Inspection on 28/09/05 for Delves Court Care Home

This inspection was carried out on 28th September 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.

Other inspections for this house

Delves Court Care Home 10/08/06

Delves Court Care Home 10/02/06

Delves Court Care Home 04/10/04

Delves Court Care Home 28/04/04

Delves Court Care Home 26/03/04

Delves Court Care Home 09/03/04

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Maple Lodge

Heathlands

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Breme

Ravenhurst

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Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Delves Court Care Home 2 Walstead Road Walsall West Midlands WS5 4NZ Lead Inspector Richard Eaves Unannounced 28th September 2005 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. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Delves Court Care Home Address 2 Walstead Road Walsall West Midlands WS5 4NZ 01922 722722 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) Hallmark Healthcare (Walsalll Limited) Vacant Care Home 64 Category(ies) of OP - Old Age (64) registration, with number of places Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide 2 Stepdown/intermediate care beds. Date of last inspection 4th October 2005 Brief Description of the Service: Delves court is a care home providing accommodation, nursing and personal care for up to sixty four older people, this includes two people who are resident for intermediate care at any one time. Owned by Hallmark Healthcare (Walsall) Ltd. the home is located in the Bescott area of Walsall, close to shops and local amenities. The home opened in March 2002 and consists of a threestorey purpose built premises with off road parking to one side and an enclosed attractively maintained patio garden area to the rear of the building. Internally each floor is self sufficient for communal rooms and toilets and bathing facilities. Nursing is provided on the first and second floors. The bedroom accommodation consists of 60 single rooms, 20 having én-suite and 2 double rooms. The ancillary services of catering, laundry housekeeping and maintenance are provided in-house. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and undertaken by two inspectors over the period of a day. The focus of the inspection was on the delivery of care and included case tracking service users care. The inspection also included a tour of the building, meeting with service users and inspection of records. During the visit the inspectors spoke with many of the service users who are currently living at the home, with longer discussions taking place with the residents or their relatives, whose care was looked at in depth. The home was found to be functioning calmly and efficiently and in conversation with the service users they were happy to confirm that they were content with life at the home. What the service does well: What has improved since the last inspection? An extensive programme of redecoration has commenced with the top floor completed and the first floor due to commence. The assisted bathing provision on the second floor has been reviewed and a new bath has been ordered and will be fitted shortly. The views of service users on the types of activities they would like to be provided has been sought and progress made in introducing changes. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 6 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. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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 Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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) 1 - 6 The homes statement of purpose and service user guide are good sources of information providing details of the service enabling service users and families to make informed decisions about admission to the home, this is confirmed at admission by contract. Skilled and experienced staff use a comprehensive range of assessment tools, which means that service users needs are thoroughly assessed to ensure that care needs will be met and confirmation of this is given. Introductory visits and trial stays are encouraged by the home, ensuring that people have time to make decisions, which are right for them. Dedicated staff provide intermediate care that prepares service users to return home. EVIDENCE: Copies of the statement of purpose and service user guide were available in reception and the guide is available in each bedroom and issued to persons making enquiries. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 9 The case files for each of the three floors of the home were inspected and found to include a pre-admission assessment and further in depth assessments at the time of admission using an activities of daily living model and including individual risks such as falls, pressure sores, nutrition and continence. The risk assessments are subject to monthly review but not the activities of daily living. The home uses an assessment raised by the hospital for intermediate care service users, this is received pre arrival at the home and a confirmation is returned that confirms the unit can meet the assessed needs. Introductory visits and trial stays are encouraged by the home, ensuring that people have time to make decisions, which are right for them. Rehabilitation therapies are provided by hospital out reach staff. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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 Health care needs of service uses are fully met and care planning in the home is overall of a good standard adequately guiding staff in the delivery of care needs, there remains scope to improve if service users are not to be at risk of needs not being fully met. Arrangements for the administration of medication are good and ensure service users medication needs will be safely met. EVIDENCE: Detailed care plans are developed from the comprehensive assessments, undertaken by senior nursing staff preadmission and where available, the community care plan. An inspection of a random sample of plans was undertaken on each floor and overall shows the care plans to be relevant to the assessed needs of service users and detail the actions required by staff to meet these needs. In most cases the plans are drawn up with the service user or family member and kept under review on an at least monthly basis, but some examples of failure to document this involvement was apparent. On the first floor a monitoring record for a service user with diabetes showed a distinct change requiring a response by staff in a timely way, but this was not Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 11 reflected in a subsequent review of the care plan. In another case file a care plan was seen for multiple wounds rather than on an individual basis. A number of service users whose care plans identified requirements to prevent pressure sores such as pressure relieving cushions did not have cushions on the chairs they were seated on. All service users are registered with a GP of their choice and other allied health care providers attend on a regular basis. The home has a good range of pressure relieving equipment and these were for the most part observed to be in use and where a mattress was in use an equivalent cushion was identified to be used. Arrangements for medication management are robust and undertaken by the nursing staff on the nursing floors and carers on the personal care area, all use a monitored dosage system for most medicines. The processes are audited weekly by the manager and quarterly by the pharmacist. There was evidence of re-sheathing of used hypodermic needles. New arrangements have been implemented to meet pharmaceutical waste requirements. On the day of inspection the medicine storage room temperature was recorded at 2°c above recommended level at 27°c. Carers have received the Boots training and are due to attend an accredited training course. