CARE HOMES FOR OLDER PEOPLE
Palm Court 1 Curzon Road Hoylake Wirral CH47 1HB Lead Inspector
Inger Moynihan Unannounced Inspection 19th December 2005 11:30 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 Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Palm Court Address 1 Curzon Road Hoylake Wirral CH47 1HB 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) 0151 632 0900 Mr Michael Arthur Burke Mr Anthony Crane Mrs Jacqueline Burke Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: Palm Court is a private residential care home providing 24 hour personal care and accommodation for 18 older people. Palm Court is owned by Mr M Burke and Mr A Crane and is managed by Mrs J Burke. The home is located in Hoylake town centre near to shops, pubs, a post office, bank and other town amenities. A rail network gives easy access to Liverpool and other parts of the Wirral. The home is also within a five minutes walk of the promenade. The home is a large Victorian detached property. The accommodation is provided on three floors. All bedrooms are single occupancy some with en-suite facilities. The sizes of the rooms vary considerably. A lift is available to all floors. Bathrooms and toilets are available on all floors close to bedrooms and living rooms. The communal rooms comprise of a lounge, a snug and a dining room. There is a garden at the back of the property along with patio furniture. The front of the home is mainly taken for parking although this has been made attractive with plants and hanging baskets. There is also a seating area at the front of the home. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 2.5 hours and was the statutory unannounced inspection for 2005/2006. During the last four inspections all of the documentation required for the management of this service has been examined and is kept in good order. In the light of this, this inspection concentrated on speaking to the service user group and finding out their views on the standard of care they receive while living at Palm Court. What the service does well:
Staff provide an appropriate package of care to ensure service users care needs are fully met. All of the service users spoken to during the inspection confirmed their needs were met in every way. They said the staff were fully up-to-date on all of their particular needs and requirements and they felt well cared for. One service user stated the staff are excellent, they are extremely patient and kind. Systems are in place for the safe handling, storage and administration of service users medication. All of the service users spoken to confirmed they always received their medication as prescribed by their GP. One service user commented on how quickly the staff responded when she was unwell and confirmed her GP was called immediately. Another service user stated the staff are very helpful and very kind. The manager is lovely, she is very efficient and I am very happy with the care I receive. All of the service users spoken to during the inspection confirmed the staff treated them with respect and dignity at all times and particularly when carrying out personal care The service users confirmed a range of social activities take place during the week which they are free to participate in if they wish. Some of the service users stated they did not wish to become involved in these activities and were happy the staff respected their decision. A number of service users confirmed they had their own routines which enabled them to exercise choice and control over their lives. All of the service users commented on how much they enjoyed the food with one service user stating I always enjoy the meals and I always have enough
Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 6 to eat and drink. Service users confirmed their particular likes and dislikes were addressed and confirmed staff went out of their way to ensure a varied menu was provided. Service users were aware of who to contact if they wished to make a complaint. All of the service users spoken to during the inspection confirmed they were treated with respect and courtesy at all times, and had never experienced anything other than kindness from the staff team. The standard of the decor at Palm Court remains very high and provides a comfortable and pleasant environment for service users to live. Service users needs were met by the number and skill mix of staff. The home is managed by Mrs Jacqueline Burke who is of good a character and manages the home for service users best interest. One service user commented Jackie is lovely, she is very efficient and has a lovely manner, I see her every day. The relative of one service user also confirmed the manager was very efficient and attentive to service users needs. What has improved since the last inspection? What they could do better:
The service users spoke highly of the manager and staff team commenting on their kind and courteous manner. They all stated they were completely satisfied with the standard of care they received. This was further endorsed by a relative and friend of two service users. From these comments it is clear the care provided at Palm Court meets service users assessed needs appropriately.
Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 7 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. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 8 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 Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 9 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): 3 and 4 Staff provide and appropriate package care to ensure service users care needs are fully met. EVIDENCE: All of the service users spoken to during the inspection confirmed their needs were met in every way. They said the staff were fully up-to-date on all of their particular needs and requirements and they felt well cared for. One service user stated the staff are excellent, they are extremely patient and kind. A relative and friend of two service users visiting the home at the time of the inspection also said the staff were attentive to service users care needs and they were very happy with the standard of care provided. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 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): 8, 9 and 10 Service users health care needs are fully met. Systems are in place for the safe handling, storage and administration of service users medication; all of this ensures service uses good health and welfare. Service users said they are always treated with respect and their right to privacy is upheld. EVIDENCE: The service users spoken to during the inspection confirmed they were well cared for and had access to relevant health care professionals such as they GP, when necessary. One service user commented on how quickly the staff responded when she was unwell and confirmed her GP was called immediately. Another service user stated the staff are very helpful and very kind. The manager is lovely, she is very efficient and I am very happy with the care I receive. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 11 The relative of one service user also commented the staff are very quick to respond to any issues relating to my aunts health and they always keep me up-to-date with everything that is happening. All of the service users spoken to during the inspection confirmed the staff always treated them with respect and dignity and particularly when carrying out personal care. One service user commented the staff are very discreet when carrying out personal care and attend to my needs in a very sensitive way. When service users are unwell or become vulnerable in anyway, they must rely on the staff to care for them properly. It is clear from the service users comments that staff are providing a standard of care which is in line with good practice and meets service users individual needs. Systems were in place for the safekeeping and handling of service users’ medication and only trained staff are allowed to administer medication. The service users spoken to during the inspection confirmed they always received their medication as prescribed by their GP. All of this ensures service users ongoing good health. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 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, 14 and 15 A range of social activities are provided to ensure service users interest and mental stimulation. Service users have their own routines which enables them to exercise choice and control over their lives. A varied and nutritious diet is provided to ensure service users interest and good health. EVIDENCE: The service users confirmed a range of social activities take place during the week which they are free to participate in if they wish. Service users confirmed Christmas activities are being provided and birthdays are always celebrated. Some of the service users stated they did not wish to become involved in these activities and were happy the staff respected their decision. A number of service users confirmed they had their own routines with regard to social activities and were free to go about their day as they wished. All of the service users spoken to during the inspection confirmed the routines within the home are flexible and they could come and go as they wish. The
Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 13 relative of one service user confirmed she could visit the home at any time and was always made welcome by the staff. All of the service users commented on how much they enjoyed the food with one service user stating I always enjoy the meals and I always have enough to eat and drink. Service users confirmed their particular likes and dislikes were addressed and confirmed staff went out of their way to ensure a varied menu was provided. They also confirmed a choice was available. The dining room is a pleasant and comfortable area for service users to have their meals and staff had taken steps to ensure service users could enjoy their meals at their leisure. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 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): 16 Service users were aware of who to contact if they wished to make a complaint. EVIDENCE: The service users spoken to during inspection said they were aware they could make a complaint about any aspect of the service and who they should contact in the event of them wishing to do so. One service user commented the staff are very kind and caring and I have no complaints to make about the way I am looked after. Another service user stated the staff are excellent, nothing is ever any trouble, I have absolutely no complaints to make about the standard of care I receive. All of the service users spoken to during the inspection confirmed they were treated with respect and courtesy at all times and had never experienced anything other than kindness from the staff team. The CSCI has never received any complaints about the standards of care provided at Palm Court. It is recommended that the telephone number of the organisation Action on Elder Abuse is made available to staff and service users so they report any incidents of abuse anonymously. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 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): 19 The standard of the decor at Palm Court remains very high and provides a comfortable and pleasant environment for service users to live. EVIDENCE: The standard of furnishing throughout the home remains very high. On the day of the inspection the home was clean and tidy and pleasantly warm. Service users confirmed the laundry facilities were good in that their clothes were always returned to them in a good condition. It is clear the staff are continuing to work very hard to ensure a high standard of cleanliness is maintained. All of the service users spoken to confirmed their bedrooms were clean and tidy as were all communal rooms and toilets and bathrooms. On the day of the inspection the home was decorated in preparation for Christmas and looked particularly homely and attractive. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 16 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 Service users needs were met by the number and skill mix of staff. EVIDENCE: The staff rota indicated staff were evenly deployed to ensure service users’ care needs were met at all times and to ensure their safety and well-being. The staff spoken to confirmed there were sufficient staff on duty to care for the service users. The staff group at Palm Court is stable. All of these issues contributed to creating a positive working environment and prevents poor working practices developing. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 17 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 The home is managed by Mrs Jacqueline Burke who is of good character and manages the home for service users best interest. EVIDENCE: Discussion with service users confirmed that Palm Court is run and managed for service users best interest. The service users spoke highly of the registered manager and stated she was always available for support and advice when necessary. One service user commented Jackie is lovely, she is very efficient and has a lovely manner, she is always around and about and I see her every day. The relative of one service user also confirmed the manager was very efficient and attentive to the service users care needs. The staff also spoke highly of the manager saying she was very supportive and had contributed to creating a friendly working environment. The staff said they enjoyed their work and worked well as a team.
Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 18 It is clear from these comments that the manager is well thought of and provides a supportive working environment for the staff team. This is a positive aspect of the home and ensures good standards of care are maintained. Staff confirmed they had undertaken fire safety training recently and the registered provider confirmed all fire safety checks were up-to-date. Although the electrical appliances are tested monthly, a record of these checks had not been maintained. The registered provider agree to ensure this issue was addressed. For service users further safety and welfare, the registered person is advised to keep up-to-date with all of the information provided on the Health and Safety Executive and Medical Devices Agency Web Sites. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 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 X x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x 2 Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 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 38 Regulation 13 Requirement The registered persons are required to keep a record of any electrical tests carried out on small electrical appliances. Timescale for action 22/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP18 Good Practice Recommendations It is recommended that the telephone number of the organisation Action on Elder Abuse is made available to all service users and staff in order that they can report any incident of abuse anonymously. Palm Court DS0000018923.V272559.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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