5 hours. Mrs Joan Adam, inspector, visited the first floor where residents who need nursing care are accommodated. Mrs Helena Dennett, inspector, visited the ground floor where residents who need personal care only are accommodated. Most parts of the home were visited. Residents, visitors and staff were and staff records, care records and other records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Care plans must be drawn up for residents to make sure that staff are aware of their needs. These should be reviewed and changed when a resident’s needs change. Staff must ensure that oral hygiene/mouthcare is offered as appropriate. The procedures for giving out and recording medicines need to be improved, particularly on the ground floor of the home. A requirement about this was made at the last inspection but has not been met. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 6 Staff need to be guided to respect the fact that the home is for the residents. They must ensure that if they bring their children into the home, they are supervised at all times. The lounges are for residents to sit in and should not be used for other purposes by staff. 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. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 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 Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 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) 3 & 6 Assessments are carried out before residents move into the home so that they, their relatives and the staff know that each resident’s needs can be met at the home. However, not all residents are given a statement of terms and conditions of living at the home so do not have information about their rights and responsibilities whilst living there. EVIDENCE: Eleven care files were inspected. All contained assessments of residents’ needs, covering all aspects of personal care, and any specialised care that might be needed. These had been done before the resident moved into the home so that it was clear that person’s needs could be met at the home. A copy of the contract with the home is given to those residents who pay for their own care but there is no statement of terms and conditions for people who have been placed at the home by local authorities. The area manager confirmed that from April 2005, all new residents will be given a copy of the terms and conditions for living at the home so they and their relatives know what their rights and responsibilities are. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 9 Individual care plans had been drawn up from the assessment that was done before residents moved into the home but there was no care plan in place for one resident who had recently moved into the home. See Requirement 1 Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10,11 Although there were care plans for most residents, there is a risk that residents’ needs will not be met properly because not all of them had accurate care plans that showed what all their needs were and how these should be met. Although the medicine policies and guidelines for the home were good, they were not always being followed accurately, which meant that it may not be possible to check accurately what medicines residents had taken. A review of procedures for dealing with the belongings of residents who have died is needed to ensure that these circumstances are dealt with sensitively. EVIDENCE: Seven residents said that they were happy with the care and attention they received at the home. One resident said that she feels she is treated with dignity and her privacy respected. All confirmed that staff are aware of their needs. Six relatives spoken with said they were happy with the care provided at the home. Several confirmed they are kept well informed about the health of their relative. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 11 One resident on the ground floor did not feel their privacy was respected. A concern was raised that a member of staff’s child has entered the room when the resident wished to be alone. Two other people had also made a complaint about this. See Requirement 3. Ten of the eleven files checked contained individual care plans but there was no care plans or risk assessments in place for one resident who had recently moved into the home. The staff spoken with did not know what this resident’s needs were or how to meet them. A small number of omissions and inaccuracies were found in the care plans, including an incorrect nutritional assessment, no guidance for staff on how to deal with one resident who used the call buzzer frequently, and incorrect information about one resident’s dental hygiene needs. Care plans were not always updated when resident’s needs change. A medicine pot containing several tablets was seen on the table in one resident’s room. The resident confirmed that he does not keep or administer his own medicine and was intending to take the tablets with his breakfast. The medicine administration record (MAR) sheets were checked immediately and showed that these tablets had been signed for as having been taken. This is not good practice because the member of staff giving out the medication could not be sure that it had been taken and the sheet should not have been signed to say that it had, otherwise the medication records could be inaccurate. Another MAR sheet identified that prescription capsules were to be taken three times a day. This appeared to have been followed up to the 1St April 2005 but signatures written after 29th March 2005 were heavily scribbled over with a note written ‘course completed 29/3/05’. This is not considered good practice as it is not clear whether staff continued to give the medication and sign for it after it should have been completed or whether it had been signed for but not given. See Requirement 2. The Commission for Social Care Inspection had received a complaint that referred to the fact that the room of a resident who had died in hospital had been cleared three days after her death. Her clothes had been placed in a black bin bag in the small lounge to be collected by her relative. Staff confirmed that this did happen and the manager explained that attempts had been made to contact the relatives to make arrangements about the room as there had been a person waiting to move in from hospital. A review of how these sensitive situations are dealt with is needed. See Recommendation 2. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 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 standard(s) 13 &14 Residents can choose how they spend their time at the home, which enables them to keep control over their lives. They said the standard of the food was good. Visiting can take place at any reasonable time so that residents can keep in touch with their relatives and friends. EVIDENCE: Most of the residents said they could choose where and with whom they spend their time. This was observed during the inspection. Relatives and friends were seen visiting the home. Residents were positive about the meals provided at the home. They said the food was good and they have a choice of meals. During the inspection, a resident was given a mug of tea and two slices of unbuttered toast for breakfast in his room. He remarked on this and was then provided with buttered toast. He confirmed that although he had not been asked what he wanted for breakfast that morning, he is usually asked what he would like. The operations manager confirmed that some relatives had raised concerns, including concerns about the food provided at the home, at a recent meeting. An action plan has been drawn up to address these concerns. The operations manager confirmed that she will be monitoring this. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 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 Information about the complaints process for the home is readily available so residents and their relatives know how to make complaints and who to make them to. Staff have received training on adult protection to help them make sure that residents are protected from abuse. EVIDENCE: Service users spoken with confirmed that they had no complaints. The complaint procedure is available in the service user guide. The CSCI has received copies of two complaints about the home since the last inspection. Both complainants have sent their complaints for investigation to the head office of the company that runs the home. The company’s area manager confirmed that she is in the process of investigating these. The operations manager stated that some concerns had been raised during a relatives meeting about care issues, food and laundry. An action plan has been drawn up to address these concerns. There is a policy for the home on the protection of vulnerable adults. Members of staff confirmed that they had a training session including a video on adult protection. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 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, 20,24 The home was well maintained with comfortable living spaces and suitable facilities for the residents. Action needs to be taken to make sure that lounges and other rooms used by residents are safe and available for them to use at all times. EVIDENCE: Daneside Court is a purpose built care home. It was clean and tidy on the day of the inspection. However, at a recent relatives’ meeting concerns were raised about some items such as the failed window units. An action plan has been put in place to address this. There were two pressure mattresses plugged in and laid out on the floor in the main lounge on the first floor. These could be a hazard for any residents wishing to use the lounge. The small room off the lounge, which is used for residents having aromatherapy, had boxes and wheelchairs stored in it, so it could not be used for aromatherapy. The manager agreed to sort out both these problems following the inspection. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Staff were observed meeting the needs of the residents on the day of the inspection. The recruitment procedures include thorough checks of new staff to make sure they are suitable to work in care and that residents are protected. EVIDENCE: Residents said that all staff are very good, kind and helpful. One resident commented ‘staff are always busy but are very nice’. Two other residents said staff are helpful but in the evening it is ‘some time’ before the buzzer is answered. See Recommendation 3. Members of staff said part of their role is to put laundry away for the residents and that this is time consuming. All staff were seen to be polite and helpful towards residents and appear to communicate well with them. There is a good, friendly atmosphere in the home. A visiting district nurse said she had no concerns about the home, staff ‘are on the ball’ and communicate well with service users who appear to be well cared for. Thirteen health professionals who visit the home had completed a questionnaire issued by the manager. All stated ‘good to excellent’ for the attitude of staff, care and communication. A local GP had identified the care as excellent. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 16 There was evidence that adequate checks had been undertaken including POVA and CRB checks and two references prior to employing a new member of staff in the home. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 & 38. The manager is experienced and qualified so the home is run well for the benefit of the residents. Health and safety for residents and staff is well managed and improvements need to be made to the records of residents’ possessions kept in the home so that these can be properly safeguarded. EVIDENCE: The manager of the home is a registered general nurse and is registered with the Commission for Social Care Inspection. She confirmed that she has intends to complete the NVQ Level 4 in Management by the end of May 2005. Meetings with service users and relatives are held regularly. The area manager has put an action plan together on issues raised at the last meeting with appropriate deadlines for the action to be taken by. There is a quality monitoring system for the home, which includes collecting views of a range of people who are involved with the home about the way in which it is being run. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 18 The manager confirmed that no record of the belongings of a resident who had recently died had been made and that no written acknowledgement of the return of valuables to relatives had been received. See Requirement 4. Staff confirmed that fire safety, moving and handling, and food hygiene training is carried out. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 2 x x x 3 x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 2 x x x Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 20 Yes 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 7 Regulation 15 Requirement Timescale for action 31/5/05 2. 9 13 3. 10 12 4. 35 17 Schedule 4 A written plan of care identifying how a residents needs will be met must be in place for all residents. Medicines must be given and 31/5/05 recorded accurately in line with the homes policies and procedures and the NMC guidelines. (Previous timescale at all times not met) Staffs children must be at all times supervised on visits and gain the consent of residents before visiting them. A record of all valuable deposited 31/5/05 by a resident or on behalf of a resident should be kept and a written acknowledgment of the return of money or valuables be obtained. 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 8 Good Practice Recommendations Staff must ensure that residents are assisted with cleaning F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 21 Daneside Court Nursing Home 2. 3. 11 27 of their teeth/dentures as appropriate. The manager of the home should review the procedures for dealing with the belongings of residents who have died to ensure that these are carried out with sensitivity. The numbers of staff on duty and the duties of care staff, particularly io the evening shift, should be reviewed to ensure that all residents needs are met and that residents are not left waiting before buzzers are answered. Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Daneside Court Nursing Home F51 F01 S18768 Daneside Court V220577 140405 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. 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