Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 03/05/06 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 3rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

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 service users were satisfied with the care and service provision. The service users, particularly the frail ones appeared well cared for. The company had effective systems for example, complaints, care planning documentation and quality assurance. The activities were well co-ordinated, with records that proved evidence of the activities, which were appreciated by the service users.

What has improved since the last inspection?

At the time of the last inspection the acting manager had just come into post, and identified areas of the home, which needed to be addressed. The opinion of the inspector is that she has implemented changes, which have improved the quality of care and service provision. Example: The changes to care practices regarding the fluid intake and the observation of frail service users.

What the care home could do better:

It is required that there should be more action on the outstanding issues of redecoration, re-carpeting and the registration of the manager, which are outstanding from previous inspections.

CARE HOMES FOR OLDER PEOPLE Eckington Court Nursing Home Penny Engine Lane Off Church Street Eckington Derbyshire S21 4BF Lead Inspector Ivan Barker Unannounced Inspection 3rd May 2006 09:30 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 Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eckington Court Nursing Home Address Penny Engine Lane Off Church Street Eckington Derbyshire S21 4BF 01246 430066 01246 430077 eckingtoncourt@highfield-care.com 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) Southern Cross Care Management Limited Mrs Ann Elizabeth Barlow Ayodele Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th October 2005 Brief Description of the Service: The home is purpose built and 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 Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on several of the ‘key standards’), and the previous requirements. The persons present at the inspection was: Mrs T Mcardle, acting manager. Within this inspection, which occurred over a four-hour period, the inspector toured the building, examined requirements relating to the previous inspection, spoke with service users, and staff and examined some documentation. The registered manager named on page four of this report, as being Mrs A E Barlow Ayodele, was no longer in post, and Mrs Mcardle was operating in an acting role. What the service does well: What has improved since the last inspection? What they could do better: It is required that there should be more action on the outstanding issues of redecoration, re-carpeting and the registration of the manager, which are outstanding from previous inspections. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 6 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 Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 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 the following standard(s): Standards 3, 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Accurate assessments will ensure that the home has sufficient information to be aware of the service user’s needs prior to admission. EVIDENCE: The home received service user assessments from the Social Services Care managers or the hospital prior to admission. The acting manager or senior staff prior to admission to the home assessed all service users. The inspector was shown evidence of the assessments of the service users who he case-tracked. Regarding Standard 6, the acting manager advised the inspector that the home did not provide intermediate care. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 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 the following standard(s): Standards 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Inaccurate care plans will not contribute to the delivery of care, and may place service users at risk, should the care staff follow the ‘out of date’ prescriptions of care, prescribed by the qualified nurse. Service users were satisfied with the care they received. EVIDENCE: On examination of the care plans, from the service users who were being case tracked, the inspector established that only one of the 3 plans was up to date, and had been evaluated on a monthly basis. One care place was last evaluated in January 2006, and the other one evaluated in January 2006 and then April 2006. The inspector discussed the service users’ care needs with care staff, who were knowledgeable about the service users’ needs. It was agreed with the acting manager that staff were aware of the service users needs and that the care plan records were out of date. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 10 Risk assessment were included within the documentation and included moving and handling, pressure area, and nutritional risk assessments. The inspector spoke with the service users who were being case tracked. They informed the inspector that; ‘The care was good’. ‘Satisfied with the care’. ‘We are being looked after well’. At the time of the inspection, the Community Pharmacist was auditing the storage and administration of medications. These were found to be satisfactory. The service users, who were receiving personal and nursing care, had their medication administered by the qualified nurse. Visitors were allowed to visit the service user in the communal areas or in the privacy of their own room. The acting manager advised the inspector that as well as the lounges, if a ‘large’ family visited then the activities room would be made available for the visitors. Whilst touring the building, the inspector observed that several service users were frail and were being nursed on bed-rest. The acting manager advised the inspector that she had placed the fluid balance charts in the rooms of the frail service users, because when the records were stored with the care plans in the office, the documents had omissions. Now that they were readily available, at the point of the delivery of care, the documents were being completed and gave an accurate record of the fluid intake. The inspector examined the records and found that the documents had been completed. Also he did observe a member of staff assisting service users with their fluid intake, and entering a recording on the document. The inspector observed that all the frail service users appeared very comfortable and well cared for. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Various activities were organised within the home, which would provide stimulation to service users and enhance their quality of life. Service users were given the opportunity to exercise their right of choice regarding the provision of meals, and the activities. EVIDENCE: The home had a specific room for activities. The acting manager informed the inspector that an activities co-ordinator was employed and worked 3 days (16½ hours) per week. The activities programme was displayed. The acting manager informed the inspector that as well as the programme being displayed the activities co-ordinator ‘announced’ to the service users, sat in the lounges, the intended activity for the day and time that it would occur. The acting manager produced the activity co-ordinators records which indicated what activities had occurred and who participated in the activity. Unfortunately, the day of inspection was not one of the 3 days that the activity co-ordinator was present, so that the inspector could observe the activities. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 12 The acting manager advised the inspector that service users were able to visit the local church supported by the activities co-ordinator and several service users accessed the local village, supported by relatives or staff. This information was supported by entries in the activities co-ordinators records. Regarding the meals, the acting manager informed the inspector at the last inspection on the 13th October 2005, during breakfast the service users were asked for their lunchtime meal choice and during the afternoon tea, the service users were asked for their evening meal choice. She identified, at that time, that the system was working very well and she had received positive comments from the service users. On discussing the provision of meals at this inspection, the acting manager informed the inspector that the dining room assistants asked the service users for their choice of meal, prior to the meal being served. To achieve this practice the kitchen staff had to provide larger quantities of food rather than producing meals to order. The inspector accepted that if the home wished to ‘over cater’ that was the company’s choice, so long as service users were offered a choice of meal. The acting manager informed the inspector that she was unsure why the practice had changed from the ordering as described at the last inspection and would review the practices with the cook. The acting manager informed the inspector that a full cooked breakfast was available, every morning except for Sunday, when it had been established that a full cooked breakfast and then a Sunday lunch was ‘too much’ for the service users. The service users had expressed these opinions, regarding the ‘excessive’ food and the manager had taken on board the service users’ comments. The inspector received positive comments from the service users, who were being case –tracked. The comments were as follows; ‘Regarding the meals, they know what I like and give me a choice’. ‘The food is good’. ‘Meals- I have a choice’. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 18. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. As far as could be established the home had a complaints procedure in place, which was operating according to the company policy and complaints were resolved within the expected timescales. The home was unable to evidence that the staff had received Adult Protection training. Therefore staff may not be aware of their responsibility regarding the protection of vulnerable adults and this may place the service users at risk. EVIDENCE: The complaints procedure was displayed and available to the service users and relatives. On discussing complaints with the service users, they informed the inspector that they were ‘happy’ with their care. No complaints were addressed to the inspector, at the time of this visit. On examination of the complaints book, the last entry was the 9th January 2006, and the entry indicated that the complaint had been positively acted upon and resolved to the families’ satisfaction. The Commission had received no complaints since the last inspection. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 14 Regarding Adult Protection training, the acting manager was unable to evidence that the staff had attended the training, over the past 3 years. (The Derbyshire County Council Adult Protection Unit had set the 3 yearly timescale.) The acting manager advised the inspector that she would liaise with the Adult Protection Unit to establish when the next training courses were available. The acting manager offered a timescale of 3 months to ensure that all staff had received the required training. The inspector accepted this timescale. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The environment, monitored at this inspection, had not been maintained to the required standard to provide a safe, well-maintained environment for services users. EVIDENCE: The home was clean and odour free, generally well maintained. On monitoring the previous requirements, it was established that locks had been provided to the bedroom doors and that 3 of the 4 rooms, which required redecoration had received attention. However Room 40 was still outstanding and had been outstanding since the inspection 18th May 2005, almost a year ago. The acting manager apologised and explained that the decorator had planned to complete all the rooms, but had been called away from the work to Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 16 undertake some other urgent task. The manager offered a timescale of one month to complete the work. Room 29, which had sustained fire damage, in 2005, was