CARE HOMES FOR OLDER PEOPLE
Palm Court 1 Curzon Road Hoylake Wirral CH47 1HB Lead Inspector
Inger Moynihan Unannounced 05 July 2005 09:30 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. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Palm Court Address 1 Curzon Road Hoylake Wirral CH47 1HB 0151 6320900 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 Michael Arthur Burke and Mr Anthony Crane Mrs Jacqueline Burke CRH PC 19 Category(ies) of OP registration, with number of places Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: N/A Date of last inspection 22 February 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 v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over five hours and was the statutory announced inspection for 2005/2006. A tour of the premises took place and service users records were inspected. Five staff and eight service users along with one district nurse and three visitors were spoken to during this inspection. What the service does well: What has improved since the last inspection?
Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 6 Palm Court continues to provide a good standard of care with ongoing improvement been made to policies and procedures and supporting documentation. The home has now employed an administrator to take on this responsibility. The issue of the hot water raised at the last inspection has now been addressed and ensures service users safety. 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. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_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 Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_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 Service users’ care needs are assessed before they move into the home to ensure the registered manager and staff team can provide the care that is required. EVIDENCE: An assessment had been carried out with the service user most recently admitted into the home. This assessment covered a wide range of issues and enabled the staff team to know whether or not they could provide an appropriate package of care. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Details of service users care needs had been compiled into a documented plan of care which gave staff information on how to look after the service users properly and attend to their care needs. Thorough medication procedures were in place. Service users spoken to confirmed the staff respected their privacy and dignity at all times. EVIDENCE: Service users’ care needs are documented in a plan of care which provides the staff with all of the necessary information on how to look after the service users in accordance with their particular needs. The inspector had opportunity to speak with many service users and they all confirmed their health care needs were met in every way. They said they always had access to their GP and when necessary the district nurse. The service users all confirmed the staff were polite and caring and always respected their privacy and dignity particularly when carrying out personal care. A district nurse visiting one of the service users commented ‘the staff at the home are very friendly and upto-date with all of the service users’ care needs. I have a very good relationship with the manager and staff team. The relatives of one service users also commented ‘the staff are absolutely wonderful, there is a lovely atmosphere in the home and I have total confidence in the staff team. I feel
Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 10 very lucky to have found this home’. A friend of one of the service users commented ‘my friend is very well looked after and the staff are very attentive to her needs’. It is the inspectors opinion that the registered manager and staff team must be commended for the standard of care they provide. Efficient medication administration procedures are in place and all staff have been provided with training in this aspect of care. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 11 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 and 15 A range of social activities are provided and contribute to creating a lively and interesting environment for the service users to live. A varied and nutritious diet is provided which ensures service users good health. EVIDENCE: The service users spoken to confirmed that a range of social activities take place which they may participate in if they wish. The registered manager informed the inspector that service users are free to come and go within the home as they choose and staff will accompany them to the local shops if they wish. Mealtimes are flexible and service users dietary requirements are met. All of the service users spoken to commented on a high standard of food provided and said they always had enough to eat and drink. They were all aware that if they did not like the meal being offered, an alternative would be provided. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 A complaint procedure was in place to ensure service users views are taken into account with regard to the care provided. An adult protection procedure was in place to ensure service users safety and welfare. EVIDENCE: The CSCI has not received any complaints about the standards of care provided at Palm Court. The registered manager confirmed she had not received any complaints about the care provided in the home. The registered manager informed the inspector that all staff have undertaken training in relation to the protection of vulnerable adults from abuse by way of in-house workbooks. The staff spoken to demonstrated they were clear on the action they would take in the event of them receiving a complaint or suspecting or knowing an incidents of abuse had taken place. The service users spoken to during inspection all commented on the caring nature of the staff team. Some of these comments included ‘the staff are lovely and friendly and I have no complaints to make. I feel very safe in this home and nothing is ever any the trouble to the staff team’. Recently the organisation Action on Elder Abuse setup a telephone line were service users and staff could report incidents of abuse anonymously. It is recommended that for the further protection of service users, this telephone number is made available to both staff and service users in order that they can raise any concerns. The registered person can find this telephone number on the Action on Elder abuse website.
Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 This standard of decoration throughout the home remains very high and provides a comfortable and pleasant environment for the service users to live. EVIDENCE: This standard of the decoration throughout the home remains very high and provides a comfortable and homely environment for the service users to live. A programme of routine maintenance and renewal of the fabric and decoration is in place. The grounds/garden is kept tidy, safe and well maintained and provide service users with a pleasant area to sit when the weather is good. The staff at the home continue to work very hard to ensure all parts of the home are kept clean and tidy which ensures service users are kept safe within their environment. Sufficient laundry facilities are in place along with systems to ensure the prevention of cross infection. A selection of bedrooms were inspected and were all noted to be clean and tidy as were the bathrooms and toilets. A number of the service users and visitors commented on the standards of cleanliness throughout the home.
Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 29 and 30 The required staffing levels and skill mix are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are providing the required level of care. Thorough recruitment procedure had not always been followed which could place service users at risk of harm if these checks are not carried out. EVIDENCE: The staff rota indicated staff were evenly deployed across the week and that the required staffing levels as agreed by the registering authority were provided. Examination of staff files indicated that Criminal Record Bureau checks had not been carried out by the registered manager prior to three members of staff in employed. This issue was discussed with the registered provider and registered manager dealt with this issue immediately. The staff records indicated that all other staff had an appropriate Criminal Records Bureau check in place. To ensure service users are protected from the risk of harm, a criminal records bureau/POVA check must be carried out prior to any staff being employed in the building. The registered provider and manager should refer to the Criminal Records Bureau website to ensure they are up-todate on all information in this area. The staff spoken to confirmed they had completed a range of training relating to the care of older people. This is a positive aspect of the home and ensures the service users are being cared for in accordance with their particular needs and the conditions relating to old age. The registered manager informed the inspector that two staff have completed NVQ 2 since February of this year and
Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 15 arrangements are being made to compile a training plan for the forthcoming year. Examination of the staff files indicated that staff training records had not been maintained despite staff having undertaken this training. The registered person agreed to address this issue immediately. The staff spoken to during the inspection said they felt well supported by the registered manager and that she was always available the support and advice. Two members of staff stated this is the best place have ever worked and we all work well as a team. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 16 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, 33 and 38 The home is managed by Mrs Jacqueline Burke who is of good a character and runs the home for the service users best interest. Quality assurance systems are in place to ensure the service users are looked after and cared for in accordance with good practice and their particular requirements. The health, safety and welfare of the service users is promoted by all staff. EVIDENCE: Systems are in place to ensure a high quality of care is provided at Palm Court and that the home is room for the best interests of service users. Service users comments about the standard of care included I am very happy with the standard of care I receive, since being in the home I am a different person, the care staff could not do more for me. One of the registered providers carries out regular monthly checks of the standard of care being provided which is in accordance with the Care Homes Regulations 2001.
Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 17 Improvements continue to be made to the policies and procedures and supporting documentation; an administrator has now been employed to take on this responsibility. Safe working practices are promoted throughout the home and staff have been provided with appropriate training to ensure service user safety. Regular fire safety checks have been carried out on all equipment and staff have been provided with regular fire safety training for the purpose of ensuring service users safety. The inspector was informed that electrical appliances are tested monthly although no record of these checks is made. The registered providers are required to keep a record of this information. Training around first aid and health and safety has been completed by all staff in the past although an up date of this training is being organised. The radiated covers that are damage must be repaired. The registered providers are also required to hold a recognised Health Safety Executive (HSE) accident book. Information on this issue can be obtained from the HSE website. Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 18 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 N/A x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x 2 Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 19 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 30 Regulation 18 Requirement The registered persons are required to ensure a record is kept of all training carried out by the staff team. The registered persons are required to ensure all staff have completed a Criminal Records Bureau check or a Protection of Vulnerable Adults check prior to them being employed at the home The registered persons are required to keep a record of any electrical tests carried out on small electrical appliances. The registered persons are required to ensure all accidents are recorded in a book that complies with the HSE Regulations. Timescale for action 5 July 2005 2. 29 19 5 July 2005 3. 38 13 5 July 2005 4. 38 13 5 August 2005. 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 18 Good Practice Recommendations It is recommended that the telephone number of the
v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 20 Palm Court 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 v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Liverpool Area Office 3rd Floor 10 Duke Street Liverpool, L1 5AS 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. Extracts may not be used or reproduced without the express permission of CSCI Palm Court v233931 f52_f02_s18923_palmcourt_v233931_050705_stage 4.doc Version 1.30 Page 22 - 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!
