Inspection on 14/09/05 for Delaheys Nursing Home

This inspection was carried out on 14th September 2005.

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

Delaheys Nursing Home 10/06/09

Delaheys Nursing Home 09/05/07

Delaheys Nursing Home 05/01/06

Delaheys Nursing Home 01/03/05

Delaheys Nursing Home 19/11/04

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 Delaheys Nursing Home 215 Clifton Drive South Lytham St Annes Lancashire FY8 1ES Lead Inspector Mrs Christine Marshall Unannounced Inspection 14th September 2005 02:00 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 Delaheys Nursing Home DS0000006036.V251837.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. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Delaheys Nursing Home Address 215 Clifton Drive South Lytham St Annes Lancashire FY8 1ES 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) 01253 714946 01253 782097 Delaheysuk@btconnect.com www.delaheys.co.uk Mr Alan Wilson Mrs Carolyn Wilson Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 28 service users to include: up to 28 service users in the category of OP (Older People) and up to one service user in the category of PD (Physical Disability) The home may from time to time admit one service user between the age of 55 and 65 years in the category of (PD) Physical Disability within the registered maximum of 28 service users in the category of OP (Older People) 1st March 2005 2. Date of last inspection Brief Description of the Service: Delaheys is a Care Home with Nursing that is registered to offer care and nursing for 28 people over the age of 65 years. The home has a special condition of registration that allows them, from time to time, to accommodate a person between the age of 55 and 65 years with a physical disability. The home is a detached property with ground, first and second floor levels. There is a passenger lift in place. Gardens are to all sides of the home and a large conservatory is at the front. Accommodation is in single and double rooms, some with en-suite facilities. The home is furnished to a high standard. The registered providers are Mr and Mrs Wilson and Mrs Wilson manages the dayto-day care of the home. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first of two inspection visits, scheduled from 1st April 2005 to 31st March 2006. All of the people spoken to at Delaheys said that they preferred to be called residents. This unannounced inspection took place from early to late afternoon and was carried out by the home’s designated lead inspector. The inspector undertook a full tour of the home, including bedrooms, lounge and dining areas, laundry and bathrooms. All areas were very clean, hygienic and pleasantly furnished. The inspector looked at the policies, procedures and administration records for the management of the home, all of which were extremely well presented and very informative. Comment cards were received from residents, relatives and GPs prior to the inspection; all were very positive and showed that everyone is satisfied with the care that they receive. The inspector spoke privately with four of the residents, and had group discussions with several other people living at the home. All were more than happy with their care. There was one visiting relative available during the inspection visit who readily praised the home and the staff for their care. The owners, nurses and care staff spoke with the inspector and showed that there is a very good team approach to the care given to the residents. Everyone was very friendly, welcoming and co-operative with the inspector throughout the visit. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 6 What the service does well: Delaheys provides a very pleasant environment for the people who live there. There is a quiet, relaxed and calm atmosphere throughout the home. There are two lounges and a dining room; the lounges are very homely and the dining area is very light and pleasant with nice table settings in place. The fabric and furnishings of the home are of a very good standard and the home is kept extremely clean and hygienic. The inspector found the carers very friendly and professional in their approach to care and the residents spoken to said that the staff were all very caring and considerate. Daily routines for the people living at Delaheys are flexible and the residents told the inspector that they enjoyed their own personal routines and lifestyles, particularly those who preferred a quieter day. Residents’ comments included “This home is second to none.” “When I come to my room, I come home; I have all my things around me.” “We get more than care here, we get love.” “The Matron and Alan (The owners) pull out all the stops for us.” “The carers are very, very good.” The visiting relative said, “My mother is very well looked after.” All of the residents who spoke to the inspector said that the food is very good they were very satisfied with the quality and variety of meals that are provided. On resident told the inspector “ I can’t fault the food, it is very good ” There are well-kept gardens around the home and the conservatory is very light and nicely furnished. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 7 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. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 8 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 Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 9 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): 1,2,3,4 & 5 Standard 6 does not apply to this home. Anyone who is considering entering Delaheys is supplied with enough information to help them make that decision. The home also gathers enough information about that person to ensure that their needs can be met. This means that people can make good choices and receive the care they require. EVIDENCE: There is a very informative Statement of Purpose and Service Users Guide in place; this is a set of written information that tells you about the care service that is offered, who the owners, manager and staff are and what the resident can expect if he or she decides to live at the home. Residents told the inspector that so long as it was practicable, they were invited to the home to meet the staff and other residents, prior to making their decisions: Care staff told the inspector that this was the usual practice. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 10 Personal assessments are done before any person is admitted to the home, so that a clear picture of the care that is needed by each individual is prepared. The most recently admitted resident to the home told the inspector that the manager had completed an assessment of his needs before he entered the home. The inspector looked at three resident’s files, one of which was the most recent admission to the home; and each had a completed pre-admission assessment of care needs in place. These are very clear assessments and cover every possible aspect of care that a person might need. The manager told the inspector that trial periods of stay are offered so that if the resident is not happy, then a review can be done to decide whether or not the resident is in the right home for the care that he or she needs. The inspector commended standards 1 and 3. