CARE HOMES FOR OLDER PEOPLE
Palm Court Nursing Home 7 Marine Parade Dawlish Devon EX7 9DJ Lead Inspector
Clare Medlock Unannounced Inspection 25th September 2006 10:00 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 Nursing Home DS0000050094.V300011.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. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Palm Court Nursing Home Address 7 Marine Parade Dawlish Devon EX7 9DJ 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) 01626 866142 01626 888580 Palm.court@btinternet.com Mrs Lorraine Jacqueline Greenaway Mr Graham James Greenaway Mr Nigel William Charles Morris Care Home 36 Category(ies) of Dementia - over 65 years of age (3), Learning registration, with number disability (3), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (3), Physical disability over 65 years of age (36) Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. 6. Registered for maximum of 3 OP Registered for maximum of 3 LD Registered for maximum of 36 PD(E) Service Users aged 65 years and over Registered for maximum of 3 DE(E) Service Users 65 years and over Registered for maximum of 3 MD(E) Service Users 65 years and over To accommodate one Service User (named elsewhere) under 65, in the category of physical disability, may be accommodated for regular periods of respite care 16th November 2005 Date of last inspection Brief Description of the Service: Palm Court Nursing Home is a purpose built establishment located on the sea front of the holiday town of Dawlish. It is within approximately 100 yards of the town’s park, train station and main street, all of which are on the level to the home. The home is built on three levels with a car parking area at the front of the building. There are some seating areas outside and to the front of the home and a Gazebo is erected during suitable weather conditions for the Service Users. The home has a large lounge on the second floor that has uninterrupted views over the sea. There are thirty-six single bedrooms, one of which has en-suite facilities. The bathrooms and toilets are all of good size, equipped with modern facilities for the disabled and are all within a short distance of the bedrooms and communal areas. There is a shaft lift near the main entrance that provides access to each floor in addition to two staircases. A large dining room can be found at the rear of the building on the ground floor. The home is registered to provide personal and nursing care. The current range of fees are from £ 460 to £ 595. There are additional charges for Chiropody £10.00 and Hairdressing, Taxis, Paper/Magazines, Telephone Bills which are Variable in cost. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on Monday September 25th at 10.30am. It consisted of speaking with residents, relatives, staff, visiting health care Professionals and the manager. A full tour of the building was performed. Care plans, staff files and other records were inspected. Prior to the inspection, the Manager and administrator submitted an in depth pre inspection questionnaire. Resident and relative surveys were also returned and used for this inspection. What the service does well: What has improved since the last inspection?
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 6 The Manager has worked hard to address the Requirements and Recommendations set at the last inspection. The majority of these has been achieved and the remaining issues would take minimum effort to achieve. Care of residents has improved by the improvement in care planning and record keeping. Staff now have a system of care plans which are used to identify specific needs of residents, which takes into account the wishes and feelings regarding terminal illness and funeral arrangements. Residents who are at risk or unable to communicate are monitored with observation records charts to ensure they are checked regularly and are not at risk. Residents with wounds or skin problems have a separate care plan where staff record changes and improvements in would and then appropriately plan for the dressing that is required. The Provider has paid for a medication waste contractor to ensure the safe disposal of medicines now that this is no longer done by pharmacies. Residents are still enjoying the food at Palm Court and now have their weight recorded regularly. This helps staff spot when residents are at risk of loosing or gaining too much weight. The GP also prescribed dietary supplements to those residents at risk. This is helping keep residents fit and healthy and helps with wound healing. Communication has improved at the home with the Manager finding different ways to keep in touch with families. These methods have included in person and by telephone but also by letter, email and communication/message books. Recruitment Practices have improved at the home. All staff files are complete to show staff have the correct checks performed before working. Training at the home has improved. Staff have received training in adult protection awareness, fire safety, medicine training and NVQ qualifications. The induction process and Staff supervision have improved at the home. These improvements mean that staff will work in a more practical safe way and make sure their knowledge will be up to date. Policies at the home have been up dated and help staff in dealing with unusual or difficult situations. Since the last inspection the Manager has worked very hard to perform a quality assurance survey. Very Positive comments from health care professionals were seen regarding care at Palm Court. The Manager stated that he has asked the administrator to send out Questionnaires to Relatives, health care professionals and other stakeholders on a random periodic basis. The environment has also improved with the ongoing redecoration programme. The Provider continues to fund improvements to the home, which include the
