Inspection on 27/05/08 for Dove Court Nursing Home

This inspection was carried out on 27th May 2008.

CSCI found this care home to be providing an Adequate service.

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

Dove Court Nursing Home 26/05/09

Dove Court Nursing Home 10/11/08

Dove Court Nursing Home 04/06/07

Dove Court Nursing Home 28/09/06

Dove Court Nursing Home 19/08/05

Dove Court Nursing Home 21/04/05

Dove Court Nursing Home 09/07/04

Dove Court Nursing Home 04/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Dove Court Nursing Home Albert Street Kettering Northants NN16 0EB Lead Inspector Mrs Carole Burgess Unannounced Inspection 27th May 2008 10:10 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 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 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. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dove Court Nursing Home Address Albert Street Kettering Northants NN16 0EB 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) 01536 484411 01536 484410 dove.court@fshc.co.uk Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Vacant Care Home 58 Category(ies) of Dementia - over 65 years of age (28), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (58), Physical disability (10), Physical disability over 65 years of age (10) Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dove Court Nursing Home is registered to provide personal care with nursing for male and female service users whose primary care needs fall within the following categories:Old age, not falling within any other category (OP) 58 Physical disability over the age of 35 years (PD) 10 Physical disability over the age of 65 years (PD)(E) 10 Dementia over the age of 65 years (DE)(E) 28 2. 3. 4. 5. 6. No persons falling within the categories of PD or PD(E) are to be accommodated at Dove Court Nursing Home when there are 10 persons falling within these categories residing at the home No persons falling within the category of Dementia DE(E) are to be accommodated at Dove Court Nursing Home when there are already 28 persons falling within this category residing at the home Persons with dementia should only be accommodated on the ground floor at Dove Court Nursing Home To accommodate the person named in application reference number V34452 under the category MD(E) The maximum number of persons to be accommodated at Dove Court Nursing Home is 58 4th June 2007 Date of last inspection Brief Description of the Service: Dove Court is a large, modern, purpose built home situated close to Kettering town centre. The home provides both nursing and residential care. There is a qualified nurse at all times. The home is on two floors with two wings on each floor. One wing on the ground floor is currently unoccupied. All room are single with en-suite facilities and there are additional assisted bathing and toilet facilities. There are several lounges and dining areas and a safe, enclosed garden and patio area, which is accessible to all residents including people who use wheel chairs. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 5 The Statement of Purpose, Service Users Guide & last Inspection Report are available (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Service Users Guide are provided for all residents and their families. At the time of the inspection fees ranged from £341.55 to £591 per week, depending if the resident is social service or privately funded, and is dependant on the level of care required. There are extra charges for hairdressing, chiropody, newspapers and personal items. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. ‘We’ as it appears throughout the Inspection Report refers to ‘The Commission for Social Care Inspection.’ The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people who use the service and their views of the service provided. The site visit was unannounced and took place over seven hours. We selected three residents and tracked the care they received through a review of their records, discussion with them (where possible), other people who use the service, relatives, the care staff, and observation of care practices. We spoke with staff members regarding training and support. Planning for the inspection included assessing notifications of significant events, and reviewing surveys received from relatives, staff and health professional involved with the care of the patients. Thirteen residents, six relatives, three staff and a health professional responded to the CSCI ‘Have Your Say About Dove Court’ survey. Many of their comments have been included throughout the report. There were comments which showed that some residents and relatives were satisfied with the care such as, “Dove Court provides a friendly and caring environment” and “serves nice food”, but a theme which ran through the other responses highlighted concerns about the lack of activities, the lack of staff supervision at weekends and the over reliance on agency staff, particularly at weekends and at night. The Manager and other staff spoken with were positive and helpful during the inspection. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? A manager has been appointed who said that she will apply for registration with CSCI by the end of June 2008. As recommended following the last inspection, in June 2007, the manager increased staffing and there were now three care staff on duty in the dementia unit throughout the day. The home was clean and fresh throughout including the en suite bathrooms that were seen on the day of inspection. Staff training improved. The home has had a Council Grant that has enabled them to improve the environment. Some recent improvements were: • • • • • • • • • Redecoration of the lounges Installation of a wet room The purchase new dining chairs The purchase two special chairs that enable otherwise bed bound residents to get out of bed and be moved around the home. Replacing some flooring The clinic room had been refurbished and upgraded The purchased of a new washing machine The installation of new key safety pads throughout The purchased of profiling beds and mattresses. DS0000012611.V365140.R01.S.doc Version 5.2 Page 8 Dove Court Nursing Home 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. The summary of this inspection report can be made available in other formats on request. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 9 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 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their relatives are provided with sufficient information, to enable them to make an informed choice if the home is the right one for them. EVIDENCE: The home provides prospective residents and their relatives with a Statement of Purpose and Service Users Guide (both give information about the home) to help them decide if the home is the right one for them. A copy of the Service Users Guide is provided for residents in their own room. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 11 The Statement Of Purpose and Service Users Guide is currently being reviewed and updated, but the providers should be mindful to update contact details for Social Services (who manage complaints) and the CSCI so that residents and their relatives have the correct information. This information also needs to be included in the complaints policy and procedure. One resident said that before she moved there her family arranged a visit to Dove Court to look at the facilities offered, and that the visit was competently dealt with by senior staff. The three residents’ care plans reviewed contained a pre-admission assessment to show that the home could meet their specific health, welfare, and social care needs. It included personal details, relative and GP contact numbers, a past and present medical history, current health care requirements and medications. The pre-assessment could be more detailed in respect of personal preferences, social interests and hobbies to ensure that the home could meet all of a prospective resident’s needs and provide a more person centred approach. The home does not provide intermediate care. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have their health and personal care needs met, but a lack of detail in care plans results in less personalised care being provided. EVIDENCE: Residents’ care plans provide nurses and carers with good information about the health and personal care needs of the residents but for a small number of residents who were classed as ‘low dependency’ there may be an assumption by staff that they require little support. One resident described that s/he had made their own bed and that they had had to ask staff for clean sheets. Also that staff did not offer to help with Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 13 washing and dressing, which was sometimes difficult. S/he stated that ‘low dependency’ seemed to mean ‘no dependency’. Another said “If staff are busy tending to those who have greater needs I sometimes end up doing things for myself”. Having to ask for basic care support on a regular basis suggest that care needs are not being met and also compromises the dignity of this group of residents. The manager said that care plans required improvement to give clearer information for staff and provide a greater focus on person centred care for all residents. There was little information about residents’ personal preference and how these would be met. One resident said that s/he would like more baths, at least twice a week, but required assistance. The resident said that prior to admission s/he was used to bathing daily. This was not reflected in their plan of care. Appropriate risk assessments were in place for such things as fall management and nutrition, and for residents who required bedrails to ensure that they were appropriate for their care and safety. Contact with healthcare professionals such as GP’s, District Nurses and hospitals were recorded to ensure that healthcare needs and treatments were addressed. The care plans reviewed had not been signed by the resident and/or their representatives to show that residents and/or their relatives were involved in and agreed with their personal plan of care. Two residents said that they had never seen their plan of care and would welcome being more involved. The manager said that some care plans had been signed and this was work in progress. A visitor said that s/he had been consulted about the plan of care for their relative and was happy with the care provided. There had been a number of concerns raised over the last few months by residents and relatives about medication ‘running out’. The manager said that in one case the medicine had been in stock (the residents confirmed that s/he had not missed any doses), another that Boots the Chemist had missed livery, and two others had been mistakes made by staff in not ‘chasing’ a script and forgetting to order an ‘as required’ medication. This has been addressed by the manager to ensure that this is better managed in the future. Medication policies and procedures were satisfactory at the time of inspection. Only nurses and senior carers, who are trained to do so, administer medication. Part of a medication round in the dementia unit was observed and residents received their medication safely and as prescribed. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 14 Observation during the inspection showed that staff knew how to protect and promote residents privacy and dignity. Staff spoke to residents and visitors in a respectful, friendly, quiet and helpful way. A resident said that, “the regular nursing staff were on the whole excellent”, but they also said “sometimes things were missed when agency staff were on”. A relative said that the staff supported her husband and had always been very helpful and that she could not fault the care. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 14 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not meet the all of the residents’ social expectations and preferences. EVIDENCE: On the day of inspection residents were watching television, listening to the radio or spending time in their own rooms. Residents were able to have their own television, computer and telephone in their room should they choose to do so. There was little information regarding residents’ past and present hobbies and social activity preferences recorded in their plan of care. These could be improved to provide a more rounded picture of what activities residents preferred and responded to. A number of the younger residents felt there was Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 16 little for them. Activities should be integral to residents’ care to ensure that their lifestyle expectations and preferences are met and their psychological wellbeing maintained. There is a part-time activities organiser who offers a programme of activities such as craft sessions, carpet bowls, one-to-one time, and general entertainment. During this and the last inspection a number of residents identified the lack of activities as a problem. Although there was a four-week rolling programme, displayed in the foyer residents said that, apart from carpet bowls, many of the activities were often cancelled as the part time activities co-ordinator was also the home’s administrator and she did not have sufficient time to promote the activities programme. Carpet