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 11 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 The residents’ health and social care needs are met at Delaheys and people are treated with dignity and respect. Residents are fully supported in their daily lives. EVIDENCE: Care plans are written records of the care that are given to each person that lives at the home and the inspector looked at three; each of these plans was very informative and gave a clear picture of the care that was being given: Each had been regularly reviewed to make sure that the right care was being given. Those residents who were able told the inspector that they knew about their care plans and that they were happy with these. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 12 Residents spoken to also told the inspector that they had the GP of their choice and that they had regular visits by the chiropodist, dentist, optician and also hearing aid services. The residents also remarked that they were more than happy at the home and that the staff were very, very kind; they also said that their privacy and dignity is always looked after. The medication policies, procedures and systems make sure that the residents are safe. Nurses give out all medicines and the manager Mrs Wilson does very regular monitoring checks of all drugs. The inspector commended the care plans for the residents. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 13 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): 14 The owners and the staff support the residents in exercising choice and control over their lives. EVIDENCE: Residents told the inspector that they are supported in their preferred daily routines. They said that they could go to their room or to bed whenever they wished and that they made their own choices about what time they got up in the morning: They also said that they are given options of joining in with any activities that were provided, or to have quiet time in the lounges or their rooms. Residents all agreed that they had a good choice of food. Delaheys Nursing Home DS0000006036.V251837.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 & 18 Residents are able to voice their complaints and know who to speak to if they have any concerns. Adult protection and quality checks are in place, which means that residents live in a safe environment where their satisfaction is assured. EVIDENCE: There is a written complaints procedure for the residents and their relatives and this is included in the information pack; a copy is in every resident’s bedroom. The residents spoken to said that they had no complaints at all. There have been no complaints at the home or to the Commission for Social Care Inspection. Residents also said that they could get in touch with their relatives, solicitors or anyone else that they might need for help, if they wished: There are advocacy information leaflets and advice available, which is for anyone who is without relatives and needs someone to speak on their behalf. There are very robust policies in place for the protection of vulnerable people and the care staff are given training on abuse awareness. The inspector commended this policy and its approach to the prevention of abuse issues. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 15 Delaheys Nursing Home DS0000006036.V251837.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): 19,20,21,22,23,24,25,26 Residents are provided with very clean, homely and pleasantly furnished surroundings and bedrooms are personalised and comfortable; this means that people feel at home with their photographs and belongings around them. EVIDENCE: There are sixteen single and six double rooms, and each bedroom is personalised with pictures, photographs and small items of furniture. Twelve single rooms and two double have en-suite facilities and there are adequate toilets and bathrooms throughout the home. All lounges, dining areas and bedrooms are very comfortable and furnished to a high standard: There is an ongoing refurbishment programme in place. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 17 The inspector saw that there are aids and adaptations such as grab rails in toilets and special lifting and bathing hoists for the residents who need help with their mobility. There are also assisted baths for residents that cannot get in and out of the bath without help. Laundry systems make sure that there are no problems with cross-infection and the laundry area is kept very clean and tidy. The inspector generally commends the cleanliness of the home. Delaheys Nursing Home DS0000006036.V251837.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): 27,28,29 & 30 The residents care needs are met through good levels of staff, who have the appropriate qualifications and experience necessary to give a good care service. EVIDENCE: The list of staff on duty showed that there are good levels of nurses, carers and domestic staff on duty at the home. The inspector spoke to carers, who were very friendly and helpful and showed that there is a very good mix of people in place. National Vocational Qualifications (NVQ) training programs are in place and 100 of staff have achieved this. This is commendable. The recruitment policies and procedures are very robust and make sure that the residents are in safe hands. The inspector looked at a sample of staff training and personal files and each was meticulously kept with all the required information about the training programmes that had been undertaken and Criminal Records Bureau (CRB) checks. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 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 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): 31,35,36,37,38 The home makes sure that the best interests of the residents are protected in that their health and safety is promoted. EVIDENCE: Mr and Mrs Wilson are the owners of the home and Mrs Wilson manages the day-to-day running of the home. She is a Registered Nurse who holds the Registered Managers Award. Policies are in place for the protection of residents from any financial abuse. Those residents who spoke to the inspector said that they either looked after their own money or their relatives did it for them. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 20 All records are stored in locked filing cabinets and staff look at them only when they need to find out about that particular person’s care needs. There are planned supervision programmes in place and the inspector looked at a sample of staff files to confirm this. Care staff also told the inspector that they had regular supervision sessions. The inspector examined the Health & Safety check records and equipment servicing certificates, and all were current. The inspector also noted that there are extensive contingency plans in place for the health and safety of the service users, staff and the environment. The inspector commended this. Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 21 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 4 3 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X 3 4 3 4 Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Delaheys Nursing Home DS0000006036.V251837.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1 Tustin Court Port Way Preston PR2 2YQ 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. 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