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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 - 15 The home provides a varied social and recreational activity programme that provides interest and pleasure for service users. Visitors are welcome and help to keep service users informed about the wider community. Many aspects of care evidences that service users exercise choice and control over their lives. The meals are wholesome and meet the nutritional needs of service users while providing for choice and personal taste. EVIDENCE: The Home employs a social activities organiser who arranges leisure and recreational activities in and out of the home. The programme of activities is displayed on the notice boards of all three floors. Service users participate in planning events at the regular coffee mornings. The home operates an open visiting policy suited to the service users and visitors were observed to come and go across the day. Service users are encouraged to exercise choice and control of their lives to the extent of their capacity, this can be observed in the individual bedrooms that were seen to have items of personal property such as display case, favourite chair and most were decorated with pictures and photographs and other decorative memorabilia. Other choices encouraged include choosing Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 13 clothes to be worn that day, meals from the menu and times of rising and settling. The Home has a 4 week rotating menu that includes choices with an option of hot food at each meal. The make up of the menus suggest that the meals are nutritious, wholesome and well received by those service users that responded in conversation. Hot and cold drinks and snacks are available outside of meal times. The dining tables prepared for lunch were attractively set with tablecloths, place settings with serviettes, condiments and flowers on each table. In conversation a service user confirmed that this was normal practice. The meal served was nicely presented appeared appetising and those requiring help were seen to be assisted. The cook is experienced and able to meet a range of special diets and while not currently required, was able to demonstrate an awareness of religious and cultural foods and individual needs and wishes. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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) 16 The home has a satisfactory complaints policy and service users and their supporters can be confident that their views will be listened to and acted upon. EVIDENCE: The home’s complaints procedure is included in the service users guide and notices are located around the home. Four complaints have been received from relatives and these have been responded to to their satisfaction, one of which was reviewed under adult protection procedures. The procedure requires minor amendments to show the change of office address for the Commission. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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 - 26 The home is clean, free from odours and hygienic, it provides a good standard of décor, furnishings and managed services providing a safe environment and an attractive, and homely place to live. Toilet and bathing facilities are sufficient in number and located for the convenience of the service users. Individual private space is comfortable and personalised and decorated to service users liking. The home is clean, free from odours and hygienic, it provides a good standard of décor, furnishings and managed services providing a safe enviroment and an attractive, and a homely place to live. The premises are designed and equipped to allow service users to maximise their independence. Toilet and bathing facilities are sufficient in number and located for a the convenence of the service users. Individual private space is comfortable and personalised and decorated to service users liking. EVIDENCE: Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 16 Delves Court is a purpose built Home providing accommodation for up to 64 residents in 60 single and 2 double rooms , the design incorporates requirements to meet the needs of the disabled. The premises are well maintained and recently decorated and arrangements are in place for monitoring and regular servicing of equipment and utilities. The building is subject to safety monitoring and complies with fire and environmental requirements. During the tour of the building, garden furniture cushions were seen in the stairwell, prior to taking them into the garden for the day. The grounds provide a very attractive, safe and accessible area for service users and separate parking for visitors and staff to the side of the building. The gardens are well used and one service user was seen to be exercising there and another said she enjoyed the outlook from her ground floor room. Cigarette ends were seen near the back door. An internal programme of decoration has commenced with the second floor complete and the first floor due to commence. This is being taken in a timely way, damage is already apparent to doors on the second floor and protection should be considered. The home provides communal spaces of mixed lounge diners, on each floor and these were seen to be comfortably furnished and of a domestic appearance. There are sufficient toilets and bathrooms distributed around the home and close to the lounges for their convenience. A free standing toilet riser was seen to be dirty on the underside and showing signs of rusting on the tubular sections. The spacious bedrooms twenty having en-suite are furnished in accordance with the standard including a proportion of nursing beds, or alternatively to the documented wishes of the service users or their representatives. The double rooms are fitted with privacy screens. Some ground floor rooms have direct access to the garden. Many of the bedrooms seen are personalised with pictures and ornaments. Ventilation is natural from windows that are fitted with restrictors. Heating is by low surface temperature radiators, electric supply is from 3 double electric sockets, each room has a staff call, overhead and bedside lighting. The hot water supply at service user outlets are all controlled and subject to regular monitoring. The home was found to be clean, hygienic and free from odours, each floor has sluice disinfection facility and the modern laundry is fitted with washing machines with sluicing and disinfection programmes and all surfaces are washable. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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 - 30 The home has a good mix of staff in sufficient numbers to provide consistency of care that meets service users needs. The home continues to make progress in developing a skilled staff group with understanding of service users needs ensuring they are in safe competent hands. Recruitment and selection processes are to a good standard protecting vulnerable people. EVIDENCE: Sufficient care and nursing staff with the necessary skills are allocated to cover the full 24-hour day with appropriate support of ancillary staff. The allocation to each floor is for the ground floor, with up to 14 service users for personal care is a senior care and one further carer. The nursing floors are each staffed with a nurse and 4 carers for 22 or 23 service users. On the day of inspection two GNVQ trainees were on duty in a supernumary role. Staff spoken with said that the numbers were appropriate to meet the need of service users. Of 32 care staff 12 have NVQ level 2 and 8 are currently enrolled and on completion will take the home over the required standard 50 due by end of December this year. A sample of staff files were inspected and show that recruitment procedures are completed to a good standard with appropriate checks in place. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 18 The company continues its commitment to staff training and provides comprehensive induction and foundation training and there is a comprehensive package of mandatory and developmental training opportunities for all groups of staff. Records of this training are held on individual training files and is also displayed on a training matrix which shows good progress in achieving all mandatory courses for this year, including manual handling, fire safety, food hygiene and nutrition, health and safety, first aid, adult protection and abuse awareness, NVQ and challenging behaviour. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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) 31, 33, 35 & 36 The registered manager is supported well by her nurses and senior staff in providing clear leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. The systems for resident consultation at Delves Court Care Home are good with a variety of evidence that indicates that residents’ views are both sought and acted upon. Safeguards are in place at the home that protect the financial interests of the service users. Staff do not currently receive formal supervision so the home are unable to demonstrate that the service users receive consistent quality care. EVIDENCE: The new in post manager is well experienced and is progressing an application for registration. All levels of staff consider themselves to be valued and respected for their input into the team as a whole. On the day of the inspection it was apparent that there was a very good atmosphere amongst Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 20 the staff. The manager holds frequent staff meetings and maintains a record and actions taken in response to staff inputs. Service users views were last surveyed using a range of questionnaires that between them cover all aspects of service during the year ending March 2005 and an action plan was prepared as part of this years business plan. The area manager undertakes monthly regulation 26 visits completing a report of each inspection. Secure facilities are available for the safe keeping of personal money and valuables on behalf of service users. Money deposited for safekeeping is appropriately booked in and out at each transaction and receipts kept. The home does not act as appointee for any service users. Formal supervision sessions have been suspended while the manager sources training for senior staff who will be required to lead in its implementation. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x 3 x 3 1 x x Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 22 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 op24 Regulation 12(4)(a) Requirement The responsible person must ensure doors to service users accommodation are fitted with locks accessible to staff in emergency.Timescale 31.3.05 not met. The registered person must provide prospective service users written confirmation that the home is able to meet the agreed assessed needs for their health and welfare. Timescale 31.3.05 not met. The registered person must to provide accredited training for senior carers involved with medicine administration. Timescale 31.3.2005 not met. The registered person must demonstrate that appropriate consultation regarding assessment has been undertaken with the service user or representative. The registered person must ensure that care plans are prepared for each wound. The registered person must ensure that needs identified in the care plans are implemented. Identified need for a pressure Timescale for action 31.12.2005 2. op4 14(1)(d) 31.12.2005 3. op9 13(2) 31.12.2005 4. op3 14(1)(c) 31.10.2005 5. 6. op7 op7 15(1) 15(1) 31.10.2005 31.10.2005 Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 23 relieving cushion to be used. 7. op9 13(3) The registered must implement a programme of staff training and practice that demonstrates the danger of re-sheathing used hypodermic needles to eradicate this practice. The registered person must ensure that medicines are stored safely and appropriately at the correct temperature. The registered person must ensure that means of escape are not compromised by inappropriate storage of combustables in the stairwell. The registered person must ensure that staff working at the home are appropriately supervised. 31.10.2005 8. op9 13(2) 31.10.2005 9. op19 23(4)(b) 31.10.2005 10. op36 18(2) 31.10.2005 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. Refer to Standard op16 op19 Good Practice Recommendations The manager will ensure that the complaints procedure is reviewed and updated in a timely way. The responsible person is recommended to consider fitting a means of protecting doors from damage by the moving of equipment. Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 24 Commission for Social Care Inspection Halesowen Office, West Point Ground Floor, Mucklow Office Park Mucklow Hill, Halesowen West Midlands, B62 8DA 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 Delves Court Care Home E55 S29398 Delves Care Home V248086 190905 stg4.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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