bowls seemed to be an activity that many residents enjoyed, including residents from the dementia unit who are encouraged to join in. One resident commented that it was nice that people with dementia were able to mix with other residents. The home has recently been given a Karaoke machine, which was proving to be popular, and a small number of resident had enjoyed a trip to the pub. The hairdresser visits the home each week and a number of ladies said they enjoy having their hair done. Residents on the dementia unit had painted place mats that had been laminated so that they could use them. The Lions had invited the residents to tea in June. Residents have quarterly meeting, but a resident said these were not well attended and s/he indicated that s/he would like to be more involved with activities committee. One resident helps look after the garden, which s/he said s/he enjoyed. Since the last inspection activities and support for residents with dementia has improved but some effort needs to be made to provide younger, more able residents to become involved with and take some ownership of the daily life of the home. One resident said that activities had improved a great deal in the last few months. The manager also commented that two residents were unable to go far because their wheelchairs were large and difficult for staff to manage, and that as the home does not have access to a suitable vehicle staff are unable to take these residents out very often. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 17 Church of England, Roman Catholic and Methodist ministers hold regular services at the home for residents who wish to attend or will visits residents in their own rooms if they prefer. Residents said that they were able to have visitors at any time and a number of people came to visit during the course of the inspection. All meals were prepared in the home’s kitchen by the chef. There were choices at all main meal times. Special diets such as diabetic and soft diets were catered for. Residents were weighed where necessary, and had a nutritional assessment in their care plan to ensure that their dietary needs were met. Although a small number of residents said the food could be better most said that the food was good but there could be a better choice. A residents said that “Tea was always varied and appetising and that the food had improved of late”. The food provided for lunch looked nutritious, well presented and residents who required assistance were given this in an unobtrusive manner. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are satisfactory and the home’s policies and procedures protect and safeguard the residents. EVIDENCE: The home has a complaints policy and procedure; a copy is displayed in the hall and in the Statement of Purpose but both require updating to provide current information for resident and their families (see under Standards 1-6). Information regarding advocacy services through the Alzheimer’s Society was available in the reception area. The CSCI have not received any complaints about the home. However, although residents’ comments showed that people feel that they could discuss concerns with the manager and staff, concerns were not always addressed. For example a visitor said that she had made many requests to staff to ensure that her father had his hearing aid. But this was not always acted upon. Another said that she had reported that her relatives false teeth Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 19 had gone missing and that she had had to replace them at significant cost to herself. This was discussed with the manger, who said she was unaware of the situation, and agreed the home was at fault and said she would discuss it with the relative concerned and rectify the situation. New staff are provided with ‘safeguarding’ vulnerable adults information during their induction period. Twenty-six staff have undergone ‘safeguarding training since last May 2007’ and staff were able to show that they were aware of the correct procedures to follow to ensure the safeguarding of residents. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a clean and comfortable standard of accommodation. EVIDENCE: The home was clean, and warm and well maintained with adaptations to suit residents’ specific needs. It is decorated and furnished to a good standard that creates a comfortable environment for the residents. All residents’ rooms have en-suite facilities, all have a ‘nurse call’, and the rooms that were seen were clean and tidy. Residents were able to bring items Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 21 of their own furniture and possessions with them to personalise their rooms. Residents’ rooms were well personalised, which made them look homely and comfortable. There were sufficient additional lavatories, bathing and assisted bathing facilities. There was a senior housekeeper and four domestic staff. Residents and relative said that cleanliness in the home had improved and the new cleaner was excellent and did a thorough job and that décor was much improved. Another said that Dove Court provided a friendly and caring environment. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are sufficient in number to meet the current residents’ needs, but mandatory staff training must be completed, and implemented, to ensure that staff provide a good standard of care, specifically in relation to residents with dementia and mental health problems. EVIDENCE: Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 23 There were 40 residents at the time of the inspection. Staffing levels, at the point of inspection, were in line with those suggested by the Department of Health Residential Forum Guidelines and were sufficient to meet the current residents’ needs. During the day on the dementia unit there were three care staff and two at night. On the first floor – combined residential and nursing - there were four carers in the morning, three in the afternoon and two at night. There was a registered nurse on duty at all times, day and night. In addition there were ancillary staff such as administrative staff, cooks and cleaners. Since the last inspection staffing in the dementia unit has improved from two to three care staff per day shift (as recommended after the last inspection in June 2007) which enables staff to give more individualised support to each resident. Although the home has had some staffing problems this appears to be improving slowly with the home using less agency staff. Residents commented that the agency staff did not always provide the standard of care they expected. Residents found it frustrating and undignified to have to repeat their care needs on a daily