CARE HOMES FOR OLDER PEOPLE
Netherfield Court Eldon Road Eastwood Rotherham South Yorkshire S65 1RD Lead Inspector
Ian Hall Unannounced Inspection 1st February 2006 09:40 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 Netherfield Court DS0000047778.V279053.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. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Netherfield Court Address Eldon Road Eastwood Rotherham South Yorkshire S65 1RD 01709 336793 01709 336794 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) Rotherham Metropolitan Borough Council Yasmin Allen Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users aged 50 to 64 years are accommodated on a specific unit for this age range. Service is for Intermediate Care only. Date of last inspection 29th September 2005 Brief Description of the Service: Netherfield Court is registered as a care home to provide Intermediate Care. Accommodation is provided for a maximum of 21 persons aged from 50 years, and over pensionable age who require Intermediate care. The home has been registered by Rotherham Borough Council (RMBC) is jointly funded with the Rotherham Healthcare Trust (RHCT). There is no nursing care or long stay care provision on site. Fifteen service users were resident on the day of inspection. Referrals and admission may be from hospital or the community. A multidisciplinary team work at the home to provide care and intensive rehabilitation. The team consists of care enablers with support from physiotherapists and occupational therapists and intervention/support of social workers and medical/nursing staff as required. The home had undergone an extensive refurbishment and upgrading programme prior to its change of purpose and function. The home is situated in Eastwood an area that is a short walk from the town centre. There is a frequent bus service along nearby Fitzwilliam Road. There is car parking within the curtilage of the home and unlimited car parking along adjacent streets. The local community is well served by a range of facilities and local shops that include a post office and public houses. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Inspection took place over 5 hours and was the second of the cycle of inspections for year 2005/6 and followed a risk assessment carried out with the CSCI risk assessment tool. The focus of the inspection was placed upon meeting residents, relatives, visitors and the staff team. The Officer toured the site and tracked 3 resident’s files, and the records maintained. What the service does well: What has improved since the last inspection? What they could do better:
Delays with commencing the initial rehabilitation programme assessment and subsequent discharge of service users have reduced. The multidisciplinary team and community resources do not interface effectively. Screening of service users and their ability to benefit from the service offered has improved. Health Authority staff continue to make inappropriate referrals. Criteria agreed with hospital staff are to be agreed to ensure that the home is offering packages of care to appropriate service users. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 6 The authority must develop a user dependency measurement tool to enable them to respond to increased dependency levels promptly. Equipment storage is limited, potential additional space was identified during the inspection. Visitors to the home are being permitted to park their cars on new lawn areas this should be managed more effectively. Health & Safety concerns have been raised due to excessive numbers of staff working in the ancillary office area. This has been investigated and maximum numbers set for this area. 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. Netherfield Court DS0000047778.V279053.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 Netherfield Court DS0000047778.V279053.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): 1,2,3,4,5,6. Residents and their advocates are advised of the care offered. The management consider the needs of others when making this assessment; to meet the needs of existing and prospective residents needs. The Manager or her deputy assesses residents referred for Intermediate Care during their hospitalisation. A number of placements are made through the Community Care Services who are responsible for providing relevant assessment information. EVIDENCE: Case records examined contained copies of individual service user care assessments, plans and written contracts stating terms and conditions. Visitors and residents confirmed that they had been advised of the facilities and care that would be provided. However many were unclear about the level of participation required of them. Intermediate Care records demonstrated that a percentage of service users were unable to be discharged within the target dates due to delays in
Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 9 assessment and commencing occupational and physiotherapy treatment. Community support services had failed to provide either care support packages or to make the physical changes to the service user’s home to enable them to return home. There continues to be a lack of understanding and definition of intermediate care for referring hospital professionals. A number of service users were transferred before they were able to benefit from the rehabilitative programme. This has necessitated amending their treatment programme and extending their length of stay. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Residents and their families are involved in the social, physical and psychological care planning and provision. Staff were demonstrably focussed upon meeting residents needs and those of their family members. Access to health care professionals and health care services is provided for the benefit of residents. Staff interactions with service users were skilful, professional and with obvious empathy for the individual concerned. EVIDENCE: Care records of three service users were inspected; they contained individual “needs” assessments and plans for staff to follow to meet the identified needs. The records were maintained correctly, describing the service users response to the care and services provided. Changes to plans and reassessment of physical and psychological needs were ongoing. None of the service users were responsible for their own medication although the facility to enable this is in place. Staff had received additional accredited
Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 11 training for the administration of medicines. Staff were observed dispensing medications and assisting service users to take them. Service users and visitors to the home confirmed that staff were caring and helpful and that nothing was too much trouble, they were always willing and keen to help. Commencement of Occupational Therapy and Physiotherapy programmes for residents were delayed due to therapy staff Christmas holiday and weekend arrangements. This has clearly impacted upon the service provided and delayed discharge. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Residents and their families are involved in the social, physical and psychological care planning and provision. Staff were demonstrably focussed upon meeting residents needs and those of their family members. Access to health care professionals and health care services is provided for the benefit of residents. Staff interactions with service users were skilful, professional and with obvious empathy for the individual concerned. EVIDENCE: Service users had a choice of midday meal and snacks. Staff were observed to assist and encourage appropriately. The “diets” have been compiled with the assistance of the dietician, special diets were available for those persons requiring that service. The cook was actively involved in serving the meals and canvassed service users for their opinions and likes/dislikes. The food both smelled and appeared to be of a high standard. Service users were all very satisfied with the quality and quantity of food provided. Service users and their visitors confirmed that nourishing drinks and fluids were provided throughout the day and night time if needed.
Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 13 The home does not employ an activities organiser. Staff, undertake activities when staffing levels permit. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed EVIDENCE: Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The home both appeared clean and smelled fresh. The staff works hard to both maintain and improve the resident’s environment. Storage is limited. Therapy areas are cramped with equipment needing to be moved before therapy can commence. Staff parking carelessly is destroying the lawn areas. Staff park in disabled and restricted areas. Ancillary office visitors are parking with the homes grounds leaving few if any spaces for service user’s visitors. EVIDENCE: Service users and their visitors expressed their overall satisfaction with the cleanliness and maintenance of the home. Individual day areas and bedrooms appeared both homely and comfortable. During the inspection it was identified that cigarette burns had damaged a carpet. Paintwork throughout the home has suffered damage and is in need of attention. Two bedrooms were closed for redecoration following water ingress.
Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 16 There is a demonstrable lack of storage space with equipment having to be moved around before a particular area could be used. A little used office area was identified as a possible storage area and solution to the problem. The keypad restricting access to the staff only area is located approximately one metre from the floor. The inspector observed the inconvenience and risk this caused to staff. There is a lack of handrails throughout the home, the manager agreed to undertake a risk assessment. The recently landscaped (grassed) gardens are being spoiled and ploughed up by staff who visit the home being permitted to park inappropriately upon the lawn areas. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The staff group are a well-motivated and positive team. They have worked well together to meet the challenges and change brought about by the change in registration. EVIDENCE: The staff group were well motivated and enthusiastic about their work. They confirmed that they were well supported by the manager and encouraged to train and update their skills. Annual core training and updates had been delayed due to staffing levels and increased service user dependency levels. There is no dedicated Activities Person employed, this role is a key component of maintaining independence and personal life skills. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 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 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): 31,32,38. The Homes Manager’s positive approach to elder care has clearly influenced the whole team. The staff had performed risk assessments to identify areas of concern and maintain user safety. EVIDENCE: Responsibilities are shared between the senior members of the team. Visitors to the home remarked that they had ready and easy access to management and were confident in them. There is always a senior member of staff on duty at the home, with advice and support readily available. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 19 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 3 3 3 3 3 2 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 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 3 3 X X X X X 3 Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP6 Regulation 4(1)c schedule1 Requirement The Registered person must ensure that the Service User Guide reflects the purpose, facilities and services provided for service users. The Registered Person shall ensure that the care home makes timely provision for appropriate treatment and access to health services, (Occupational and Physiotherapy Services for Intermediate Care Service Users). The Registered Person must ensure that all parts of the home are free from avoidable risk to their safety and appropriately maintained, assess need for handrails in corridors, risk of fire/burns in carpet from smoking and maintain damaged paintwork. Review car parking provision for the home. Timescale for action 01/12/05 2. OP8 12(1)(2) 02/01/06 3. OP19 13, 23. 01/02/06 Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 21 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 OP6 Good Practice Recommendations The Registered Person must liaise effectively with Community Services to ensure that discharge of service users is not delayed. Netherfield Court DS0000047778.V279053.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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