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 7 purchase of new specialist beds, hoists and sliding sheets. There are plans for further development at the home, which the Provider explained at the inspection. The kitchen Management has also improved at the home. The new chef has introduced herself to the residents and some relatives. The environmental health hygiene programme (Safer food, better business) is now followed which has resulted in a more hygienic, well-managed kitchen. 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 Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 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 Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service Residents and their families are given enough information to decide whether Palm Court is the right place for them to be. The home also thoroughly assesses prospective residents to ensure staff at the home are able to meet their needs. EVIDENCE: A Statement of Purpose and Service User Guide were produced for this inspection. The Statement of Purpose was displayed on the wall in the lobby and included necessary up to date information. This enables Residents to decide whether the home is the right place for them to be. All Residents are issued with a contract. A sample of these contracts was seen and contained the correct information Previous inspection reports were located in the entrance hall by the visitor’s book.
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 10 Residents spoken to say their relatives had made the final decision to come to the home as admission was from hospital and a trial visit was not appropriate. One resident said his niece had looked at many homes and decided Palm Court was the right place for them. Care Plans confirmed that the Manager performs a thorough check on residents to make sure staff at the home can meet their needs and know where to access specific help and advice. Staff spoken to in the home confirmed they did not have any resident with cultural differences but confirmed that if this were the case they would find out as much information prior to the admission. Staff spoken to said some staff were from overseas which had worked well. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service The improved clear and consistent care planning system means that the health and social needs of Residents are fully planned. Staff communicate well with the multi disciplinary team, which safeguards Residents. There is an ethos within the home that promotes the privacy and dignity of Residents at all times. EVIDENCE: All residents seen on the day of inspection appeared well cared for. Residents being cared for in bed appeared warm, pain free and had call bells within reach. Residents were seen to have clean eyes, teeth, and were dressed in their own clothes. Residents who wore glasses had them on and footwear appeared appropriate. Residents stated that they felt very well cared for. One resident said ‘you could not ask for better staff, they work very hard and they are kind and caring’. Thank you cards seen in the home said ‘I would just like to thank you all for the kindness, caring and the special things you did for mum. My husband and I can’t speak highly enough of you.’
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 12 The home had performed a quality assurance survey. The questionnaires stated: From Relatives: ‘My mother has been depressed but she seems much more cheerful, happy even’ From GP: ‘’Overall I think Palm Court is an excellent home, mainly due to the extremely competent, caring staff who all know the residents extremely well. The low level of staff turnover reflects this clearly. The standard of physical nursing care is very high’. From Specialist Nurse: ‘Palm Court of late, appears to have improved considerably. The staff are cheerful well mannered and helpful. I as a visitor feel welcome and staff endeavour to assist me as best they can. All the patients I see appear well cared for.’ Four Care Plans were inspected on this occasion, which clearly demonstrated that the Manager and staff had improved care plans. Evidence was seen that relatives had been consulted regarding care plans and some had responded in person, via telephone, email and communication books. Care Plans were easy to read and showed that residents have all their needs met and make sure staff are aware of all aspects of the care. All care plans were up to date, well written and complete. Risk assessments for skin care, continence, risk of falls and use of bed rails were seen in care plans and had been regularly reviewed. The improvements in the care planning are to be commended at the home. Staff at the home have also introduced an observation chart for those residents at high risk or with communication difficulties. This provides evidence that staff have regularly checked residents and lists what care or social interaction has taken place. Care Plans showed that staff access a range of health care services for the residents. These services included out patient appointments, District nurse, speech and language therapist, Continence nurse specialists and other nurse practitioners are also consulted when needed. The GP visits the home on a weekly basis and the home employ a Physiotherapist who comes to the home on a weekly basis to perform exercise classes and 1:1 care prescribed by the GP. All residents spoken to said staff were very kind and caring. All residents said they wear their own clothes, staff knock before entering their room and residents receive their post unopened. During the inspection, the administrator was delivering post to residents. Some residents chose to have a telephone in their room. The trained nursing staff manages the homes medication system. The medicine administration system is a pre packed blister pack system that the local
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 13 pharmacy delivers with some additional boxed or liquid medicines. The storage area of the medicines were, clean, tidy and secure and the systems for the collection and disposal of medicines were well managed. The recording of medication was on the whole well completed. Specialist wound care plans and notes were kept in the treatment room, which prompts staff to renew dressings when they are needed. Four Resident questionnaires were received regarding this service. All stated that residents feel they always receive the care and medical support they need. Records of deceased Residents showed that staff had made sure pain relief was given and families involved in care if that is what the resident chose. Records showed that residents wishes regarding their final days and staff had followed funeral arrangements. Thank you cards in the home showed families satisfaction with the care their relative had received. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service Social activities are creative, well managed and varied. Social activities are based on the individual preferences of the Residents. Residents have choice and control over their lives whilst living at the home and enjoy the meals that are provided. EVIDENCE: Observation of the visitor’s book confirmed that friends and family have access to the home at any reasonable time. Discussion with relatives confirmed relatives are able to visit their families whenever they chose. A tour of the home confirmed that Residents rooms are personalised by bringing in personal possessions with them to the home. Residents spoken to said they are able to go out for lunch with family and friends. Observations confirmed that some more able residents often go into town independently. Residents spoken to say they always receive post unopened and are able to make and receive telephone calls in private. Residents said they had routines for their care but these could be changed if requested. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 15 Discussion with the Manager and observation confirmed that the home have an activity co coordinator who works three days a week. Records, discussion with residents and observation confirmed that there is a full mixed activities programme. These include: Dominoes, cake decorating, board games, Making cards, quizzes, film afternoons, bingo, exercise classes, ball games and skittles in the lounge and crosswords. Residents spoken to said they were able to join in with these activities if they chose. Staff said these activities are varied. Residents said they enjoyed the hairdresser visit as this tended to become a coffee morning. Special celebrations are organised by the home, which are attended by other residents. Thank you cards read: ‘Thank you all so much for all you gave us and our guests for her celebration. It was a memorable happy day for us all.’ Other activities advertised include ensuring residents remain involved in the community. Residents said the famous ‘Dawlish carnival’ was held recently and the home is in a prime spot to watch the red arrows display. Residents also said the activity co coordinator takes residents out for walks into town. Records confirmed that musicians and school choirs come to the home to provide entertainment. All residents spoken to said the food was excellent and there was enough to eat. A rota of menus was produced pre inspection. On the day of inspection residents were served braised steak, which residents said was very tender. One resident had opted to have the omelette. Staff have also started weighing residents regularly, which identifies those residents of being at risk of loosing or gaining weight. The GP has prescribed nutritional supplements and staff said the Representative from the food supplement company had come to the home to give a talk. There has been a new chef at the home who explained about the environmental health ‘Safer food better business programme’ which she was following. Observation confirmed that the kitchen appeared cleaner and more organised than at the last inspection. Relative meeting records stated that the chef said residents could ask for one off meals ‘when the fancy took them’. During the inspection care staff were heard offering residents a choice of meals. Residents spoken to said they were always offered a drink and biscuits at coffee time, and cake/biscuits with the afternoon drink. Discussion with the Manager confirmed that staff have access to food and drink at all times of the day or night just in case residents were hungry. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 16 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): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service The recent training in adult protection awareness will help to protect Residents. Residents feel able to complain knowing the manager will act on issues and concerns appropriately. EVIDENCE: Residents spoken to said they felt safe at the home and that staff were kind and gentle. All resident and relative questionnaires stated that no complaints have needed to be made but they knew how to complain. Residents said they have not needed to complain because things get sorted out before they become problems. The complaint procedure was displayed in the entrance hall and in resident bedrooms. Discussion with the Manager confirmed that they have not received any formal complaints. The Commission for Social Care Commission have not received any complaints. Staff at the home spoken to said they have never had to complain but go to the Manager with small issues, which get sorted out immediately. Discussion with the Manager confirmed that the majority of staff have had their POVA (Protection of Vulnerable Adult) training. The home have local Devon County Council Alerter Guide policies as well as up to date policies and procedures which include whistle blowing which ensure staff are protected if
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 17 they report abuse. The Inspector is aware that the Manager has dealt with allegations of abuse within a different care home and has managed this appropriately. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service Palm Court is a purpose built care home, which provides a safe comfortable home in which Residents are able to stay as independent as possible. The home has a good standard of décor, furnishings and fittings, which provide a comfortable pleasing environment for residents to live in. EVIDENCE: Palm Court is a purpose built care home. There is a large dining room on the ground floor, which residents appeared to enjoy at lunchtime. There is also a large lounge on the second floor with uninterrupted sea views. These rooms are furnished in a domestic yet homely way. There are sufficient levels of natural lighting and ventilation in the building. All rooms are of a similar size and are for single occupancy. Only one of the rooms have ensuite facilities. There are toilets on each floor, which allow wheel
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 19 chair access, and enable Service Users to receive assistance should they need it. There are 14 toilets strategically placed around the home. The bathing facilities consist of wheel in showers, high specification disabled bathing facilities and domestic style bathing facilities. The ground floor wheel in shower is often used by the Service Users. There are disinfecting sluices provided on each floor of the home. Observation confirmed the home was very clean and free from offensive odours. Residents said the cleaning staff were very good and that all areas of the home were spotless. The home employ a maintenance man who performs routine and ad hoc repairs. A tour of the building confirmed that the Provider continues to fund improvements to the home. The redecoration programme at the home is continually ongoing. The Provider has purchased new specialist beds, hoists and sliding sheets. There are plans for further development at the home, which the Provider explained at the inspection. A tour of the building confirmed that the staff use gloves and aprons and have access to soap and hand towels. The Manager has received the latest department of health guidance on infection control in care homes. Training records confirm that infection control training is provided at the home. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service The improving recruitment procedure and staff induction ensure a suitably selected team cares for residents. EVIDENCE: All residents were very positive about the staff. Comments included ‘caring’ ‘wonderful’ and ‘always kind and polite’. Discussion with the Manager confirmed that staffing levels have been stable and the use of agency has not been needed for some time. Off duty rotas confirmed that extra staff have been introduced following demand at peak times of the day. Off duty records confirm generally the aim is to provide one trained staff plus the manager in the morning with 7/8 carers. Then in the afternoon/evening one trained nurse and 4/5 carers until 8.00 and then 1RGN and 2 carers overnight. Residents spoken to said they did not have to wait for their bells to be answered. During the inspection, an emergency bell sounded. The response time from staff was very quick. Residents stated that they get their medicines on time and feel well cared for. Residents said they thought there were enough staff on duty but that they worked very hard.