basis to staff they did not know and who did not know them. Three staff files were checked during the inspection and showed that there was a satisfactory recruitment process that ensured that residents were well protected. However it is recommended that there is a procedure in place to check nurses Personal Identity Numbers (PIN) periodically to ensure that they are still on the professional register and ‘fit’ to practice to provide additional safeguards for the residents. New staff carry out an induction programme to ensure that they are competent. Two staff in the surveys said that they did not have a proper induction but there was no detail of how long they had been working at the home. A fairly new carer said she had completed an induction programme, and had had a mentor, and was well supported by staff and management. Not all staff had received all of the mandatory training, but the manager had a list of training requirements to ensure all staff training needs were identified and updated. There were three Moving & Handling trainers in the home so all staff have received this training. Additional updates were in progress such as Health & Safety, Infection Control, First Aid, Hand Hygiene and Fire Safety had been provided for a number of staff. Twenty-six staff had receive ‘safeguarding’ training since May 2007 and the manager had arranged for staff to have Dementia Care training in June of this year. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 24 The manager said that, in addition to herself and her deputy, only four care staff had completed National Vocational Qualification (NVQ) in Care, Level 2/3, although one person was doing an NVQ in Care and four others were hoping to so. It is recommended that the providers provide positive encouragement to staff and support them to undertake NVQ’s. This and the current training programme would ensure that staff have the necessary skills to give safe care to the residents. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management systems are in place but the ongoing lack of a permanent registered manager continues to be of concern. The manager, who is fairly new in post, provides an adequate standard of leadership for staff but needs to build upon the work in progress to improve service provision. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 26 EVIDENCE: The home has been without a Registered Manager since 2002. Various managers have been in post but there has been no application for registration with the CSCI since 2005, when an application was withdrawn. The Providers appointed a new manager in September 2007 who works in a supervisory and management role in addition to the nursing and care staff numbers. The new manager is in the process of applying for registration with the CSCI, which ensures that she has the necessary skills and is ‘fit’ to manage a care home. The judgement of adequate is not a personal judgement of the manager’s abilities but of the Provider’s lack in providing a registered manager for such an extended period of time which has affected the ethos, leadership and management in the home. Staff have not been regularly supervised by the manager and senior nurses in performing their nursing and care tasks. The current manager is in the process of ensuring that all staff receive annual appraisals and supervision (a regular review of staff’s personal and training needs in relation to their work). The implementation of the training programme, and regular, recorded supervision, should ensure that staff have their training needs identified and that they have the necessary skills to provide a good service for the residents. A theme that ran throughout the many comments received from residents and relatives was the lack of staff management at the weekends. One resident said it was difficult to speak to someone at the weekend if you had a concern and this was the time when things “tend to go a bit pear shaped”. The lack of management cover at the weekend was discussed with the manager, as this seems to be affecting the quality of care provided for the residents. Health and Safety Policy and Procedures, showed that the manager was mindful of her responsibilities to make sure that residents live in a safe environment. Residents’ finances were appropriately managed and there was a system in place to confirm that all was in order. Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 27 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 28 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 12 (1) (a) (2) & (3) Requirement The resident’s plan of care should be drawn up with the involvement of the resident and signed and agreed by the resident and/or a representative (if any). Residents, who wish to do so, should be actively supported to participate in formulating their plan of care to ensure that all of their care needs are identified and met. Activities and lifestyle in the home should match the expectations and preferences of the residents, with particular reference to those residents with lower dependency needs (who may be overlooked) and for those residents who are wheelchair bound and need transport to get out and about. The Registered Provider must appoint a manager who will apply for registration. This is an outstanding requirement from June 2007. Timescale for action 27/07/08 2 OP12 16 (m) 27/07/08 3. OP31 8(1)(a) & 9(1) 27/06/08 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 30 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP3 Good Practice Recommendations Residents pre-admission assessments should contain detailed information, which includes social interests, hobbies, religious and cultural needs, so that individual needs and preferences are fully identified and met. Residents dignity should not be undermined by having to ask for basic care such as having a their bed made, changing sheets or having to repeatedly explain their care needs to agency care staff. There should be clear lines of management responsibility and accountability especially at weekends and when the manager and/or her deputy are unavailable. Results from residents’ or relatives’ surveys should be made available to current and prospective residents so they are able to judge how well the home is meeting residents’ needs. Staff should receive regular formal supervision to ensure that their training needs are identified and met so they can continue to provide good care for the residents. 3. OP10 4. 5. OP31 OP33 5. OP36 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Dove Court Nursing Home DS0000012611.V365140.R01.S.doc Version 5.2 Page 32 - 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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