CARE HOMES FOR OLDER PEOPLE
Nelson Court Linked Service Centre Nelson Terrace Luton Chatham Kent ME5 7JZ Lead Inspector
Andrea Leverett Unannounced Inspection 28th November 2005 10:00 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 Nelson Court Linked Service Centre DS0000036738.V285200.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. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Nelson Court Linked Service Centre Address Nelson Terrace Luton Chatham Kent ME5 7JZ 01634 845337 01634 819316 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) Medway Council Vacant Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th June 2005 Brief Description of the Service: Nelson Court is a care home providing care and accommodation for 27 older people who are diagnosed with Dementia. Some also have additional needs. The Home is owned and managed by Medway Council. The property is located in Luton, a suburb of Chatham and is situated close to local shops, public transport and other amenities. The single storey property was purpose built and is subdivided into three wings each accommodating up to nine people. Whilst most service users are permanent residents, three places are set-aside for short term or respite care, and a fourth place has recently been designated for emergency use. The home has a large front area, mostly used for parking, and attractive courtyard and gardens at the rear. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second inspection in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 2.30pm until 5.30pm. The visit was spent talking directly with residents privately and collectively; 2 relatives and the acting manager. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct conversation with residents and their relatives, observation and evidencing records held at the home. A tour of the premises was undertaken. What the service does well:
Nelson Court provides a welcoming and homely environment, is decorated and furnished to a good standard and is clean, bright and airy. The Home benefits from well laid out communal spaces, including outdoor spaces, which are particularly suited to the needs of this service user group. Discussion with relatives evidenced that Personal health care needs are well supported and records seen at the previous inspection evidenced that the Home ensured that detailed assessments underpinned care plans. Assessments included detailed health and personal histories including likes and dislikes, mobility risk assessments. Relatives strongly commended the staff on their caring. The home benefits from a stable, well-trained and highly motivated care team with a motivated and experienced acting manager. Care staff work in a way that promotes a relaxed atmosphere. Comments received include: “I wouldn’t have my mother any where else, they can’t do enough”, “ and the staff are very kind.” Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 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. Nelson Court Linked Service Centre DS0000036738.V285200.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 Nelson Court Linked Service Centre DS0000036738.V285200.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): None of these standards were inspected on this occasion. EVIDENCE: Nelson Court Linked Service Centre DS0000036738.V285200.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): 10 Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Residents and their Relatives spoken to and observation on the day of the inspection evidenced that staff treated residents with the up most respect and dignity. Residents and their relatives spoke highly of the staff team and strongly commended the staff on their caring. Comments made included “I wouldn’t have my mother any where else, they can’t do enough”, “ and the staff are very kind.” Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 10 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): 13,15 Residents and their relatives know that the Home will encourage family contact and liaise with relatives in the best interests of residents. Residents are encouraged to access the community in line with their wishes. Residents are offered a varied and nutritious diet and know that their preferences will be taken into consideration when planning meals. EVIDENCE: Residents and their relatives told the inspector that visitors are made welcome in the Home at any reasonable time. Family and friends of residents are encouraged to come and go as they wish without prior arrangement and are encouraged to get involved in the life of the home. Relatives spoken to said that they were confident that the staff would communicate with them appropriately in the best interests of their relatives receiving care. Residents spoken to and activity records seen showed that community access had improved since the last inspection and the Home was making better use of its minibus for the benefit of residents. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 11 Discussion with residents and records seen showed that communication between the chef and residents had improved. Residents confirmed that they are consulted about menus and their feedback is sort on food provided. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 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 above was inspected on this occasion. EVIDENCE: Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 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): 26 Residents feel that their Home is clean, pleasant and hygienic. EVIDENCE: A partial tour of the Home was undertaken. All areas seen were clean pleasant and free from offensive odours. Residents spoken to confirmed that the Home was kept clean and they felt that it was a pleasant environment to live in. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 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): 27,29,30 Residents’ needs are met by appropriate numbers of staff who are trained and competent to do their job. Residents are protected by the homes recruitment policy and procedures. EVIDENCE: Staffing levels on the day of this unannounced inspection and staff rota’s inspected showed that sufficient staff are on duty to meet residents needs. Training records seen and staff spoken to confirmed that a range of mandatory and service specific training was undertaken by staff and over 90 of staff have NVQ 2 or above. A sample of staff files inspected contained all relevant information required to demonstrate safe recruitment practises. Files included application form, passport and birth certificates, 2 written references, Job descriptions and evidence of Criminal Record Bureau checks. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 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): 35 Although financial systems to safe guard residents from financial abuse are in place more could be done to promote their individual financial interests. EVIDENCE: There is an outstanding requirement that the home improve financial arrangements where the money of individual residents is managed by exploring ways of providing individual accounts instead of pooling money. The inspector has been informed that Medway Council intend to move to such a system this April. Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X X Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 17 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. 2. Standard OP35 Regulation 20(1a) Requirement The registered person must ensure that monies belonging to service users should be held in accounts in the name of individual service users. Ongoing from last inspection. Timescale for action 25/04/06 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 Nelson Court Linked Service Centre DS0000036738.V285200.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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