Inspection on 06/07/05 for Palm Court Nursing Home

This inspection was carried out on 6th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Palm Court Nursing Home 25/09/06

Palm Court Nursing Home 16/11/05

Palm Court Nursing Home 10/11/04

Palm Court Nursing Home 14/04/04

Palm Court Nursing Home 14/10/03

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Queensmount

Credence House

Poldhu

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

CARE HOMES FOR OLDER PEOPLE Palm Court 7 Marine Parade Dawlish Devon EX7 9DJ Lead Inspector Clare Medlock Announced 6 July 2005 th 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 D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Palm Court Address 7 Marine Parade, Dawlish, Devon, EX7 9DJ 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) 01626 866142 01626 888580 palmcourt@eurobell.co.uk Mrs Lorraine Jacqueline Greenaway Mr Graham James Greenaway Vacancy Care Home with Nursing 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 D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. As a condition of registration minimum staffing levels for full occupation will be as stated in the signed letter of agreement dated 16th September 2. Registered for maximum of 3 OP 3. Registered for maximum of 3 LD 4. Registered for maximum of 36 PD(E) Service Users aged 65 years and over 5. Registered for maximum of 3 DE(E) Service Users 65 years and over 6. Registered for maximum of 3 MD(E) Service Users 65 years and over Date of last inspection 10 November 2004 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. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over six hours on Wednesday 6th July 2005. The Inspection found that the majority of the standards were met and the overall quality of care was very good. The home have been subject to many changes in the last two years which have consisted of change of ownership and two changes of management. This inspection consisted of speaking with Service Users (Who have requested to be called Residents), family and friends, staff and management within the home. A full tour of the premises was conducted. Care records, staff files, policies and procedures and other records were inspected. 4 of the 34 Residents, two relatives, and six staff were spoken to. Three Relative questionnaires and three Service User questionnaires were received. Not all standards were inspected in depth on this occasion, therefore it is recommended that previous reports are obtained to gain a broader picture of events within the home. What the service does well: Palm Court Nursing Home provides a very good level of Nursing and Personal care. A dedicated well qualified staff group ensure that Residents have all their needs met and ensure residents access a full variety of services. The routines within the home are flexible depending on the choice of the residents. Residents spoken to were very happy living at the home and were full of praise for the staff within the home. The staff group are keen to maintain the high standard of care and enjoy a good team morale despite the absence of a permanent manager. Residents and staff were seen to enjoy a genuinely caring relationship. Staff have a good understanding of the needs of Residents and importance of choice, respect, privacy and dignity. The residents enjoy the well balanced, nicely presented meals which are served in attractive surroundings. The home is a purpose built building yet retains a homely atmosphere. The standard of cleanliness within the home is very good. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 6 Staff within the home organise the activities programme and encourage residents to maintain contact with friends, family and the local community. The home is well maintained and equipped to ensures Residents are helped to maintain independence. What has improved since the last inspection? What they could do better: Residents need to be safe at all times. Measures must be taken urgently to ensure care is not given without careful planning, consideration and consent from residents and families. Staff should receive training in the many different types of adult abuse, know how they can be prevented and how abuse should be reported. Communication needs to be improved at Palm Court to raise the standard of service provided. Written communication in the form of statement of purpose, Service User Guide and contract will ensure residents are informed prior to admission that the home is the right place for them to be. This communication needs to continue after moving into the home. Simple steps such as the introduction of name badges would help to orientate residents. The arrival of the new manager should provide a daily point of contact for residents and relatives. The Manager should be present to receive up dates in care and improve communication between staff, residents and their families. Residents, relatives and staff should have formal ways of meeting with the Manager to voice concerns and share ideas. This could be done formally and informally. This would become part of a quality assurance programme to ensure the care and services at Palm Court are reviewed and improved on a regular basis. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 7 Communication between staff is already good within the home but often relies on memory which potentially could place residents and staff at risk. Care Plans and records need to be improved to show the level of care that has actually been given. Training records should be maintained to ensure all staff have received the appropriate training and induction. Records should be updated to ensure residents are able to join in with planning their care and letting staff know their wishes regarding all aspects of their care. For those Residents who are unable to communicate or request help, measures must be introduced to ensure staff involve family in the planning and delivery of care. Staff should, for those Residents who are unable to communicate or request help, evidence that checks and care are performed on a regular basis. The actions taken in response to these findings can be discussed with the Manager (Mr Nigel Morris) at the home. 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 D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,4,and 5. 