Inspection on 24/05/05 for Northmore Residential Care Home

This inspection was carried out on 24th May 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

Northmore Residential Care Home 12/02/09

Northmore Residential Care Home 13/02/07

Northmore Residential Care Home 23/01/06

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 Announced 24 May 2005 10:00 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. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Northmore Residential Care Home Address 77 Barnsole Road Gillingham Kent ME7 4EA 01634 573678 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) Mr Vijay Kumar Dassour PC Care Home only 9 Category(ies) of DE(E) Dementia - over 65 registration, with number of places Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20 September 2004 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 seven care staff that work on a rota that includes 1 member of staff on a waking night duty. 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.. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place on 24-05-05 and was carried out by two inspectors who were in the home from 10.00 until 14.30. The inspectors spoke to all of service users, several family members and some members of staff plus the manager. A Care Manager from Social Services also visited the home during the inspection. Many judgements about the quality of life for residents were taken from observations, speaking with staff, reviewing records and from direct discussion with service user and families. A tour of the premises was undertaken which included all of the resident’s rooms. Some records were viewed including care plans and training records. The majority of the requirements made at the lat inspection had been complied with. What the service does well: This is a service that caters very well for residents with dementia. The main priority within the home is to ensure that residents are secure, well cared for and to have their complex care needs managed safely. The manager has developed strong working relationships with both the District Nurse team and the Community Psychiatric nurses. Visitors spoken to on the day and comments received from the Commissions comment cards confirm that relatives and other professionals hold the home in high regard. The homes management team complete in-depth assessments on prospective residents prior to them being offered a placement to ensure their needs can be met by the home. Care plans identify individual needs and give good clear guidance to staff. The home caters well for a resident with a hearing impairment. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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) 3,4,5 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 manager and a senior care completed full in-depth assessments on prospective residents to ensure they can meet their needs prior to admission. Areas of risks were identified and risk assessments completed to reduce any risks. The manager is very pro-active about ensuring prospective residents can be well cared for. Care plans indicated that the current residents were well cared for and families confirmed they were pleased with the care and the commitment shown by staff. Families confirmed that they were invited to visit the home and were given the homes Statement of Purpose prior to their relative moving in and that Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 9 information had greatly assisted them in making an informed choice over the homes suitability. The manager confirmed that each resident is offered a trial period of four weeks to ensure his or her needs can be met. Intermediate care is not provided at Northmore Residential Home. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 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. The staff had supported a resident to stop smoking after her G.P had advised her to do so. That Resident discussed how the help and support offered had assisted her in giving up cigarettes for good. The home enjoyed an excellent relationship with locals G.P’s and District Nurses. This was confirmed by comments cards from these professional. This Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 11 had enabled the home to continue to care for a resident with complex physical needs as well as a diagnosis of dementia. The family of the resident stated that she was very happy with the care her mother had received. She stated that she did not have one single complaint and that Mum was always clean and seemed content and settled. She also felt that her mother was always treated with respect and her privacy was maintained. Other visitors, and comments from comment cards, confirmed that both families, Care Managers, G.P’s and District Nurses were happy with the level of support and care shown to the residents. One Care Manager who was visiting the home stated that the manager was very pro-active in dealing with issues around resident’s mental state and was able to deal with these issues before they became a major problem. The manager always kept Care Managers informed of any changes in condition or any concerns. On the day of the inspection all residents appeared happy and relaxed. The administration of medication had improved since the last inspection with the manager addressing the issues raised. Discussion took place around collecting prescription from the G.P’s and advise was given to the home regarding the collection and signing of these prescription prior to them being dispensed by the Pharmacist. This is in accordance with the Royal Pharmaceutical Society of Great Britain Guidelines (4.7). Photos of residents and any allergies should be added to resident’s medication administration records. All staff had received accredited medication training. The home has written policies and procedures fro staff to follow in the event of the death of a resident. Policies also demonstrated that the homes would support residents, families and staff at these difficult times. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 standard(s) 12,13,15 Service users are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Religious needs are met. The service users benefit from the appetising meals and balanced diet offered by the home. EVIDENCE: One visitor stated that staff do encourage resident to become involved with various activities during the day. These activities include reminiscence session, musical sessions and various trips out with staff. The manager is considering employing a designated member of staff for these activities. The home does have a separate room should any resident want to watch something different on television or to see a guest in private. Residents are asked if they wish to attend church on a regular basis and the manager is currently looking to see if the local church would visit the home on a regular basis. Visitors confirmed that they were encouraged to visit at any reasonable time and that they were always made welcomed. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 13 Comments from both residents and relatives confirm that the food was good and offered in sufficient quantities. Drinks and snacks were available at all times. A resident had recently moved in from another home and was ‘very happy with the food and all the cups of tea’. Another resident had a severe hearing impairment and the home had produced a ‘picture passport’ to enable staff to communicate effectively with her. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 standard(s) 16,18 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 homes 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 homes complaint book was seen and no complaints had been registered this year. The homes compliments book was also viewed and this contained many letters of thanks and gratitude for the care given. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,23,24,25,26 The 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. The resident’s benefit from living in a clean, pleasant and hygienic home. EVIDENCE: The home is conveniently situated for local shops and the local town centre. The building itself is opposite a school. The home is over three floors, which are accessible by a chair lift. Due to narrow doorways on the bedrooms this home would not be suitable for residents confined to a wheelchair. The current residents are all fairly ambulant and able to manage well within the home. The home does offer a homely atmosphere but would be improved if a phased programme of redecoration was introduced. Some new carpets and furniture has been purchased for the lounge area. Radiators are now covered and thermostatic valves have been added to all the hand basins and baths. Window restrictors have been fitted to all upstairs windows. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 16 Discussion again took place over the two bathrooms and the manager was advised to ensure that the necessary remedial work is carried out in the near future. The lounge and dining room were suitable to meet the needs of the residents and presented in a very homely way. The bedrooms seen were well personalised with various ornaments and pictures and photographs. Several of the resident said they liked their rooms and that they were comfortable. There was a small conservatory to the side of the house and a pleasant garden. Some areas of the garden remain uneven but the manager stated the resident only went to the garden under supervision. Each room had a call bell and grab rails and commodes were seen. A chair lift provided access to all floors. The home also has a sensor system to detect movement at night so that staff members on duty could ensure the safety of that person. The home was clean and hygienic and free from any odours throughout. One area of concern was the entrance to the main office, which led down a steep flight of stairs. With regards to the level of disability of the residents it will be a requirement that a suitable lock be fitted to prevent access by residents. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 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) 27,28,30 The residents benefit from being cared for by staff who have a good understanding of their needs and are well trained. EVIDENCE: The figures provided by the home indicated that staffing levels were acceptable. The manager discussed the problem of recruitment and of finding suitable candidates. The manager also confirmed that they did not use agency staff and if shifts were difficult to cover then he or his sister work the shift, thus ensuring continuity of care. All staff had been trained in dementia and challenging behaviour. The home is soon to be the pilot home for a new course provided by a local college about positive care for dementia. The home is committed to training with three members of staff having completed NVQ three and three currently completing NVQ two. Adult protection training had also taken place. Staff training files indicated that staff were well trained and competent. One visiting care manager confirmed that she had witnessed good practise when prospective staff contacted the home seeking employment and felt that this was a ppositive approach in finding the right type of staff. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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) 31,32,33, 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. EVIDENCE: The manager was honest and open throughout the inspection and was able to evidence that he was competent and caring and had all the necessary experience and qualifications needed to manage the home. Visors to the home agreed that the ethos of the home was supportive to residents and very homely. Comments from Care Managers were also very positive. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 19 The atmosphere was relaxed and comfortable. The home was very responsive to the needs of the residents both physically and emotionally and this was reflected in the positive comments received from relatives and friends. Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 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 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 x 15 3 COMPLAINTS AND PROTECTION 2 3 2 x 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 x 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 3 3 x x x x x Northmore Residential Care Home H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 21 yes 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 OP19) Regulation 23(2)(d) Timescale for action General repairs are made to both Action plan bathrooms by 28 dyas from receipt of this report A programme of routine Action plan maintenance and renewal of by 28 dyas fabric and decoration of the from premises is produced and receipt of implemented this report A suitable lock must be fitted to To be the door leading to the office. actioned by 19th June 2005 Requirement 2. OP19) 23(2)(d) 3. OP38 13(4)(a) 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. Refer to Standard OP9 OP9 Good Practice Recommendations it is recommended that medication administration records should include a recent photo and list any allegies that resident may have t is recommended that prescription are collected from the GP and signed by the manager or representative prior to being dispensed H56-H06 S28894 Northmore V221805 240505 Stage 4.doc Version 1.30 Page 22 Northmore Residential Care Home Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane, Maidstone Kent. ME16 9NT 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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