still awaiting a new carpet. The acting manager advised the inspector that she had obtained a quote for the fitting of the carpet. The quote was shown to the inspector. The acting manager informed the inspector that it was intended to take up the quote and a timescale of six weeks was agreed. Within Room 38 there was considerable damage to one of the walls, a wheelchair had caused this damaged. The wall needs to be repaired and redecorated. Along one corridor of the home, a boarder paper had been fitted above the handrail. The acting manager advised the inspector that a service user had particularly ‘targeted’ the paper and torn section of the paper from the wall. Therefore the décor required attention. As previously stated there were a number of frail service users being nursed in bed. Within each of the rooms, the fire door to the entrance of the room had been propped open. Therefore ‘over-riding’ the closure mechanism, which closed the door. The acting manager identified that the reasons the doors were propped open were to be able to observe and monitor the condition of the frail service user, and to allow them some form of social interaction, rather than be alone in the room, with the door closed, which may create fear and anxiety for the service user. The inspector fully accepted the acting managers reasons and indeed would support and commend her action. However when closures are fitted to fire doors it is undertaken taking into account the whole of the fire protection system, within the home. Therefore it was agreed with the acting manager that she would consult with the Fire Authority, as soon as possible, for the Authority to visit the home and advise on the fire protection system relating to the disabling of the door closures to the bedroom doors. The inspector was aware that in other care homes, with consultation with the Fire Authority, satisfactory ways of maintaining the fire protection and allowing the doors to remain open had been achieved. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The robust staff recruitment process should provide protection for the service users. The company, at the time of inspection, were unable to provide evidence that staff had received Adult Protection training, which as stated in Standard 18, may place service users at risk. EVIDENCE: On examination of the rota the following was indicated. Am shift. 1 qualified nurse plus 6 care staff. Pm shift. 1 qualified nurse plus 6 care staff. Night shift. 1 qualified nurse plus 3 care staff. Plus, the acting manager and activities co-ordinator. There was also ancillary staff consisting of: 1 2 1 1 1 administrator Housekeeping staff Laundry staff Cook Kitchen Assistant DS0000002053.V292963.R01.S.doc Version 5.1 Page 18 Eckington Court Nursing Home 1 Dining Room assistant. The staff files had been identified as a shortfall and a requirement at the last inspection, because they did not contain the required documentation. On examination of the 3 staff files, all 3 contained the required documentation. There was also a requirement to ensure that staff received the necessary training. This was in relation to Moving and Handling. The acting manager showed the inspector the training records that indicated the training had occurred. Regarding Adult protection training, this has been previously addressed at Standard 18. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The management of the home does not comply with the requirements of the Care Homes Act, as no registered manager is in post. Extensive quality assurance systems were in place that should assist the acting manager and operation manager to measure the home against expected outcomes. EVIDENCE: At the previous inspection, there was a requirement that a registered manager was in post, and the timescale had passed. There was still an acting manager in post. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 20 Mrs T Mcardle, the acting manager advised the inspector that she had visited the Derby office of Commission for Social Care Inspection, and made an application to the Criminal Records Bureau, and on receipt of a satisfactory CRB check, intends to submit her application. The acting manager provided the inspector with evidence of her qualifications. He was shown her certificates for, ‘The management qualification in Health and Social care Organisation’ and ‘The Intermediate Certificate in Supervising Heath and Safety’. Regarding quality assurance, monthly audits were undertaken by the acting manager and validated by the operations manager. The audit consisted of the analysis of accidents, risk assessments, the environment, medications, complaints, training, and social activities. The operations manager undertook regulation 26 visits. The inspector was shown documentary evidence of previous visits. Regarding service users monies the company operated a basis credit and debit system. Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 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 Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 22 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 Requirement The registered person must ensure that the care plans are up to date and reviewed monthly to provide an accurate record of care to be delivered. The registered person must ensure the home is kept in a good state of repair and kept adequately decorated, and carpeted. (Relating to new and previous requirements) The registered person must ensure that the staff received the required training to meet the needs of service users. The registered person must ensure that the staff received the required training to meet the needs of service users. The registered person must ensure that a registered manager for this particular establishment is in post. Timescale for action 03/06/06 2. OP19 23 14/06/06 3. OP18 18 03/08/06 4. OP30 18 03/08/06 5. OP31 8 03/07/06 Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Eckington Court Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Derbyshire Area Office 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 Nursing Home DS0000002053.V292963.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!