Inspection on 04/10/05 for James Dixon Court

This inspection was carried out on 4th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

James Dixon Court 06/01/09

James Dixon Court 09/01/07

James Dixon Court 12/01/06

James Dixon Court 23/02/05

James Dixon Court 06/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE James Dixon Court Harrops Croft Netherton Liverpool Merseyside L30 0QP Lead Inspector Mrs Julie Garrity Unannounced Inspection 4th October 2005 11:00 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 James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service James Dixon Court Address Harrops Croft Netherton Liverpool Merseyside L30 0QP 0151 931 5748 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) Arena Housing Association Limited Mrs Christine Cole Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 18 OP Date of last inspection 23rd February 2005 Brief Description of the Service: James Dixon Court is a Home registered to provide personal care for up to 18 older people of both sexes. (A variation to increase this capacity is currently being processed by CSCI). The Home is owned by Arena Housing Association, whom provides a range of services as a registered charity. Accommodation is in single rooms, all with en-suite facilities. Sheltered accommodation is also managed by Arena, this is adjacent to the Home, and the whole complex is in a large residential area near to local facilities and transport links. Communal facilities consist of a large lounge/dining room, and a separate smoking and sitting area. Gardens to the rear are used when weather permits. There is parking to the front of the building, which is well used by service users, families and staff. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 1 day and was a total of 5 hours. It was a routine unannounced inspection. A tour of the premises took place, eleven residents, two relatives, three staff and the manager were spoken with. A variety of records were reviewed including the care records of residents, medication records and medication storage, accident records, certificates of maintenance and staff training. A brief review of the premises was also part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: There have been no significant improvement in dealing with medications and despite staff training the Home is unable to demonstrate that staff are competent to deal with medications. In general health and safety of the Home is well addressed however there needs to be further development regarding up to date certificates such as Gas and Portable Appliance testing. All accidents are well documented but not monitored in order to assist in the prevention of accidents. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 6 The Home is due to expand the care it provides to more residents, however levels of staff and residents dependency needs are not currently monitored and will need to be developed in order to accommodate and care appropriately for the new residents once admitted. 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. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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 James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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): 1, 3 All residents are appropriately assessed before they are admitted. Without an up to date Statement of Purpose prospective residents will not have all the information they need to make an informed choice about living in the James Dixon Court. EVIDENCE: A recently admitted resident explained that before they came to live in the Home a member of staff came to see them. They “had a big long natter and found out all kinds of things about each other”. A records viewed contained a clear assessment that enable staff to determine residents needs. Social services assessments were also available to assist the staff with their own assessments. The Home has built a number of new bedrooms and new communal space, the statement of purpose for the Home has not yet been updated to reflect these changes. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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): 7, 8, 9, 10 The staff in the home have clear instructions as to how they are to care for the residents and are able to maintain their privacy and dignity. Staff seek advice and support to care for residents who require health care from external services. The current management of medications is poor and has not improved from the previous inspection. Staff are not maintaining the safety of residents with regards to medications. EVIDENCE: Each resident has an individual care plan. The care plans contain useful information regarding the residents, in particular the past history and gives staff an understanding of the person they are caring for. The plans are signed by residents or their representatives this is good practice as it supports the resident to take an active part in the care that they receive. There are clear indications that all residents are supported to access health care services and external support such as District Nurses. One resident said “ I am very happy, well cared for and feel that all my needs are meet. Staff make sure a doctor comes when I need one and somebody always comes with me to the hospital”. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 10 There continues to be poor practice regarding the recording of medications. This includes not recording medications on arrival in the Home and not confirming medications instructions. A review of the records showed that medication records are inaccurate. Staff spoken with were clear as to the means to maintain the dignity of the residents in their care. Residents spoken with were very complimentary about the way staff act. Several residents spoken with were confident that they were treated “very nicely by staff” and that staff spoke to them “ as a though I was a member of the family”. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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 Resident’s daily routines are as they choose, they are supported to make choices by the staff. However many of these choices are based on staff perceptions rather than clearly record choices. This runs the risk of staff making incorrect and inappropriate decisions for the residents. EVIDENCE: Staff are clear that they know what choices residents wish to make. However there are very few residents choices recorded in any of the documentation in the Home. Residents said that many of their needs regarding social choices are meet. One resident said, “there are plenty of books” and another said, “my main past-time is smoking and I like that this is not restricted”. Several residents spoken with said that “winter is not good for days out”, but also said “ we don’t go out that much, more trips shopping would be good”. Three residents confirmed that they do what they want when they want to including, “going to be when I want, getting up when I want and mostly eating what I like” . The manager detailed that there was a variety of daily activities such as board, quizzes, cards, films and discussion. A game of cards with five residents was observed on the day of inspection. However several other residents were not involved in any activities. Relatives said that they were always welcome in the Home and kept up to date with the progress made by their relatives. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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 the following standard(s): None of the standards in this section were reviewed. EVIDENCE: James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 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 the following standard(s): 19, 26 The home is clean, pleasant and hygienic. It is well maintained and homely in appearance. The pictures removed when the corridors were redecorated would further create a homely atmosphere. EVIDENCE: The Home has recently been redecorated and an extension for additional beds built. A separate lounge for residents who smoke has also been created at this time. As yet this area is not finished for residents usage. Residents said they were “pleased” and “really like” the redecoration in the main corridors. Residents are encouraged to personalise their own bedrooms with “knickknacks” and “items from home”. All the residents spoken with thought the Home was “lovely and clean”, “kept really tidy by the staff” and “a very nice place to live”. Four residents said that they felt that the walls were “bare” and not “welcoming”. The manager explained that the pictures were removed for redecoration but have not been replaced as yet. Cleaning staff are largely successful in keeping the home clean and tidy and there was lots of protective clothing available such as aprons and gloves. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 14 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): 27, 30 There are sufficient staff available to meet the needs of the residents. Planning for the future increase of residents has not been undertaken and will need to be done in order to make sure that there is sufficient staff available at all times. Staff receive a variety of training, however competency or their understanding of the training has not been explored. The lack of definite competency in medications places residents at risk. EVIDENCE: Residents, relatives and staff were “happy” with the amount of staff available in the Home. Residents felt that they were “not rushed” and “able to get on with things at my own pace”. Staff felt that they were free to attend to the “niceties” of resident’s daily routine. The Home will be increasing the bedrooms and have not undertaken to monitor the staffing levels in line with the residents needs. Staff detailed a variety of training undertaken including dementia care, medication and moving and handling as examples. Records show that several members of staff have received training in a number of areas. There were no records relating to the proof of competency of staff in particular those that had undergone medication training and were responsible for giving out medications. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 15 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): 31, 33, 38 The manager is aware of her responsibilities and has the confidence of residents, relatives and staff. Quality audits are regularly undertaken in order to run the Home in the best interests of the residents. The Health, Safety and welfare of the residents and the staff is not fully protected and places them at risk. EVIDENCE: A resident said, the manager “is very easy to get on with, she’s always ready to help me and anyone else who asks”. Staff and relatives too found the manager “supportive”, “caring” and “kind”. The Home has undertaken a quality review of its services with a private company and achieved an excellent standard. Additionally regular questionnaires are sent to residents and their families for their opinions. The results were very positive and indicated a good level of service provided by the home. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 16 The home records all accidents but a review as to the nature and cause of the accidents in order to help prevent future accidents or identify residents at particular risk has not been undertaken. Essential Health and Safety certificates for the Home did not have copies available although the manager stated that these had been undertaken. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 17 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 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement The medication policy must be updated and all staff instructed on how to give, record and monitor medications safely. Timescale for action 04/12/05 1 13 (2) OP9 2 13 (2) OP9 The manager must investigate the medication discrepancy regarding Temazepam identified during the inspection. A report detailing the investigation, any outcomes and action that the Home will be taking to 20/11/05 prevent a re-occurrence must be made with a copy sent to Commission for Social Care Inspection. (This requirement is outstanding from the previous report) 3 23 (2) (b) OP38 A copy of the gas certificate and Portable Appliance Testing for the Home must be sent to CSCI 20/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 19 No. 1 2 3 Refer to Standard OP1 OP13 OP19 Good Practice Recommendations The manager should update the Statement of purpose to reflect the new bedrooms and communal areas nearing completion. The manager should review the potential of service users having days out over the winter. The pictures removed for redecoration should be returned to the main corridors. Service users dependency needs should be determined at regular intervals, in order that the manager can ensure that there are sufficient care staff available to meet the dependency needs of the service users cared for. An annual development plan specific to the Home should be developed. 4 OP27 5 OP33 James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 James Dixon Court DS0000005406.V259455.R01.S.doc Version 5.0 Page 21 - 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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