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Inspection on 18/05/05 for Eckington Court Nursing Home

Also see our care home review for Eckington Court Nursing Home for more information

This inspection was carried out on 18th May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is part of a large national company, which has the benefits that this type of company can provide. For example; The investment in extensive policies and procedures, and Additional systems and personnel to support the home. The home is purpose built and clean and well decorated, except for the issues raised within this report. The inspector received a warm and friendly welcome at the home, from the managers, staff and service users. The inspector received all positive comments from the service users regarding the care and service provision. The service users stated that they were satisfied with the care that was being delivered. The inspector received positive comments such as; `The staff are kind and caring`. `The care is good`. `Good food and choice is available`. The inspector also received several commendations relating to the manager.

What has improved since the last inspection?

The home has acted upon all the majority of previous requirements of the last inspection.

What the care home could do better:

It was accepted by the manager that some areas of the home still required improvement. For example; On examination of the care plans, the inspector established that they were not up to date, and may lead to inconsistencies in the delivery of care. The qualified staff and senior care staff should ensure that the care plans are up to date. The staff should reports repairs and redecoration to the maintenance man and or the manager, so that the appropriate action can be taken. There was use of another individual`s lotions or creams, which is unacceptable practice.

CARE HOMES FOR OLDER PEOPLE ECKINGTON COURT PENNY ENGINE LANE OFF CHURCH STREET ECKINGTON DERBYSHIRE S21 4BF Lead Inspector IVA N BARKER Wednesday 18th May 2005 at 10:00am 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. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Eckington Court Address Penny Engine Off Church Street Eckinton Derbyshire S21 4BF 01527 511200 01527 527020 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) Highfield Care Management Ltd Mrs Anne Ayodele Care Home with Nursing 50 Category(ies) of OP registration, with number of places ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 29/11/04 Brief Description of the Service: The home is purpose built and is located in the village of Eckington, which is on the Derbyshire and Sheffield boundaries. There is a large lounge and combined dining area on to the ground floor, with a further large lounge to the first floor and two separate quiet lounges – one to each floor. The home is registered for 50 places and offers both nursing and personal care in the category of Older person. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection by this particular inspector, so these judgements were based on the previous report and this inspection rather than his knowledge of the home over several years. Within this inspection, the inspector toured the building, spoke to staff and service users and examined the care plans and other documentation. He was accompanied by the region manager and manager, during this inspection. What the service does well: What has improved since the last inspection? The home has acted upon all the majority of previous requirements of the last inspection. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 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. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 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 ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 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) 6 Intermediate care was not provided. EVIDENCE: The manager advised the inspector that the home did not provide intermediate care. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 9 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 The delivery of care may be compromised due to inconsistent record keeping. The system for the administration of the medicine, relating to lotions is poor and may place the service users at risk. EVIDENCE: On examination of 3 care plans, the inspector first assessed the previous requirement, which related to the high Waterlow scores not being acted upon and a care plan produced. The care plans had now been produced. On examination of the documents at this inspection, the inspector established that the care plan documents had not been signed by the service user or their relative. The inspector spoke with the staff regarding the service users needs relating to the care plan. Through these discussed it was established that staff were aware of the service users needs. However the day-to-day delivery of care was not recorded within the care plan. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 10 The service users stated that they were satisfied with the care that was being delivered. The inspector received positive comments such as; ‘The staff are kind and caring’. ‘The care is good’. ‘Good food and choice is available’. The inspector also received several commendations relating to the manager. The home had acted upon all the medication requirements raised within the last report. However at this inspection the inspector found the following. A container of Sudacrem was found in a service users en suite facility. The label on the container denoted a service user name, not that of the service user residing in the room. On examination of the medication storage room, the inspector found that the door to the room was secured by a ‘Yale’ lock. He discussed the need for better security and both the internal and external security of the room was discussed. It was proposed that the door have a 5 lever lock fitted to create a more secure ‘cell’ and that the internal specification may be reduced. For example the chains on the trolley, securing them to the wall may be removed. At present all the extra topical applications (creams, lotions etc) were stored in the service user’s own room, and subject to a variety of different conditions of temperature and moisture. It was agreed that a topical application cupboard would be created within the medication room. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) none These standards were not assessed at this inspection. EVIDENCE: ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 12 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) none These standards were not assessed at this inspection. EVIDENCE: ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 13 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) 19,22,23,24,25,26 The standard of decoration and maintenance was poor, in some areas of the home. Much of these shortfalls were because of factors relating to the staff. EVIDENCE: The previous requirements were monitored. The manager produced a portable loop system, which the company had purchased. The inspector discussed the need for ensuring that all service users who required such a device had one to meet their needs. The manager informed the inspector that she would purchase more, if the service users were assessed as requiring such equipment. The manager informed the inspector that staff had now received deaf awareness training. This was supported by confirmation by the staff. The manager advised the inspector that the home currently had 4 adjustable beds. She identified that she needed 4 more adjustable beds to meet the needs of the service users receiving nursing care. A new timescale of 3 months was agreed with the manager and region manager. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 14 The manager advised the inspector that since the last inspection, 10 bedroom door locks had been fitted, and 39 more were required. A new timescale of 6 months was agreed with the manager and region manager. Following a tour of the building the following was established. Within Room 4 there was a strong odour. The manager informed the inspector that the carpet had been shampooed this morning, but this exercise had had minimal effect. It was agreed that a new floor covering was needed. Within rooms 9, 17,18, 39, 40, and 44, the decoration to the walls had been damaged possibly caused by wheelchair handles or footrests. The inspector discussed with the manager why these walls were damaged and the manager informed the inspector that the service users residing within these rooms were not self-propelling, so it must be the staff who were damaging the walls with the wheelchairs. These rooms need to be redecorated. The external windows had flaking paint and were in need of redecoration. The manager informed the inspector that the estates department were already aware of this matter. The two bathrooms near room 32 had been decommissioned and were without an operating bath or shower. The manager informed the inspector that a new shower and bath was being fitted. However there was no one working on the refurbishment at the time of the inspection. A chest of drawers and continence pads were being stored at the bottom of a staircase, which was a means of escape in the event of fire. On raising this issue the manager immediately instructed staff to remove the objects. The ‘automatic hold open and door release’ mechanism on the fire door located outside the Activity room had a fault and would not hold the door open. Within room 31 there was a broken draw from a chest of drawers. Room 26, had fire damage, and required repair, redecoration and refurbishment. The inspector had been advised of this matter, at the time of the incident, which was prior to the inspection. Within room 23, resided a lady who wished to remain in her room. The door had a door closure fitted. To render the door closure inoperable a chair had been placed by the door, so as to hold it open. The inspector discussed this situation with the service user. She identified that she liked to see and speak to people going past, so the door had to be propped open. On examination of other rooms the inspector had found the bedrooms doors had various closure / hold open devices. The manager informed the inspector that ‘automatic hold open’ or ‘swing free’ devices were fitted on the request of the service user, and ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 15 in consultation with the Fire authority. The manager identified that she was aware that a door propped open with a chair was not acceptable and that a hold open mechanism would be fitted. Within the bathroom, opposite room 12, a bath panel was loose and needed to be re-fitted to the bath. Within room 27, there was an over-head bed light missing from the wall. On examination of the maintenance book, the inspector could find no evidence that any of the repairs or redecoration issues stated above had been reported to the maintenance man. Should staff not report repairs etc, then the inspector questioned how the maintenance man could act upon these issues. ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 16 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 Current staffing levels in place would appear to meet the current dependency needs of service users, accommodated within the home. EVIDENCE: On examination of the duty rotas and discussion with the manager the inspector established the following; On the am shifts, there were I qualified nurse and 6 care assistants. On the pm shifts, there were I qualified nurse and 6 care assistants. On the night shifts, there were I qualified nurse and 3 care assistants. Plus the manager and administrator. The manager informed the inspector that the Highfield company, work to a nursing ratio of 1 to 5 am and pm, and 1 to 10 at night, and 1 to 8, 1 to16 for residential. She went on to identify that the 21 service users receiving nursing care required 4 staff and 21 service user receiving personal care required 2.5 staff. Therefore 7 staff on shift was correct. As previously stated the service users informed the inspector that the staff were ‘kind and caring’ ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 17 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) none These Standards were not assessed at this inspection. EVIDENCE: ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 18 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 x x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 1 2 x 2 2 2 2 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 19 No 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 7 Regulation 12 Timescale for action The registered person must 18th June ensure that the care plans are up 2005 to date and discussed and signed by the service user or relative. The registered person must 18th June ensure medications are only 2005 used / given to the service user to whom the medication is prescribed. The registered person must 18th JUne ensure that all medications are 2005 stored correctly. This includes the correct temperature and humidity levels. The registered person must 18th August provide sufficient equipment to 2005 meet the needs of the service users. This includes the provision of adjustable beds. Previous requirement. The registered person must 18th provide locks and keys to November bedroom doors, so as to affford 2005 the service user privacy, dignity and security. Previous requirement. The registered person must 18th August ensure that the home is kept in a 2005 good state of repair both internally and externally and be kept clean and decorated. Version 1.30 Page 20 Requirement 2. 9 13 3. 9 13 4. 22 12 5. 23 12 6. 19,22,23, 24,25,26 23 ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc The registered person must act upon and resolve the issues raised within Standards 19,22,23,24,25, and 26. 7. 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 Good Practice Recommendations ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Cardinal Square Nottingham Road Derby DE1 3QT 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 ECKINGTON COURT C52 CO2 S2053 Eckington Court V228438 180505 Stage 4.doc Version 1.30 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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