6 is not applicable. Residents and their families are made to feel welcome prior to moving in. Residents are thoroughly assessed prior to admission which ensures the home is the right place for them to be. However, the written information given on admission and before admission is inadequate which may cause confusion and misunderstandings. Residents are cared for by a skilled team of staff. EVIDENCE: Palm Court have a Statement of Purpose and Service User Guide which were found to not contain the correct information. The home has a pre-admission form that covers a total of 23 (twenty three) areas including all the points required by the standard. The nursing staff use this form to make sure that Palm Court is the correct place for residents to be. Once Residents are admitted to the home they have a settling in period and can give a months notice if the home is unsuitable. Residents all have contracts whether they are funded privately or by a third party. Contracts seen appeared to be suitable but did not include the rooms to be occupied. Residents and relatives spoken to said they knew that visits could be made Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 10 prior to admission but that family had looked around before moving in as they were in hospital. Discussion with the Manager and records confirmed that there is a registered nurse on duty at all times and that the staff have a variety of skills and special interests to meet the needs of the Residents. Posters discussion with staff and records confirmed that staff access a range of specialist training. Examples included: Infection control, talks from medical Representatives , wound Care, catheter care, and skin care training. Discussion with staff and Residents confirmed that there are senior carers and trained nurses who organise the workload and supervise care staff. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10 and 11. A newly introduced clear care planning system means that the health and social needs of Residents are planned but does not reflect the high standard of care seen during the inspection. This potentially could place Residents and staff at risk. Staff communicate well with the multi disciplinary team. Changes in the systems for the management of medications have been made, which safeguards Residents. There is an ethos within the home that promotes the privacy and dignity of Residents at all times. EVIDENCE: Three Care Plans were inspected on this occasion. All care plans were in the process of being changed. Observation confirmed that information of what the residents need is gathered from the pre-admission form. A plan of care is then made. Observation confirmed that this care is given but not always recorded in a way that reflects the level of the care given. All Residents seen on the day of inspection looked very well cared for with the finer details of care attended to. Examples included nail, hair and eye care. Residents confirmed that NHS services are accessed and that staff contact the General Practitioner and other multi disciplinary health care professionals Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 12 promptly. Staff stated that whilst residents are able to keep their General Practitioner on admission (If their General Practitioner agrees) the home have an agreement with a local General Practitioner that works well, with the General Practitioner visiting every Monday with extra visits as necessary. All Residents spoken to confirmed that they think that the care they receive is very good Residents said that staff are very kind and sensitive. Observation confirmed that staff knock on Residents doors prior to entering and prevent entry when care was being given to protect their privacy. Residents said this was normal practice. Residents spoken to said that generally they do not have to wait long for the call bell. One resident was keen to show how promptly staff answered the bell despite it being lunch time. Observation confirmed that Residents are able to receive visitors in private and use the telephone in private. Staff spoken to said they felt the standard of care given was good within the home. Observation confirmed that the staff use safe systems for the ordering, receipt, storage, administration and recording of medication. Residents spoken to confirmed that staff give their medications on time and that the staff seek advice from the General Practitioner regarding medication. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 13 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) 12,13,14, and 15. Social activities are creative, well managed and varied. Residents have choice and control over their lives whilst living at the home and enjoy the meals that are provided. EVIDENCE: Residents and staff confirmed that forthcoming activities are displayed on a notice board and by care staff on a daily basis. Residents stated that the activities included: entertainers, singers, visiting pets, pantomime artists at Christmas and church services. Discussion with the Provider confirmed that the activities coordinator has recently left and that staff are ensuring the activities programme continues. Residents stated that they are able to join in or opt out of these activities as they chose. On the day of inspection a physiotherapist was performing an exercise class. Observation confirmed that residents were able to join in as much or as little as they chose. Residents stated that they also provide their own entertainment in the form of trips out into the local town. Observation confirmed that residents are able to ‘go out’ for walks with relatives. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 14 A tour of the building confirmed a photograph board which demonstrated activities which included a visit to a zoo and staff participation in the local carnival. One resident stated that the carnival is a highlight within Dawlish and that the home benefit from views of the red arrow display. All residents spoken to felt they had enough choice whilst living at the home. Residents stated staff will help them with what they choose to do. Residents spoken to said they prefer a routine but know that staff help if they chose to go out or have a lie in. Observation confirmed that residents are able to wear their own clothes. Residents stated that they are pleased with the laundry service that is provided within the home. All relative questionnaires and discussion with relatives confirmed that staff welcome visitors to the home. The visitors book confirmed that relatives are welcomed at the home at all times. The Pre inspection questionnaire confirmed the home have a four week menu plan which appeared to be nutritious and well balanced. A tour of the kitchen confirmed there was plenty of fresh fruit and vegetables and that the management of the kitchen appeared to be good. Residents said that the food was generally good. However, during the inspection comments were given that feedback was sometimes difficult to give to the chef. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 15 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) 16,17,and 18 The complaints process within the home is adequately managed and ensures Resident’s views are listened to and acted upon. The inadequate knowledge of adult protection issues, lack of key documents and training is placing Residents at high risk. EVIDENCE: The home has a complaints procedure and a book held by the registered manager that records complaints and incidents and how they were investigated with the outcomes recorded. The complaints procedure is held in the Statement of Purpose and Service Users Guide as well as displayed at the entrance of the home and in each of the Service Users rooms. The home and the CSCI have not received any formal complaints since the last inspection. Residents stated that they were able to vote at the last election by either postal vote or by going to the polling station. Discussion with the administrator confirmed that the electoral register is updated each time it is sent and staff within the home assist residents with their preferred method of voting. Staff spoken to did not know the correct reporting procedure if adult abuse issues were suspected. Staff stated that there was a video but no formal training had been given in respect of adult protection issues. Observation confirmed that the home did not have the Devon County Council Alerters Guide or information on local reporting procedures. Observation confirmed that the use of bed rails was common practice within the home. Staff confirmed that residents were happy with this practice, but Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 16 there were no records to confirm consent and detailed care planning had been performed. These shortfalls are placing residents at high risk and must be addressed as a matter of urgency. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 17 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) 19,20,21,22,23,24,25 and 26 Palm Court Nursing Home is a purpose built and 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 lunch time. 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 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 Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 18 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. The home also has its own hairdressing salon. Each room appeared to be clean and decorated. Discussion with the provider confirmed that residents are able to chose the décor if they wish. Observation confirmed that residents are able to bring in items to personalise their own rooms. The majority of rooms had adjustable beds. The bedroom doors do not have door locks fitted. Risk assessments were available but not inspected. Residents said if they asked for one to be fitted, they were confidant this would be done. All rooms have telephone points and a private phone line can be established if a Service Users wants one. All doors had closure systems which allow residents to have their doors open or closed, but automatically close with the onset of the fire alarms. Discussion with the maintenance man and records confirmed there is a rolling programme of decoration and repairs to the home as well as the daily ad hoc repairs. The maintenance man explained how residents and staff are prevented from legionella within 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. Records confirmed that’s some staff have received infection control training and have access to the Health Protection Agency Infection Control guidelines. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 19 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) 27,28,29, and 30 There is a dedicated stable staff group at the home who meet the needs of the residents well. The staff files and recruitment procedures are adequate. The lack of induction records means that staff rely on memory and communication to ensure staff are prepared which places Residents at risk. EVIDENCE: Despite two changes of manager the sickness rate and staff turnover has been low within Palm Court. Staff spoken to said staff rally round and fill in gaps so that agency use is kept to a minimum. Staff stated that morale is generally good with support being provided by two senior carers and trained nurses. Off duty confirmed that staff levels are stable. On the day of inspection there appeared to be sufficient numbers of staff to meet the needs of the residents. All staff seen on the day of inspection were extremely polite, professional and cooperative. All staff were in a uniform but none of the staff were wearing a name badge. Staff spoken to confirmed that name badges were not issued. Five staff files were inspected, although not in depth. Newly appointed staff files contained all the information necessary. Discussion with staff confirmed that new staff are supported well but no records or check lists are used to ensure that new staff are well orientated to the home. Discussion with the deputy Manager confirmed that many staff are Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 20 doing NVQ training. Once this training is completed the home will meet the standard that states that 50 of staff must have NVQ2 or equivalent. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 21 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) 32,33,34,35,36,37 and 38 Although staff within the home have coped well on a day to day basis, the changes of, and lack of, permanent manager have affected the communication within the home. EVIDENCE: There have been changes of management within the home. Discussion with the Provider confirmed that an experienced manager has been appointed and is due to commence a few days following this inspection. Discussion with staff confirmed that all staff have taken on extra responsibility to ensure the residents are not affected. Staff stated that morale continues to be high and support given by the Provider, Administrator, Trained staff, senior carers and from each other. Staff stated that supervision has not occurred during then absence of the manager. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 22 Residents spoken to have missed the presence of a Manager and are looking forward to the new manager starting at the home. Residents stated any thing they need on a day to day basis is managed by the staff. Discussion with relatives confirmed that whilst care given is good, communication between staff and families has been affected. Resident questionnaires stated that staff welcome relatives to the home but the lack of manager means the relatives have to go and find someone to receive up dates or feedback about their relatives. Feedback cards also sated that family members are rarely consulted about the care of their relative. Feedback cards confirmed that generally the care seen was very good but communication could be improved within the home. Discussion with the Provider confirmed the anticipation is that communication will be improved when the new manager arrives. Discussion with staff confirmed that staff used to have meetings but that these have not happened recently. Discussion confirmed there are no resident or relative meetings and that feedback is given on a daily informal basis with reduced confidence that anything will be done about issues. An example given was the food. It was stated that although the food was generally good, there is no way to feedback ideas or opinions. Records confirmed there is an improvement programme and check list in respect of maintenance of the building but not of the nursing or social care residents received. Discussion with the administrator, Provider and observation confirmed that the home have adequate insurance and financial cover for the home. Residents also are able to keep a small amount of personal money with the administrator to spend on what they chose. Discussion with residents, relatives and the Provider confirm that in the majority of cases, either residents or families manage the personal finances of residents. The home manage the personal finances of a small number of residents. Discussions highlighted improvements to the management of these accounts to safeguard the residents and the home. Generally, records seen within the home were secure and well maintained. However, care plans did not reflect the level of care given and the absence of formal records could potentially place residents at risk. Policies and procedures within the home had not been up dated and training records were not available to evidence the mandatory training provided. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 23 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 1 2 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 1 x 2 1 3 1 1 1 2 Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 24 no 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 OP1 Regulation 4(1-3) Schedule 1 Requirement The Manager must ensure the Statement of Purpose contains information listed in schedule 1 which includes: 1.The Name and address of the Provider and Manager 2.The relevant qualifications of the registered provider and manager 3.The number, relevant qualifications and experience of staff working within the home 4.The organisational structure of the care home 5.The age range, sex and range of needs of that the care home is intended to meet including whether nursing is to be provided. 6.Details of the admission procedure 7.The arrangements for residents to engage in social activities, hobbies and leisure interests 8.The arrangements made for consultation with residents about the operation of the care home 9. The Fire precautions and emergency procedures in the care home. Version 1.40 Page 25 Timescale for action Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc 2. Continued 3. OP1 5(1-3) 4. OP7 15(2c) 5. OP11 12 (2&3) 6. OP15 12 (2&3) 21 13 (4c) 13(6) 13(8) 7. OP18 10. The arrangements made for religious services, contact with friends and families. 11. The complaints register 12.The arrangements made for dealing with reviews of the care plans 13.The numbers and sizes of rooms within the home 14. Details of specialised treatments given at the home 15.The arrangements made for maintaining privacy and dignity. The Manager must ensure the Service User Guide contains: 1. A summary of the Statement of Purpose 2.The terms and conditions of the accommodation provided and detail of fees 3. A standard contract 4.The most recent inspection report or where this may be found 5.A summary of the complaints procedure with contact details for the CSCI The Manager must ensure: 1. consult with residents and/or relatives regarding the care plan 2. Ensure records are kept which reflect and demonstarte that care has been delivered The Manager must ensure that the wishes and feelings regarding terminal illness and death are recorded in care plans The Manager must ensure residents and staff have opportunities to give feedback and opinions regarding the food. The Manager must: 1. Ensure all staff training in adult protection issues, so staff are aware of the different types of abuse and what to do if abuse is suspected. 2. Ensure the home have copies 31/10/05 31/10/05 31/10/05 31/10/05 31/10/05 31/10/05 Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 26 8. OP30 18(1c) 9. OP32 12(2&3) 21(1) 10. OP33 24(1a&b) 11. 12. OP35 OP36 13 18(2) 13. OP38 18 (c) of the Devon County Council Alerters guide. 3. Ensure all staff are educated on the appropriate use of bed rails and lap belts 4. Ensure that is bed rails and lap belts are used as a result of the care planning process that conseent from the resident or next of kin is obtained. The Manager must ensure that the induction process is formalise to ensure staff have all the skills and knowledge required prior to working at the home The Manager must take steps to improve the communication within the home. The Manager must introduce systems to enable residents and staff to voice concerns and ides and to up date family. The Manager must introduce and maintain a system for reviewing and improving the qulaity of nursing and social care provided at the home. The Provider must ensure any accounts held for residents are separate and not pooled. The Manager must ensure staff are supervised at the home including clinical supervision for staff The Manager must ensure evidence is provided to show all staff have mandatory training in respect of moving and handling, Infection control, food hygeine, first aid, fire safety and adult protection 31/12/05 31/12/05 02/04/06 31/10/05 31/12/05 31/12/05 Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard OP2 OP7 OP18 OP28 OP24 OP37 OP32 Good Practice Recommendations The Provider should include the room to be occupied on admission to the home on the contract. The Manager should devise a check list to ensure residents who can not call for help or who are being nursed in bed are checked on a regular basis. The Manager should ensure all staff the free training provided by the multi disciplinary adult protection team The Manager should ensure staff complete NVQ training to meet the standard 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. The Manager should ensure that all policies and procedures are relevant to the home and up dated on at least an annual basis The Manager should consider the introduction of name badges to improve communication within the home. Palm Court D54-D07 S50094 Palm Court V225760 060705 Stage 4.doc Version 1.40 Page 28 Commission for Social Care Inspection 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. 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