Inspection on 05/09/05 for Guy`s Court Nursing Home

This inspection was carried out on 5th September 2005.

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 20/11/06

Guy`s Court Nursing Home 16/01/06

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 Guys Court Nursing Home 409 Poulton Road Fleetwood Lancashire FY7 7JY Lead Inspector Wesley Cornwell Announced 5 September 2005 @ 9:30 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. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Guys Court Nursing Home Address 409 Poulton Road Fleetwood FY7 7JY 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) 01253 776073 European Care (UK) Ltd Mrs Norma Elezabeth Needham CRHN Care Home with Nursing 40 Category(ies) of OP Old Age 35 registration, with number TI Terminally Ill 5 of places Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The places designated for (TI) may also be utilised by persons within the category OP providing the total number of people accommodated in the home does not exceed 40. Date of last inspection 30 November 2004 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 qaulified 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. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and was undertaken by three Inspectors and took over 6 hours. The Inspectors spoke to eight residents, seven staff members, one visitor and the manager. Comment cards were completed by 12 residents providing their views about the home. Staff and care records were also examined. A full tour of the premises was undertaken with a member of staff. What the service does well: This is a care home where residents are well looked after. The staff team work well together and show a good understanding of the needs of the people living at the home. Those residents spoken to said they liked living at the home and felt they were being well cared for by the staff. One resident said, “I like living at the home. It’s much better than being at home on your own. The staff are very friendly and I am well fed. My family visit most days and are always made welcome”. One visitor said, “My relative stays at the home regularly on short term care. She enjoys her stay and wouldn’t come back if she didn’t feel well cared for”. Meals are varied with a choice always available. Residents were pleased with the choice and variety available. The assessment and ongoing review of care is thorough ensuring residents care needs are being met. Residents spoken to were very happy with the arrangements in place for social activities. One resident said, “ We have something going on most days and have the choice of whether to join in or not. There is no pressure from the staff which I like as I cant always be bothered”. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Visitors were seen coming and going freely throughout the Inspection. The staff team are well trained and supervised. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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 Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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) 3 The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The records of three residents admitted to the home had full assessment information. Staff members confirmed they had access to this information and could describe in detail the care needs of residents. Catering staff had been informed about residents who had special dietary needs. Staff members spoken to also said they were aware of residents with special dietary needs. Care plans seen by the Inspectors confirmed residents or their relatives had been involved in the assessment process. Residents spoken to were happy that their needs were being met by the home. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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 and 9 Promotion of health is taken seriously. Residents welfare is closely monitored and health needs were met. EVIDENCE: Individual records are kept for each resident with a plan of care setting out in detail the action that 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 on most care plans and daily entries made setting out the care given. The records of three residents were looked at and these clearly described their healthcare needs. Discussion with staff members confirmed they were fully aware of the healthcare needs of residents and these are monitored and kept under review. Entries made on care plans showed good communication between the home and healthcare professionals. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 10 Residents who were being cared for in bed had been provided with a special mattress that was suitable for the relief of pressure and prevention of pressure sores. 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 were assessed by a pharmacy Inspector and issues raised during the assessment are to be dealt with separately to this report. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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) 12,13 and 15 Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact ensuring personal relationships are maintained. EVIDENCE: Residents spoken to confirmed they enjoyed the food provided by the home. Discussion with residents, catering staff and observation of records confirmed special diets were being accommodated. One resident spoken to said, “I enjoy the food provided by the home and I always get plenty to eat”. Meal times were served in a relaxed and unhurried manner with staff seen providing discreet assistance to residents who required help with eating. Snacks and drinks were provided between meals. The menus were inspected and found to provide a varied and balanced diet. One resident said a choice of meal is always available. The catering staff were able to confirm they had information about residents with special diets and personal preferences. Staff members also confirmed they were fully aware of residents who had special dietary needs and these were being met. Residents spoken to said they were happy with arrangements in place for receiving their visitors. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 12 The Inspectors were able to observe throughout the inspection relatives and friends visiting the home. One visitor said, “I am always made welcome whenever I visit my relative. The staff are always helpful and very cheerful”. The home organises regular social activities and also has an entertainer who visits for social afternoons. On the day of this inspection a clothes party was held. Residents were observed having fun trying clothes on and making purchases. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 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. People visiting the home also said they were aware of the complaints procedure but hadn’t had any cause to make a complaint about the home. The Inspectors were satisfied that complaints received by the home 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. The staff members on duty informed the Inspectors abusive practices and how to recognise these had been covered during their NVQ training. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 14 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) 19,20,21,22,23,24,25 and 26 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 and safe environment. EVIDENCE: Since the last inspection the homes owners have made some improvements to the environment with the carpet on the second floor being replaced. Lounge and dining areas have been decorated and furnished for the comfort of residents. However, the Inspectors did observe some of the furnishings are old and if replaced would improve the appearance of the home. One resident sitting in the garden room said, “ I think the home should spend a bit of money on the furnishings. It used to be so pleasant sitting in this room”. Residents spoken to said they were happy with their rooms and were provided with the choice of spending time on their own or in the lounge area’s. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 15 One resident said, “ I am very comfortable living at the home. I have my own television and like to spend time in my room reading”. Bedrooms have been furnished to ensure the comfort of residents. En-suite facilities are available in 10 rooms. Toilet and bathing facilities are located on all floors and are easily accessible for residents. The home has a passenger lift to provide access between the three floors. The Inspectors observed residents using the passenger lift independently during the visit. Radiators throughout the home are guarded or have guaranteed low temperature surfaces to protect residents from the risk of burning. 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. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 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) 27,28, 29 and 30 Staff are well trained to ensure they have the competencies to meet residents needs. The deployment of staff throughout the day is sufficient to meet the needs of residents. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they receive from the home and were well treated by the staff. One resident said, “The manager and staff are lovely. I am very happy living at the home”. One visitor said in their opinion there are always sufficient staff on duty. 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. Observation of care practices throughout the inspection showed that staff cared for residents in a pleasant and dignified way. Records show eleven staff members have gained National Care Qualifications and another five staff members are due to commence this training. The homes owners have provided the manager with a training budget. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear understanding of the specific care needs of residents accommodated at the home. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 17 Examination of staff records showed the home was obtaining relevant documentation for staff members employed at the home. The Inspectors discussed with the manager the recruitment checklist completed confirming references and police clearances had been received. The Inspectors were unable to identify when references and the police clearance had been applied for and received, as the form had not been dated. The homes procedures should be reviewed to ensure this information is clear. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 18 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) 31, 33, 36 and 38 The home is well managed and run in the best interests of residents. 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. Residents, visitors and staff members were very positive in their comments about the homes manager and her style of management. Residents and visitors spoken to said they found the manager to be approachable, supportive and helpful. Staff members said they found the manager was supportive and provided a clear sense leadership. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 19 The manager has developed good systems to gather staff, residents and relative’s views as part of her monitoring of quality. Staff spoken to had a clear understanding of their role and what is expected of them during their shift. Inspection of records for residents were comprehensive, well written and up to date. Staff members spoken to confirmed they receive formal supervision and value the support of management. Inspection of maintenance records confirmed facilities and equipment was being maintained as required. Records were available to the Inspectors to verify that training on health and safety issues had taken place. Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 20 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x 3 x 3 Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 21 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 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 Good Practice Recommendations Guys Court Nursing Home F57 F09 S6048 Guys Court V210963 050905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Area Office, Unit 1 Tustin Court Port Way Preston PR2 2YQ 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. 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