Inspection on 10/06/05 for Darlington Court Care Home

This inspection was carried out on 10th June 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 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

Darlington Court Care Home 22/07/08

Darlington Court Care Home 24/04/06

Darlington Court Care Home 31/10/05

Darlington Court Care Home 18/10/04

Darlington Court Care Home 22/04/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Darlington Court Station Road Angmering West Sussex BN16 3SE Lead Inspector Helen Tomlinson Unannounced Friday 10 June 2005, 9:30am, V229691 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. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Darlington Court Address Station Road, Angmering, West Sussex, BN16 3SE 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) 01903 850232 Care UK Community Partnerships Limited Mrs Ruth Streeter Care Home 61 Category(ies) of Care Home with Nursing 61 registration, with number of places Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 61 service users may be accommodated. A maximum of 6 service users aged 50years and over in the category (PD). A maximum of 6 service users aged 50 years and over in the category dementia (DE) Date of last inspection 18/10/04 Brief Description of the Service: Darlington Court is a care home providing nursing care and accommodation for up to 49 older people and 12 people aged 50 years and over. The service users needs can be physical or resulting from dementia. The home is owned by Care UK Community Partnerships Limited. This organistaion owns around 80 care services in the UK. The building was purpose built around 10 years ago. It is situated on a residential cul-de-sac close to a main road. It stands in its own gardens to the rear and has a car park at the front. Accommodation is provided on 2 floors with a passenger lift and stairs providing access to all floors. The service users who were mentally frail were accommodated and cared for on the ground floor with those whose main problems were physical frailty were accommodated on the first floor. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Miss Helen Tomlinson and Mrs Sheila Gawley. They arrived at the home at 9.30am and left at 4.30pm. They conducted the inspection by separating onto the 2 floors to conduct observations, read documents, talk to residents, visitors and staff and examine care records. Mrs Gawley remained on the ground floor with Miss Tomlinson going onto the first floor. A tour of the building was carried out by both inspectors. The registered manager was present throughout the inspection. 1 complaint had been made since the last inspection. This had been investigated by the organisation registered to run the home. The outcome of this was not to the satisfaction of the complainant and the issues were further investigated at this inspection. What the service does well: Residents and visitors commented that the staff were friendly and cheerful when assisting them. They were seen to treat the residents with respect and maintain their dignity when helping them with personal needs. Residents said the food was good and there was a variety of meals served with a choice and plenty of food offered at all meal times. Residents were admitted from the hospital who remain supported by the hospital doctors and receive physiotherapy and occupational therapy. Visiting medical people said they had a good relationship with staff at the home, they were always helpful, knowledgeable about individual resident’s condition and could provide up to date records on request. The care plans were clear and provided a lot of information about the resident. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 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 Darlington Court H60-H11 S24133 Darlington Court V229691 100605 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 All residents had their needs assessed before they entered the home. EVIDENCE: The file of the latest admitted resident was seen. A full assessment of their needs had been completed, by the manager of the unit, four days prior to admission. The registered manager and the nurse in charge said that no person would be admitted without a full assessment of their needs having been undertaken. They said this was fully understood by the hospital from where many of their admissions came. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 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 and 9. Care plans had details of the health and personal care needs of the residents well documented. Some care practices meant the health needs of the residents were not fully met and presented a potential risk. Some aspects of medicine handling and recording potentially put residents at risk. EVIDENCE: Five care plans were examined and others were looked at for specific information. The care plans were detailed and contained clear information regarding the personal needs of the residents. One resident had been admitted four days previously. A detailed care plan was in place for this resident. The individual resident’s files contained various health assessments including moving and handling, pressure sore risk, nutrition assessment and continence assessment. Issues of risk of infection were identified and measures put into place to prevent a spread to other residents. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 10 A lack of appropriately experienced care staff led to some issues of concern which could have an effect on the health of the residents. There was a lack of drinks made available to residents throughout the morning. Residents on the unit for people with dementia did not have cold drinks available to them, either in their bedrooms or the communal lounge. On being asked staff said that it was not suitable for many residents to have water present, due to behavioural issues and their was a lack of water jugs. A blanket approach should not be taken and all residents should receive adequate drinks throughout the day. Those who needed assistance to have drinks and food were not always offered this when needed. This was seen to result in one resident’s breakfast and drink being still in their room, untouched, at lunchtime. This was not discovered by care staff until they went into this room to serve lunch. Staff supervision of each unit must be such that all residents who choose to stay in their rooms get the help they need with food and drinks. No hot drinks were given out throughout the morning. On the first floor staff said this was due to a lack of cups on the unit and shortage of staff. On the ground floor the activities coordinators gave out hot drinks during the morning, if they got downstairs in time. The charts for recording the food and fluid taken by residents, on the first floor, were not completed. Nothing had been entered for the 9th June 2005 on these charts. 