Inspection on 04/06/07 for Dove Court Nursing Home

This inspection was carried out on 4th June 2007.

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

Dove Court Nursing Home 26/05/09

Dove Court Nursing Home 10/11/08

Dove Court Nursing Home 27/05/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Dove Court Nursing Home Albert Street Kettering Northants NN16 0EB Lead Inspector Mrs Carole Burgess KEY Unannounced Inspection 4th June 2007 09:40 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.V336050.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.V336050.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.V336050.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 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. 28th September 2006 2. 3. 4. 5. 6. 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 on duty day and night. The home is on two floors with two wings on each floor. All room are single with en-suite facilities. There are several lounges and dining areas, and additional assisted bathing and toilet facilities. It has a safe, enclosed garden and patio area, which is accessible to all residents including people who use wheel chairs. The Statement of Purpose and Service Users Guide (both give information about the home) are provided for all new residents, and a copy is available in the hall. A copy of the home’s most recent inspection report is available on request. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 5 Fees at the time of inspection were: £331.80 - £562 pr week. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. The site visit was unannounced and took place over seven hours. The Inspector selected four residents and tracked the care they receive through a review of their records, discussion with them, and their relatives (where possible), and the care staff, and observation of care practices. The Inspector spoke with staff members regarding training and support. The Temporary Peripatetic Manager and other staff spoken with were positive and helpful during the inspection. Planning for the Inspection included assessing notifications of significant events sent to the CSCI by the home. Eight residents and seven relatives and staff responded to the CSCI ‘Have Your Say About Dove Court’ survey. Many of their comments have been included in the report. What the service does well: What has improved since the last inspection? Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 7 Residents who require bedrails have been risk assessed by a qualified nurse. The home has appointed an activities organiser who is to undertake training with an experienced activities organiser at another Four Seasons home, and will have some training in dementia care. A number of staff have received dementia care training. What they could do better: This is what the home must do to improve: Staff must be ready to offer assistance to residents in eating where necessary, before meals are left to go cold, and encourage residents, especially those with dementia, to eat a wholesome and nutritious diet. All complaints must be answered in a timely manner, in line with the company’s own complaints policies and procedures, and appropriate records of the correspondence retained for inspection. All parts of the home must be kept clean, especially en-suite facilities to prevent the spread of infection to vulnerable people. All staff must have two written reference before appointment, and gaps in their employment history explored, to ensure that residents are fully protected from abuse. Staffing must be appropriate for the health and welfare needs of residents, and not based on a numerical head count, with additional staff provided at peak times when necessary, to ensure that residents’ care needs are fully provided for. Staff must receive training appropriate to the work they do, including induction training when first appointed, and specific training for all staff working with residents who have dementia. A manager must be appointed who will apply for registration to provide stability and leadership for the home and improve care for the residents. Interim management arrangements for the home, and any changes to those arrangements must be provided to the CSCI. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 8 This is what the home should do to improve care for the residents: 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 catered for. Care staff should be made fully aware that residents’ medication is for residents alone and not for their personal use. To do so is an offence. Residents should have the opportunity to receive activities appropriate to their needs, especially people with dementia, which are provided by a person who has an understanding of their special requirements. All staff should receive safeguarding adults training which is updated at least every two years to ensure that residents are protected from harm, and all staff should receive appropriate, annual, mandatory training to ensure that they have the basic skills required to care for the residents. Results from residents’ or relatives’ surveys should be published and made available to current and prospective residents so they are able to judge how well the home is meeting the residents’ needs. Where individual residents’ money is handled by the home it should not be pooled, and appropriate records should be maintained to protect the interests of the residents. Staff should receive formal supervision to ensure that their training needs are identified and met so they can continue to provide good care for the residents. 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.V336050.