Inspection on 20/11/06 for Guy`s Court Nursing Home

This inspection was carried out on 20th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Guy`s Court Nursing Home 04/01/08

Guy`s Court Nursing Home 16/01/06

Guy`s Court Nursing Home 05/09/05

Guy`s Court Nursing Home 30/11/04

Guy`s Court Nursing Home 30/06/04

Guy`s Court Nursing Home 09/09/02

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

CARE HOMES FOR OLDER PEOPLE Guy`s Court Nursing Home 409 Poulton Road Fleetwood Lancashire FY7 7JY Lead Inspector Mr Wesley Cornwell Unannounced Inspection 20th November 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 Guy`s Court Nursing Home DS0000006048.V312444.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. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Guy`s Court Nursing Home Address 409 Poulton Road Fleetwood Lancashire FY7 7JY 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) 01253 776073 01253 870136 guyscourt@fleetwood409.fsnet.co.uk European Care (UK) Limited Mrs Norma Elizabeth Needham Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (35), Terminally ill (5) of places Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The places designated for (TI) may also be utilised by persons within the category OP providing the total number of persons accommodated in the home does not exceed 40. 16th January 2006 Date of last inspection Brief Description of the Service: Guys Court is a purpose built home located in a residential area of Fleetwood. The home is one of a number owned by European Care (UK) Ltd and is registered under the Care Standards Act 2000 to care for forty older persons requiring nursing or residential care. Five of these beds are registered to care for residents with a terminal illness and a qualified nurse is employed at the home who has the appropriate training. The home has three floors comprising of bedrooms, toilet and bathing facilities. Resident accommodation comprises of thirty-two single rooms and four double rooms. Ten bedrooms have en-suite facilities. The home has a passenger lift to facilitate easy access between the three floors. Lounge and dining areas are located on the ground floor. Regular social activities are organised within the home. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £366.00 to £555.00 covering all aspects of care, food and accommodation. The manager provided this information on the 20th November 2006. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the homes Key Inspection. The site visit commenced at 9.30am and took place over 5 hours. The Inspector spoke to two staff members, three residents, one visitor and the manager of the home. Comment cards were completed by nine residents and their relatives and one General Practitioner providing their views about the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the manager. What the service does well: Residents seen during the visit said they liked living at the home and felt well cared for. Several residents were very positive in their comments about the staff who were described as being caring and conscientious. One resident said, “ I really like living at the home. The staff are kind and caring and the food is good. I really couldn’t want for more”. The relative of one resident said, “ I looked around many homes three years ago for my wife and considered this home to be the most suitable. The standard of care is very high, the staff are pleasant and very competent, the home is clean and well furnished and the food is good and plentiful. I couldn’t be more satisfied”. The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognise the diverse needs of residents. Observation of practice and discussion with staff members confirmed facilities and equipment is provided to assist them in meeting the needs of residents with specific disabilities. Staffing levels were sufficient for the number of residents living at the home. Staff members seen said they were happy with their workload and were well supported by the manager. Staff at the home are well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed residents are treated with respect and dignity. Meals are varied with an alternative choice available if required. Residents were pleased with the choice and variety available. Catering staff confirmed they are provided with assessment information about all new residents so that special diets and personal preferences can be accommodated. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 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 Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The care plan records of two residents recently admitted to the home had full assessment information including the religious/cultural, relationship and dietary needs of residents. Staff members confirmed they had access to this information and could describe in detail the care needs of the residents. Staff responsible for the preparation of meals said they were informed about residents who had special dietary needs and these are always accommodated. The relative of one resident confirmed they had been involved in the assessment process and were happy that the needs of their relative were being met. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 9 This home does not provide intermediate care. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs were met. Residents feel respected by the staff team and their right to privacy is upheld. EVIDENCE: Individual records are kept for each resident with a plan of care setting out the action that is needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed at least once a month and updated to reflect any changing needs in the health and personal care of the resident and these were being actioned. The records of two residents were looked at and these described their healthcare needs. Discussion with staff members on duty confirmed they were Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 11 fully aware of the healthcare needs of residents and these are monitored and their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. The care plan of one resident confirmed a healthcare problem had been identified and appropriate action had been taken to resolve the problem. One General Practitioner said staff at the home communicated clearly and worked in partnership with them and they were satisfied with the overall care provided to residents. The relative of one resident said, “The standard of care provided by the home is excellent. I looked around a number of homes with my mother and in my opinion this was the best. Living so far away from my mother it is so reassuring to know she is receiving such good care”. Observation of practice and examination of care plan records confirmed staff were meeting the diverse needs of service users with specific disabilities and specialised equipment was readily available to assist them with their duties. Discussion with staff confirmed they were aware of the needs of the residents and the level of care that needed to be provided. Medication practices observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received accredited training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Residents spoken to said the staff team respected their privacy and they could spend time on their own if that was their wish. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes procedures enable residents to exercise choice and control over their lives. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Residents spoken to said routines were flexible and they were able to make their own decisions about how to live their lives. One resident said, “ I am very happy living at the home. I like to spend time on my own in my room and the staff respect my wish. I have always been happy and very satisfied with the care provided. The staff are very caring and friendly. You can come and go as you please and I have all the comforts of home”. Residents spoken to said they were happy with arrangements in place for receiving their visitors. The relatives of four residents said they were always Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 13 made welcome by the staff when they visited the home and found the staff friendly and approachable. Most residents handle their own financial affairs or these are handled by their relatives/representatives. Records being kept in respect of residents unable to manage their own finances were being well maintained. The home provides a varied and balanced diet for residents. The staff member responsible for the preparation of meals was able to confirm they had information about residents with special diets and personal preferences. Residents spoken to were happy with the choice of meals available. One resident said, “ The chef comes around the home every day to tell us the choice of meals for the day. If we don’t like them an alternative meal is always provided. I really enjoy the food and get plenty to eat”. Meal times were served in a relaxed and unhurried manner. Staff members were observed being very attentive to residents needs. Residents spoken to were very happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. The relative of one resident also said they were aware of the complaints procedure but hadn’t had any cause to make a complaint. At the time of this site visit one complaint had been received by the home. The Inspector was satisfied the complaint had been taken seriously and had been dealt with appropriately. The home has a procedure in place for dealing with allegations of abuse. The manager and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members on duty informed the Inspector abusive practices and how to recognise these had been covered during training recently provided by the home. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely, clean and safe environment. EVIDENCE: The home has been well maintained and decorated for the comfort of residents. Since the last inspection the corridors on the ground floor had been redecorated and the garden room at the rear of the premises had also been painted providing a bright and cheerful room for residents to sit in. The manager said the refurbishment of the home was ongoing and there were further plans for refurbishment throughout the building with new chairs being ordered for the lounge areas. Residents spoken to were very happy with the improvements being made. However, the Inspector did observe some of the Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 16 furnishings in the dining room areas are old and if replaced would improve the appearance of the home. A tour of the building confirmed resident bedrooms had been personalised with their own belongings. All residents spoken to were happy with their rooms and said they had the choice of spending time on their own or in the lounge area’s. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. It was observed during the visit the home was clean and hygienic providing a pleasant environment in which to live. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment of staff throughout the day is sufficient to meet the needs of residents. Staff are trained and competent to do their jobs. The homes recruitment procedures are not robust and these potentially place residents at risk. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they were receiving and were well treated by the staff. One resident said, “ The staff are all very kind and attentive. I like to spend time on my own in room so I am reassured to know the staff are available if I need them”. Another resident who also liked to spend time in their room said the staff respond very quickly if you need help. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met Records show 83 of staff members have achieved National Care Qualifications. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 18 understanding of the specific care needs of residents accommodated at the home. Examination of staff records showed all relevant documentation was being obtained for staff members before they commenced their employment ensuring the protection of residents. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents. The homes financial records are well maintained ensuring residents financial interests are safeguarded. The home has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. EVIDENCE: The manager of the home is a Registered General Nurse and has achieved a relevant management qualification. She is well supported by the owners of the home who visit regularly. Records seen confirmed the manager has access to training to ensure her knowledge and skills are updated. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 20 Residents spoken to were very positive in their comments about the manager who was described as being friendly, approachable, very helpful and professional. Quality assurance systems are in place to gather the views of residents and keep them informed about events being organised. The manager also undertakes surveys to seek the views of visitors about the level of service being provided for the residents. Completed surveys recently returned were seen and were very positive about the standards being achieved. Inspection of records for residents finances were well maintained and up to date ensuring residents interests are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 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 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP19 Good Practice Recommendations The registered person should continue with a programme for the routine maintenance of the fabric and decoration of the home. Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Guy`s Court Nursing Home DS0000006048.V312444.R01.S.doc Version 5.2 Page 24 - 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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