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 3:30 5 January 2006
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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.V271660.R01.S.doc Version 5.1 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.V271660.R01.S.doc Version 5.1 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.V271660.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 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) 14th September 2005 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 day-to-day care of the home. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second 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 during the late afternoon and was carried out by the home’s designated lead inspector. The inspector found that all areas of the home were very clean, hygienic and pleasantly furnished. The inspector looked at the policies, procedures and administration records for the medication systems and the provision of meals, each of which was extremely well presented and very informative. Comment cards were received from residents and relatives prior to the inspection; all were very positive and showed that everyone is satisfied with the care that they receive. The inspector spoke generally with the residents, and had discussions with two visitors. All were more than happy with the care that home provided. 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. What the service does well:
Delaheys continues to provide a very pleasant environment for the people who live there. There is a quiet, relaxed and calm atmosphere throughout the home. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 6 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 maintained to 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 confirmed to the inspector that they enjoyed their own personal routines and lifestyles, particularly those who preferred a quieter day. Residents’ comments included “ I am very well thank you dear, we are well looked after.” “ Everything is very nice here.” A letter of thanks was displayed on the notice board, which said, “Since I came to Delaheys, I have started to laugh and smile a lot more.” Visiting relatives said, “We visited many homes before we brought Dad here, and we are very happy with the care that he receives. The quality and quantity of food that he gets is really very good.” 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. There are well-kept gardens around the home and the conservatory is very light and nicely furnished. What has improved since the last inspection?
As on the previous inspection visit, the inspector did not find any areas for improvement. The owners make every effort to provide a high quality nursing care service. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 7 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.V271660.R01.S.doc Version 5.1 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.V271660.R01.S.doc Version 5.1 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): No judgement has been made. EVIDENCE: All of the standards were assessed on the previous inspection visit and all were met, with standards 1 and 2 being commended. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 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): 9 The residents are protected by robust policies and procedures for the administration of medications. EVIDENCE: Standards 7, 8, 10 and 11 were assessed on the previous inspection visit and each was met, with standard 7 being commended. The inspector examined the medication systems and found these to be safe, accurately recorded and robustly monitored by the matron Mrs Wilson. Any resident who wishes to be responsible for their own medicines undertakes a risk assessment, signs a self-medicating disclaimer and is given locked space in their bedroom to store the drugs. There were no residents self-medicating at the time of this inspection visit. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 11 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 & 15 Family and friends are welcomed at any time, and the residents’ benefit from social activities and a good choice of food from menus that are varied and nutritious EVIDENCE: Standards 13 and 14 were assessed on the previous inspection visit and each was met. The home has a more spontaneous activities programme, for the individual choice and preference of the residents. There have been Christmas parties and sing-songs and karaoke. Generally the residents said that they had enjoyed Christmas and that they’d had their relatives stay for meals and refreshments. The inspector stayed at the home during the teatime meal and this looked appetising. Residents who were able said that they had a good choice of food. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 12 Soft diets were presented in an appetising way and care staff were very attentive during the mealtime, helping any resident who needed it in a relaxed and dignified manner. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 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 the following standard(s): No judgement has been made. EVIDENCE: Each of the standards was assessed on the previous inspection visit and each was met with standard 18 being commended. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 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 the following standard(s): No judgement has been made. EVIDENCE: All of the standards were assessed on the previous inspection visit and all were met. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 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 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): No judgement has been made. EVIDENCE: Each of the standards were assessed on the previous inspection visit and each was met, with standards 28 and 29 being commended. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 16 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): No judgement has been made. EVIDENCE: All of the standards were assessed on the previous inspection visit and all were met, with standards 31, 36 and 38 being commended. Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Delaheys Nursing Home DS0000006036.V271660.R01.S.doc Version 5.1 Page 18 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.V271660.R01.S.doc Version 5.1 Page 19 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
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