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.V336050.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 adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with sufficient information, and have their health and welfare care needs assessed, but there is insufficient personalised information to identify individual social care needs. EVIDENCE: The home provides prospective residents and their relatives with a detailed 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. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 11 Four residents’ care plans were seen. Each contained a pre-admission assessment, completed by a qualified nurse, to show that the home could meet the resident’s health and welfare needs. The assessments were in the style of a pro-former questionnaire, with a numerical scoring system to determine the level of the resident’s dependency. Although there was space for ‘additional comments’ these were rarely filled in, and all four lacked details such as social interests, hobbies and personal preferences that would form the basis of an individualised, personal care plan. Copies of the residents’ contracts (terms and conditions) are kept in the home in a separate file and residents, or their relatives, are provided with a copy. Residents spoken with were unclear if they had received a contract and the Temporary Manager agreed to check and provide copies where required. The home does not provide intermediate care. Dove Court Nursing Home DS0000012611.V336050.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: Care plans were satisfactory and had risk assessment and interventions to address residents’ specific, health and welfare needs such as specific concerns discussed with the residents GP, such as nutritional requirements, specimens taken, outcomes and treatments prescribed, hospital and clinic appointments. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 13 Contact with healthcare professionals such as Chiropodists, Opticians and District Nurses were recorded; treatments carried out as recommended, and recorded in the resident’s care plan and daily record to make sure that the resident’s health care needs are met. The Manager said that she was not happy with the care plans which required more detail. Care plans had not been agreed and signed by the residents and/or their representatives. This should be done for all new care plans and when care plans are changed, so that all of the resident’s health, welfare and social care needs are identified, agreed and continue to be met. A resident of the dementia care unit was asleep and had missed her lunch, which had gone cold and inedible at her bedside. The inspector pointed this out to a carer, who had just come on duty. She gently woke the resident who indicated that she felt ‘sick’. The resident was then attended to, but it is of concern that the morning carers did not notice this and that the resident went without her lunch. One resident and her relatives were concerned that, on occasions, she had not received her weekly bath. The resident said that she would prefer to have a bath twice a week; also that her water jug was not kept filled. This was discussed with the Manager, who will review the resident’s care and discuss this with to ensure that her personal care needs are met. A relative said that her relative’s hearing aid was not always put in, ‘the one thing she needs doing’. A resident said, ‘The staff always provide the support and care I need and we have a good relationship’. Another said ‘The doctor is always called when necessary and the qualified staff are very helpful’, and ‘If I don’t feel well the staff look after me well’. Medication policies and procedures were sound. All medications is only administered by nurses, and senior carers who have receive medication training to ensure that residents receive their medication as prescribed. A resident said ‘Any medication is careful monitored and delivered’ and a relative said ‘I am always kept informed about hospital appointments and changes in (my relative’s) medication’. All residents’ rooms have a lockable draw. Residents are able to continue to self medicate following a risk assessment to ensure that they are safe to do so but know one was administering there own medication at the time of the inspection. A carer was heard to ask for antacid medication for herself, as if this was usual practice. The senior carer refused, saying that she was not allowed. The Manager was informed and will ensure that care staff were told that they are not allowed, under any circumstance, to use medication prescribed for and belonging to the residents. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 14 Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity. Staff spoke to residents in a respectful, friendly, quiet and supportive way. Three residents and three relatives all said that staff were kind, caring and respectful. A resident said ‘The staff always respect my wishes’. Dove Court Nursing Home DS0000012611.V336050.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 but does support residents with their everyday choices. A wholesome and varied diet is provided, but some staff do not provide adequate support at meal times for less able residents. EVIDENCE: On the day of inspection residents were watching television, listening to the radio or spending time in their own rooms. Residents are able to have their own television in their room should they choose to do so. Residents were seen reading, knitting and talking to visitors. One resident helps look after the garden. Quite a few ladies had their hair permed by the hairdresser who visits the home each week. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 16 Ten residents living in the ground floor dementia unit had the television on but no other activities took place. There are two carers who provide for all of their personal care needs, so they received very little additional social stimulation appropriate to someone with dementia. A relative said that ‘staff should have more time to spend with residents, encouraging them to walk in the garden’, and (for her relative) ‘to drink more water as this affects her health’. The home has a recently appointed activities organiser. The Manager said that the activities organiser was not very experienced in this area but was very enthusiastic. She is to be provided with support and training at their sister home and will undertake training in dementia care. She has made a good start in collecting ideas of residents’ preferred activities and hobbies; has set up a folder to record the daily activities provided for each resident; and has entertainers booked each month for the remainder of the year, including a Christmas variety show. There is also to be a Summer Fayre in July and an Advent Fayre in November. A relative said that residents had got used to staying in their rooms so did not easily join in any more. She hoped that the home would plan some trips out for the residents. A number of residents identified the lack of activities as a problem, but carpet bowls seemed to be an activity that many of the residents enjoyed. A resident said that there were also card games and dominoes and quarterly entertainment, but from the latter part of 2006 and until March 2007 activities were rare, apart from the carpet bowls. The resident said that with the new activities lady he looked forward to enjoying more varied activities. Another resident said that he would like to take part in a painting group and help in the garden. The Manager said that she also hoped to introduce film evenings and regular residents meetings, which are not happening at present, to encourage residents to take an active part in the home. There are two church services in the home each month, one Church of England and one Methodist service. The Manager said that this needs to be better organised so that residents who want to attend could be helped to get ready in time. Residents said that they are able to have visitors at any time and a number of people came to visit, and were spoken with, during the course of the site visit. Staff support residents with making choices in their everyday life. Meals are prepared in the home’s kitchen: there are choices at all main meal times. Residents have a nutritional assessment in their care plan to ensure that their dietary needs are being met. Special diets such as diabetic, vegetarian, vegan and soft diets are catered for. Additional advice is sort from health professional such as the GP, residents who require them receive Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 17 additional supplements such as Fortisip. Two residents said that they always enjoy their meals and one said that her special requirements were catered for. A resident of the dementia care unit was asleep and had missed her lunch, which had gone cold and inedible at her bedside. Residents who are not supported and encouraged to eat their meals may become nutritionally malnourished with the attendant health care problems such as increased falls, fractures. Dove Court Nursing Home DS0000012611.V336050.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 weak, which may compromise the protection of residents’ rights. EVIDENCE: The home has a complaints policy and procedure; a copy is displayed in the hall and in the Statement of Purpose. Information regarding advocacy services is available in the reception area. The CSCI has received one complaint about the home, which was passed to Social Services to follow up and is ongoing. The complaints file was checked and had six complaints were recorded. One made to the home at the start of the year had no recorded response to the complainant, although the Manager said that this might still be on the computer. But it remained unclear if a response was sent to the complainant in line with company policy and in adherence to ‘The Care Homes Regulations’ 2001. The Manager will follow this up to ensure that a response was sent to the complainant. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 19 The home’s complaints process reflects Safeguarding Adults policies but needs updating to reflect local information provided through Northampton Interagency Safe Guarding Adults Policy. Two of the staff files seen contained Protection of Vulnerable Adults (PoVA) training certificates for 2006. Although the Manger said that staff receive Four Seasons ‘in house’ PoVA training there was no evidence that staff had received PoVA training as part of their induction, nor was there a training plan to periodically update staff and ensure that they have the necessary information to recognise and safe guard the residents against abuse. Staff, were however, able to demonstrate the correct procedures for safeguarding the residents from abuse. One resident was not really sure how to make a complaint but another resident said, ‘I can always speak to the staff to get a problem solved’; and two residents said that they would complain to the home manager and it would get sorted out. Dove Court Nursing Home DS0000012611.V336050.