2 residents on the first floor were assisted to sit in wheelchairs when they got out of bed. They remained in these wheelchairs all morning and during lunch. They were not assisted to the toilet or to sit in a more comfortable chair. One of these residents said they were not comfortable in the wheelchair and would prefer another chair. No pressure sore prevention cushions were in place for these residents. Of the twenty three bedrooms seen on the unit for people with dementia thirteen had no call bell in their room. On the unit for people with physical health needs not all residents had a call bell in place. Some of those who did could not reach them from where they were positioned in their chairs. Staff on the unit for people with dementia said many call bells were broken and were waiting to be mended. It was discussed all residents must be able to summon staff and receive an adequate level of supervision whilst in their rooms. The majority of bed rails on the first floor did not have bed rail protectors in place. There was no specific risk assessment, in the care plans seen, for bed rail use. No bed rails should be used without protectors or without a risk assessment being completed. Bed rails on the unit for people with dementia did have protectors in place. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 11 Medication policy and procedures are available to staff. Staff commented that there was insufficient time to read these. The homely remedies policy referred to a list of medicines, which was not available. Visiting hospital doctors or GPs prescribe on the Drug Prescription and Administration Charts. The administration observed, was recorded, after the preparation of the medicines and before administration. Dates that medicines were stopped and who authorised this, were not clear. The pharmacy agreement includes provision of advice and training on medicines. An external cream prescribed for one resident was seen in the bathroom of another resident. As discussed above, the resident whose breakfast remained untouched also had medication on their table which had been given with breakfast but had not been taken at lunchtime. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 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) 12 and 15 There was a lack of social activity for the residents on both units. The activity co-ordinators worked as care staff. The food was nutritious and well presented with a variety of meals served to meet the choices and needs of the residents. EVIDENCE: On the care plans seen there were sheets available to record the resident’s interests, family life, working life, what they enjoy, important people and dates. These were not completed on any of the care plans seen. This information would provide a good picture of the social life of the resident. Staff spoken with were unaware of this aspect of the residents life. 2 activities co-ordinators were on duty. They shared their morning between both floors, working together. They played dominoes with 3 residents on the first floor, providing them with drinks and social banter for approximately 1 hour. They then went downstairs. On the unit for people with dementia they assisted in giving out drinks and meals. On questioning if this was the correct use of their time it was said they were helping out due to the lack of staff. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 13 They said there was no budget for activities. Residents who were able to express an opinion said there was a lack of things to do during the day. Some watched T.V., listened to the radio and read books in their own rooms. The residents were complimentary about the food served in the home. They said they enjoyed their meals, were given a choice, plenty of food and it was nicely presented. The food was served from a hot trolley on both floors. On the first floor many residents ate in their bedrooms and were assisted by the staff. The layout of the home and the number of staff on duty meant other parts of the floor were without supervision during this time. Food was liquidised separately and the chef discussed the need to serve a balanced diet to meet the needs of the older people in the home. Examination of the kitchen showed it to be clean and tidy. A full cleaning schedule was in place. All food was correctly stored. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 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 standard(s) None of these standards were assessed at this inspection. EVIDENCE: Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 15 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 and 26 Most areas of the home were well maintained. Some areas were not homely. The current fire procedure would not safeguard residents in some parts of the home. The home was clean and tidy. Measures to control the spread of infection were in place. EVIDENCE: A maintenance man was employed at the home. He did the day to day maintenance jobs as identified by the care staff. For larger jobs contracters were brought in. He said a rolling programme of decoration of the bedrooms was ongoing and they were done as they became vacant, unless in urgent need between this. He identified some bedrooms which did require redecoration. Generally the bedrooms were well maintained and the residents said they were satisfied with them. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 16 Some communal lounges were sparsely furnished and did not contain homely fixtures and fittings. Since the last inspection advice had been sought from the fire service. Doorguards had been fitted which released open fire doors to close when the fire alarm sounded. For 9 fire doors these were not fully operational. The registered manager said the contracters were due back to make the necessary alterations. It was advised that in the meantime these fire doors be kept closed. An interim fire procedure had been put into place, but on talking to staff this was confusing and could result in staff putting themselves at risk. This should be reviewed. One small lounge on the ground floor had a bolt fitted to the door. This should be removed. The home was generally clean and most areas were free from offensive odour. One sluice on the ground floor was particularly malodorous. Staff showed a good understanding of the risk of spread of infection and their role in preventing this. Protective clothing was seen to be used. Information regarding special precautions was present where needed. The necessary washing machines were present. It was discussed with staff that the system of staffing the laundry had changed. There was now 1 person in the laundry for 7 days per week from 9am to 3pm. Previously there had been 2 people. Staff reported sometimes a shortage of towels and dirty laundry waiting to be washed. Residents discussed a loss of a large amount of clothing. For 1 resident this resulted in a need to wear pyjamas due a lack of other clothing. This was extremely restricting for this resident. Visitors discussed clothing going missing also. It was discussed that the current system should be reviewed and residents clothing should not go missing. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 17 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 and 29 The staff numbers did not meet the dependency needs of the residents or the layout of the building. There is a large reliance on agency staff. Staff were not recruited in a manner which safeguarded vulnerable adults. EVIDENCE: The duty rotas for week commencing the 6th June 2005 were examined. On the first floor 26 care staff shifts were covered by 17 different agency staff. This resulted in occasions, especially weekend, when the workforce consisted almost totally of agency staff. This and the number of fully competent care staff available was insufficient to meet the high dependency needs of the residents. This was made worse by the layout of the building and the supervision required in each wing. On the day of the inspection, on the unit for people with dementia there was a shortage of permanently qualified staff and a high use of agency staff. The activities co-ordinator stayed on to cover a late shift as a care staff member. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 18 She had not received the necessary training to carry out this role. On the first floor from 4pm to 6pm there was 1 qualified nurse, 1 agency care worker and 1 care worker in her first week of work and working under supervision. It was discussed this was not an adequate number of appropriately experienced staff for the residents accommodated. It was discussed with the registered manager that the current staffing situation could potentially put residents at risk. The number, skills, knowledge and competence of staff must, at all times, meet the needs of the residents accommodated. Three staff files were examined. These did not contain the relevant information to make sure the necessary checks had been carried out to safeguard vulnerable adults. For two there were gaps in employment history which had not been explained. For all three references from the last employer had not been obtained and their reason for leaving had not been explained. A letter was on file, from the head office, which said a Criminal Records Bureau check had been received. It did not say if it was free from criminal offences or if the Protection of Vulnerable adults list had been checked. It was discussed with the registered manager that all persons employed to work at the care home must be fit to do so. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 19 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) None of these standards were assessed at this inspection. EVIDENCE: Darlington Court H60-H11 S24133 Darlington Court V229691 100605 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 1 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Darlington Court H60-H11 S24133 Darlington Court V229691 100605 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 8 Regulation 13(4)(c ) Requirement All residents must have risk assessments completed for the use of bed rails and protectors must be in place at all times. All residents must have sufficient amounts to drink to meet their needs and choices. Residents must be consulted about their social and leisure interests and appropriate activities take place. All fire doors must be in full working order. The numbers, skills, knowledge and experience of staff working in the home must, at all time, be appropriate to meet the needs of the residents. The use of agency staff must not prevent residents from receiving continuity of care. All persons employed to work at the care home must be fit to do so. Timescale for action 31/7/05 2. 3. 8 12 16(2)(i) 16(2)(m)( n) 23(4)(c )(i) 18(1)(a) 30/6/05 31/7/05 4. 5. 19 27 30/6/05 30/6/05 6. 7. 27 29 18(1)(b) 19 and Schedule 2 30/6/05 30/6/05 Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 22 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. 2. 3. 4. 5. 6. 7. 8. 9. Refer to Standard 8 9 9 8 12 8 22 26 Good Practice Recommendations All residents should be monitored and assisted to move and change position at least 2 hourly. Records should show a date a medication was stopped and who authorised this. Drug charts should be signed after residents have taken or refused a medication. Staff should be deployed so that all residents in all areas of the home receive adequate supervision. The activities co-ordinator should not undertake care staff duties. All daily charts and records should be completed at the appropriate time. All residents should be able to summon assistance at all times. The system of laundering and returning clothes to residents should be reviewed. Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Darlington Court H60-H11 S24133 Darlington Court V229691 100605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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