Inspection on 13/02/07 for Northmore Residential Care Home

This inspection was carried out on 13th February 2007.

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

Northmore Residential Care Home 12/02/09

Northmore Residential Care Home 23/01/06

Northmore Residential Care Home 24/05/05

Northmore Residential Care Home 20/09/04

Northmore Residential Care Home 29/12/03

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

CARE HOMES FOR OLDER PEOPLE Northmore Residential Care Home 77 Barnsole Road Gillingham Kent ME7 4EA Lead Inspector Sue McGrath Key Unannounced Inspection 13th February 2007 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 Northmore Residential Care Home DS0000028894.V327556.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. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Northmore Residential Care Home Address 77 Barnsole Road Gillingham Kent ME7 4EA 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) 01634 573678 Mr Vijay Kumar Dassour Mrs Santosh Rita Dassour Care Home 9 Category(ies) of Dementia - over 65 years of age (9) registration, with number of places Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: Northmore Residential Home is located within the town of Gillingham and within approximately half a mile from the town centre and railway station, bus stops are close by. The home occupies detached premises with accommodation on three floors, with nine single rooms. There is a stair lift between the ground and first floor and second floors. The home has an attractive rear garden, which is mostly paved with borders and raised beds, making a pleasant place for residents to sit in the warmer weather. The home employs eleven care staff that work on a rota that includes one member of staff on a waking night duty and one sleeping in. Both owners are on-call off the premises. The home operates a key-worker system for service users. The home caters for older people with a diagnosis of dementia. Fees range from £418 to £479 per week. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection that took place on 13th February 2007 and was conducted by Sue McGrath, Regulation Inspector for The Commission for Social Care Inspection. The key inspections for care home services are part of the new methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Some judgements have been made through observation only. Overall this was a positive inspection with generally good outcomes for service users. What the service does well: What has improved since the last inspection? Several improvements in the environment have improved the life of the residents. They can now have two totally refurbished bathrooms, which are fresh and clean. An extra bath hoist has been fitted to enable all residents to have access to this facility. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 6 New carpets and armchairs have been purchased for the lounge area and a new door had been fitted to the conservatory. A new fire door has been fitted in the hallway. The hallway and two bedrooms have also been re-decorated. 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. Northmore Residential Care Home DS0000028894.V327556.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 Northmore Residential Care Home DS0000028894.V327556.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): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they need to make an informed choice about moving into the home. Residents benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: The home’s Statement of Purpose and Service User Guide were viewed and were comprehensive, detailed and meet with requirements of this standard. When a prospective resident or their families initially approach the home they are supplied with a copy of the statement of purpose and invited to visit when convenient. After a week Mr Dassour will contact the family to obtain feedback on the approach of the initial contact. They are asked to complete a Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 9 questionnaire that is used to ensure the first impressions are good. Responses in the questionnaires are fully considered and often acted upon. This starts the process of quality assurance and monitoring as required by standard 33. All of the residents had detailed contracts that included terms and conditions. Mr Dassour did discuss the difficulty in obtaining singed copies back from some relatives and was advised to record that contracts were given but not returned as necessary. The manager completes full in-depth assessments on prospective residents to ensure they can meet their needs prior to admission. Areas of risks are identified and risk assessments completed to reduce those risks. Mr Dassour is very pro-active about ensuring prospective residents can be well cared for. Families confirmed that they were invited to visit the home and were given the home’s Statement of Purpose prior to their relative moving in and that information had greatly assisted them in making an informed choice over the home’s suitability. They also confirm a trail period is offered. The home specialises in caring for clients with varying forms of dementia and does not offer intermediate care. Northmore Residential Care Home DS0000028894.V327556.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): 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Care plans are regularly updated to ensure changes are recorded and acted upon. Health needs are met and service users benefit from having full access to all professional health care services as required. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Care plans were sampled and were seen to be comprehensive and provided staff with detailed information and gave clear guidance on how to support the residents with health and personal care. Families were involved with any changes in care for their loved ones. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 11 It is recommended that all the information regarding a resident should be kept in one folder and not in several separate folders. The daily notes are of a good quality and give a good picture of what it is like to live at Northmore. It is also recommended that separate sheets be completed so that GP, DN and CPN visits can be easily recorded. This will enable to the to easily track such visits rather than trawl through the daily logbook. Nutritional assessments were discussed, as sufficient dietary intake is often a problem for people with dementia. Mr Dassour confirmed that if they have any dietary concerns they would contact the GP. This had happened with one residents and advice had been sought. Details of dietary risk assessments were left with Mr Dassour. One member of staff was able to discuss tissue viability. Her conversation with a district nurse evidenced she had a good understanding of the treatment and outcome of tissue viability care. The home enjoyed an excellent relationship with locals General Practitioners and District Nurses. Comments cards from these confirmed this. The residents have full access to General Practitioners, District Nurses, Chiropodist, Opticians and Dentists as needed. Medication is now administered using the Boots blister pack system, which has proved successful. No errors were found in the administration and the home followed the guidelines issued by the Royal Pharmaceutical Society of Great Britain. All staff that administer medication have completed an accredited safe administration of medication course. Staff were seen to be respectful and courteous to the residents and from discussions with some of them, it is evident the dignity and privacy of residents is respected at all times. The home has written policies and procedures for staff to follow in the event of the death of a resident. Policies also demonstrated that the home would support residents, families and staff at these difficult times. Northmore Residential Care Home DS0000028894.V327556.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. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Religious needs are met. Residents are encouraged to exercise choice and control over their lives where possible. EVIDENCE: The home cares for people with varying degrees of dementia and lifestyles can be very challenging for some. Organised activities can be stressful for some residents and others find concentration difficult. The home endeavours to offer a range of activities that suit the individual residents. Some might enjoy helping with the washing up whilst other like to help tidy their rooms. Other prefer to watch television or to read magazines or books. Some like knitting. The days are relaxed and easy going. Levels of challenging behaviour are managed well. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 13 With the levels of dementia within the home it is not always easy to ensure full choices are given at all times, however staff were seen to offer choices where possible and where not possible gave full support and consideration. Families are encouraged to visit and to be involved with the care of their loved ones. Mr Dassour actively promotes this contact as he feels it helps the home care for the residents appropriately. Care staff cook the food for the residents and they confirmed the residents were given a choice. They were also aware of likes and dislikes. Drinks are freely available at all times and the residents receive three meals a day. Supper can be provided if wanted. One family member said she thought the food was good. One resident said the food was lovely and that she always had enough. Northmore Residential Care Home DS0000028894.V327556.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. The home has a clear complaints procedure and residents and relatives are aware of how to complain. The home’s Adult Protection Policy and procedures protect residents from abuse. EVIDENCE: The home’s complaint procedure was included in the Statement of Purpose and the policy was also seen in the foyer. Visitors spoken to confirmed that they had been given this information but had never had to use it. The home also had an Adult Protection Policy that complied with the Public Disclosures Act 1998 and the Departments of Health’s guidance No Secrets. The home’s complaint book was seen and no complaints had been registered this year. The home’s compliments book was also viewed and this contained many letters of thanks and gratitude for the care given. Staff spoken with had a good understanding of Adult Protection and had clearly had training in this field. Northmore Residential Care Home DS0000028894.V327556.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, 21, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have access to safe and comfortable indoor and outdoor communal facilities, however the interior décor would benefit from a planned maintenance and refurbishment programme. Residents benefit from living in a clean, pleasant and hygienic home. EVIDENCE: Mr Dassour has refurbished both bathrooms and has installed a second bath hoist in the bathroom on the second floor. This is a big improvement. The flooring in the bathroom on the first floor id due to be laid by the end of February. Both rooms will then be completed. New carpets have been fitted in the lounge and also new armchairs have been purchased. One of the residents said they liked the new chairs and the colour of the carpet. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 16 New patio doors leading to the conservatory have been fitted as well as a new fire door leading to the hall. The hallways have also been painted. Two bedrooms have also been decorated. Clearly a lot of work has been done. Standard 19.2 states that a programme of routine maintenance and renewal of fabric and decoration of the premises is produced and implemented with records kept. Mr Dassour has identified that new carpets are required in most of the rooms and hallways and that new bedroom furniture would improve the quality of life for the residents. He has applied to the local Council for a discretionary grant to complete these works. It is also advised that he considers renewal of the kitchen including a new cooker and redecoration of the outside of the premises. Northmore Residential Care Home DS0000028894.V327556.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. Residents benefit from being cared for by staff that have a good understanding of their needs and are well trained. Residents are protected by the home’s robust recruitment procedures. EVIDENCE: Information taken from the pre-inspection questionnaire and evidence seen on the day confirm that sufficient staff are employed at Northmore to ensure assessed needs are met. Staff training is very important to Mr Dassour who recognises that good staff training benefits all of the residents. All staff have been trained in dementia care and appear competent. Sixty three percent of staff have completed a National Vocational Qualification (NVQ) in care to level two or above. The remaining staff are hoping to start their awards in the very near future. It is the intention that all staff will complete NVQ to at least level two. Other training includes manual handling, first aid, food hygiene, fire safety, infection control, challenging behaviours and adult abuse. This is a sample of courses completed. Other courses are planned for the coming year. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 18 Mr Dassour has a robust employment procedure in place, which is closely followed to ensure appropriate staff are employed and all the required checks are completed. Staff files were in good order. The home does not use agency staff. Northmore Residential Care Home DS0000028894.V327556.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, 32, 33 34,35, 36, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from living in a home where the manager is competent, enthusiastic and experienced with the care of older people with dementia and has a clear vision for the home. Sound financial procedures protect residents. The health, safety and welfare of residents and staff is well protected. EVIDENCE: Mr Dassour was honest and open throughout the inspection and is able to evidence that he is competent and caring and has all the necessary experience and qualifications needed to manage the home. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 20 Visitors to the home agreed that the ethos of the home was supportive to the residents and very homely. The atmosphere is relaxed and comfortable. The home is very responsive to the needs of the residents both physically and emotionally and this is reflected in the positive comments received from relatives and friends. Quality Assurance could be improved and Mr Dassour is advised to follow the guidance offered on CSCI website for standard 33. It is acknowledged that some work does take place for quality assurance. Discussion with the owners and records seen indicated that appropriate records were kept of all financial transactions. Insurance cover was in place against loss or damage to the assets of the business and for public liability. The home looks after a small amount of monies for some of the residents so they can purchase minor items such as hairdressing and chiropody. Records were seen that were accurate and well maintained. Some of the families deal with their loved ones finances and some are managed by Social Services Financial Affairs office. The money is kept in a secure box that is stored in a secure cupboard. The home prefers to return any valuable items to the families if the residents can no longer care for them. A few items are stored by the home and these are all appropriately recorded. Staff confirmed that they have regular supervision and could also discuss any issues with the owners at any time. They stated they felt well supported. All of the records to ensure the health, safety and welfare of the residents and staff were accurate and up to date. The accident book was viewed and contained only minor accidents. Northmore Residential Care Home DS0000028894.V327556.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 17 x 18 3 2 X 3 X X 2 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 2 3 3 3 3 3 Northmore Residential Care Home DS0000028894.V327556.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 Home’s 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 2 3 4 5 6 Refer to Standard OP7 OP19 OP19 OP19 OP19 OP26 Good Practice Recommendations It is recommended that all the information concerning each individual resident be maintained in one file. It is recommended that new bedroom furniture be purchased. It is recommended that new carpets be considered throughout the home. It is recommended that consideration be given to painting the outside of the home. It is recommended that consideration be given to refurbishing the kitchen It is recommended that advice is sought from the infection control nurse over the possible purchase of a sluice disinfector. Northmore Residential Care Home DS0000028894.V327556.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Northmore Residential Care Home DS0000028894.V327556.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!