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 adequate. This judgement has been made using available evidence including a visit to this service. Residents are provided with a comfortable standard of accommodation but greater attention to cleanliness is required to safeguard residents from infection. EVIDENCE: The home is safe and well maintained with many adaptations to suit residents’ specific needs. It is decorated and furnished to a good standard that creates a comfortable environment. The dementia unit has a tropical fish tank, which needs some attention, but the Manager has arranged for it to be cleaned and restocked. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 21 All residents’ rooms have en-suite facilities and most were clean and well decorated. Residents are able to bring items of their own furniture and possessions with them to personalise their rooms. Most of the residents’ rooms were personalised, some with the resident’s home furnishings such as a sofa. There are sufficient toilets, bathing and assisted bathing facilities for residents who require extra help with bathing. All rooms have ‘nurse call’. One relative and a number of residents said that the rooms were kept nice and clean. A visiting relative was not happy about the cleanliness of the en-suite and toilet, which had not been cleaned properly. She felt that the room was only superficially cleaned and areas such as behind furniture left. She said that, periodically, she cleaned the room herself. This was discussed with the Manager, the toilet was cleaned and the Manager will arrange for a ‘deep clean’ of the room. The Manager acknowledged that there were deficiencies in the cleaning regime and that she needed cleaning staff later in the day, as well as in the mornings, and that the Housekeeper needed to be more proactive in supervising the cleaners to ensure that the home is cleaned thoroughly. Residents have access to a safe garden and patio, and all areas of the home are fully accessible for people who use wheelchairs. The home’s health and safety arrangements such as regular maintenance and servicing of equipment, regular fire drills and monitoring heat control valves on hot water taps show that the providers are mindful of their responsibilities to make sure that residents live in a safe environment. Dove Court Nursing Home DS0000012611.V336050.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): 17, 28, 29 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Current staffing levels, especially on the ground floor dementia unit may, at specific times, place residents at risk. EVIDENCE: Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 23 There were, at the time of the site visit, thirty-five residents, ten being in the ground floor dementia unit. One wing of the ground floor was closed. On the first floor (two wings managed as one) there is one qualified nurse in charge with three carers in the morning and two carers in the afternoon. A carer and senior carer staff the ground floor dementia unit for up to 10 residents, above ten residents there are three carers. It is difficult for two staff to ensure the safety of residents at all times, such as when they are bathing a resident, leaving other residents unsupervised. A carer said that with only two staff it was difficult to give all of the care required such as making sure residents nails were cut and clean. Staffing must be planned to reflect the dependency of the residents, and not the number of residents, using additional staff at peak times where necessary, to ensure that residents have all of their care needs met and safety if maintained at all times. There are always trained nurses on duty, day and night. In addition, during the day, there are cooks, cleaners, kitchen and laundry staff and a maintenance person. The Manager is short of permanent staff and is recruiting but uses the Velvet Glove agency to cover shifts to ensure that there are sufficient staff on duty to meet the residents needs. A resident said, ‘The staff are always available whenever I need them, but if another resident is being attended to then there may be a short delay’. Another resident said that there should be ‘more response to the panic button (‘nurse call’); I think the home needs regular staff rather than agency and we do need a deputy manager. A lot of good staff have left. And a relative said that the staff were, ‘friendly and caring’, but there was a ‘large turn over of staff ‘ who required ‘more supervision’. Two of the four staff files checked during the inspection showed a satisfactory recruitment process. However, one file contained only one reference and gaps in the person’s employment record had not been fully explored. A second file did not contain any references. The person had been employed for some time by Four Seasons and had transferred from another home. The Manager believes that her references were not transferred with all of the other paperwork and will follow this up, providing the required information to the CSCI in a timely manner. All staff had had Criminal Records Bureau (CRB) checks to make sure that residents were safe from abuse. Four staff training files were reviewed. None contained a record of induction. The Manager said that staff did have induction booklets but there was nothing in the training files to show that this had been done. One member of staff said that she had shadowed another member of staff for three days but had not received a formal induction. There was no evidence of planned annual, mandatory training in such things as moving & handling and Health and Safety to enable staff to continue Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 24 providing a good standard of care for residents. However, the training files did show that staff had received some ‘in house’ training in such things as food hygiene, dementia, safeguarding adults, moving and handling care of pressure ulcers and fire safety within the last twelve months, each having recived some but not all of the training. The Manager said that five carers had completed a National Vocational Qualification (NVQ) in Care Level 2; one carer is undertaking an NVQ in care and a further three have applied. Dove Court Nursing Home DS0000012611.V336050.