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 21 Four staff files were inspected on this visit. All files contained all information required to show that all staff have had the necessary checks performed. One file contained a very recent CRB performed by a previous employer. Overseas staff files contained home office information. The Manager confirmed that he does not provide a record of the interview process. It is recommended for equal opportunities that a record is kept to show the procedure is consistent. Written induction records are now made which staff find easy to use. The Manager also has a skills for care, nationally recognised, induction programme which he will be introducing. Off Duty records and discussion with the administrator confirmed that at least 50 of the staff have NVQ 2 or equivalent. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service The manager is supported well by staff within the home with all staff demonstrating an awareness of their roles and responsibilities. The home is well managed and provides a safe place to live. Training at the home is adequate and helps to protect residents, staff and the Provider from risk. EVIDENCE: The Manager has become registered with the Commission for Social Care Commission since the last inspection. The Manager is a Registered Nurse with experience of running care homes. He also has been studying for the Registered Managers Award but has been let down recently by the closure of the training centre. A letter was provided to show evidence of this. The
Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 23 Manager is experienced in the Management of Care homes and updates his knowledge on a regular basis. Communication between the Commission for Social Care Commission and Manager is good. The Manager has also worked hard to try and achieve the Requirements and Recommendations set at the previous inspection. Residents, Staff and Relatives all spoke highly of the Manager and said he was approachable and tried his best to sort out things before they became problems. Records and discussion with staff confirmed that staff receive regular supervision and have daily report sessions each day. Staff also stated that they also receive daily supervision as part of the Management process and through staff meetings. Staff meetings have been held on a regular basis. Minutes demonstrated that the Managers at the home enable staff to voice their opinions and concerns. Resident meetings are held within the home and show that relatives and the residents are kept informed of changes at the home and with the inspection process. Since the last inspection the Manager has worked very hard to perform a quality assurance survey. Positive comments were seen regarding Palm Court. These can be seen in an earlier section of this report. The Manager stated that he has asked the administrator to send out Questionnaires to Relatives, health care professionals and other stakeholders on a random periodic basis. The Home is managed very well. The Manager employs an administrator who is involved in the day-to-day running of the home. Together they have control in how ‘pocket monies’ are recorded. A spot check of two resident ‘pocket money’ was made and both were well recorded, had receipts and had correct balances. Since the last inspection the Provider has looked into setting up individual accounts for the two named residents for whom he has managed finances for a very long time. The Provider is unable to find a bank who would manage this situation appropriately, but gave assurances that receipts and separate records would continue to be made until he could find a solution. Discussion with Residents and Relatives confirmed that, apart from the two named residents, the home do not manage the financial affairs of the Residents and that this is done by the Residents, their families or a solicitor. Up to Date Service Records were seen in respect of fire safety, lift, bath and hoist maintenance, gas and electricity checks, and waste management. Insurance certificates for public, treatment and employer liability were seen. A Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 24 recent Environmental Health report was produced and showed two minor recommendations, which were being addressed. First Aid boxes were present at the home and Accident books were correctly completed. Accident books allow for the reporting of dangerous incidents to RIDDOR and allow follow up and action. Generally the records seen within the home were well maintained. Policies and procedures have been updated. Staff minute meetings showed that staff have been told about these and where they were located. A Training profile was provided to show staff have received training in fire safety, manual handling, first aid, infection control and the protection of vulnerable adults. Since the last inspection the Manager has worked very hard to perform a quality assurance survey. Positive comments were seen regarding Palm Court. These comments can be seen earlier in the report The Manager stated that he has asked the administrator to send out Questionnaires to Relatives, health care professionals and other stakeholders on a random periodic basis. Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 25 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 X 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 2 3 3 3 Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 26 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 Homes 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. Refer to Standard OP24 Good Practice Recommendations Standard not inspected: Doors to Service Users accommodation should be fitted with locks suited to Service Users capabilities and accessible to staff in emergencies to fulfil this standard. Existing Recommendation: The Provider should ensure all staff are interviewed with notes taken to demonstrate the home recruit staff in line with equal opportunities. The Provider should perform an independent CRB and POVA check as well as staff providing their own from previous employer Carried Forward :The Provider must ensure no further accounts held for residents and if an option arises to separate the accounts, this should be done. The Provider should continue to keep detailed accounts and records of these accounts. 2. OP29 3. 4. OP29 OP35 Palm Court Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Nursing Home DS0000050094.V300011.R01.S.doc Version 5.2 Page 28 - 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!