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 is affecting the ethos, leadership and management of the home. EVIDENCE: Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 26 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 most recent manager left some months ago. The CSCI was not informed of this or what interim management arrangement were in place, as required by the Care Homes Regulations 2001. A Four Seasons Peripatetic Manger is currently managing the home. A deputy manager is being appointed and the Manger said that they are advertising for a permanent manager who will apply for registration. Residents finances are managed through a Personal Allowance Barclay Bank ‘on line’ account. Small amount of residents money for small purchases is kept in the home, but this is pooled in a locked tin and not kept in separate wallets as recommended in the Care Homes for Older People, National Minimum Standards (NMS) 2003. This is considered good practice to safeguard residents’ money. Records and receipts are kept. The home has a quality assurance and quality monitoring system in place. Questionnaires were sent to residents and relatives at the end of 2006. No results were available. This is considered to be good practice to ensure that residents and their relatives/representative have a voice and play an active part in the organisation of the home. There is no formalised system of staff supervision and appraisal. The Manager said that she would be introducing this soon. This is considered to be good practice to ensure that training needs are identified and staff maintain the standards of care expected for the residents. Health and Safety policy and procedures, such as regular hot water checks are completed, to ensure the health and safety of the residents and staff. Risk assessments were in place for residents who require bedrails as required following the last inspection to ensure that they are appropriate for their care and safety. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 27 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 X X 3 Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 28 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 OP15 Regulation 16(i) Requirement All staff must be ready to offer assistance in eating where necessary, before meals are left to go cold, and encourage residents, especially those with dementia, to eat a wholesome and nutritious diet. All complaints must be answered in a timely manner, in line with the company’s own complaints policies and procedures, and appropriate records of the correspondence retained for inspection. All parts of the home must be kept clean, especially en-suite facilities, toilets and bathrooms to prevent the spread of infection to vulnerable people. All staff must have two written reference before appointment, and gaps in their employment history explored, to ensure that residents are fully protected from harm. Staffing must be appropriate for the health and welfare needs of residents, not based on a numerical head count, with DS0000012611.V336050.R01.S.doc Timescale for action 04/07/07 2. OP16 22(3) 22(4) 22(8) 04/07/07 3 OP26 23(d) 04/07/07 4 OP29 19(4) & (5) 04/07/07 4 OP27 18(1)(a) 04/07/07 Dove Court Nursing Home Version 5.2 Page 29 5 OP30 18(1)(c) (i) 6. OP31 8(1)(a) & 9(1) additional staff provided at peak times when necessary, to ensure that residents’ care needs are fully provided for. Staff must receive training appropriate to the work they do, including induction training. Training in dementia care for all staff working on the ground floor dementia unit remains outstanding 01/01/07. The Registered Provider must appoint a manager who will apply for registration. 04/07/07 04/09/07 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. Care staff should be made fully aware that residents’ medication is for residents alone and not for their personal use. To do so is an offence. Residents should have the opportunity to receive activities appropriate to their needs, especially people with dementia, provided by a person who has an understanding of their special requirements. All staff should receive safeguarding adults training which is updated at least every two years to ensure that residents are protected from harm. All staff should receive appropriate, annual, mandatory training to ensure that they have the skills required to care for the residents. Results from residents’ or relatives’ surveys are published and made available to current and prospective residents so they are able to judge how well the home is meeting DS0000012611.V336050.R01.S.doc Version 5.2 Page 30 2 3 OP9 OP12 4 4 5 OP18 OP30 OP33 Dove Court Nursing Home 6 7 OP35 OP36 residents’ needs. Where individual residents money is kept in the home it should not be pooled and appropriate individual records maintained to protect the interests of the residents. Staff should receive formal supervision to ensure that their training needs are identified and met so they can continue to provide good care for the residents. Dove Court Nursing Home DS0000012611.V336050.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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.V336050.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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