Inspection on 03/05/07 for Palmersdene

This inspection was carried out on 3rd May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Palmersdene 25/05/06

Palmersdene 06/01/06

Palmersdene 19/07/05

Palmersdene 22/02/05

Palmersdene 13/09/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Palmersdene Grange Road West Jarrow Tyne And Wear NE32 3JE Lead Inspector Sam Doku Unannounced Inspection 3 May 2007 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 Palmersdene DS0000000248.V337163.R02.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. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palmersdene Address Grange Road West Jarrow Tyne And Wear NE32 3JE 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) 0191 428 0660 0191 483 7726 robert.lyall@anchor.org.uk sharon.blackwell@anchor.org Anchor Trust Robert William Lyall Care Home 40 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (40) of places Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2007 Brief Description of the Service: Palmersdene is a purpose built home, which was built in 1990 in a location that could be described as the centre of the local community. It is a 2-storey construction and is close to local shops, bus and metro services. There is also a range of community services such as G.P and religious places of worship. The home has its own driveway and private entrance to the front, in which there are some garden areas with bench seating and a goldfish pond. The home is registered to provide personal care for 40 older people over the age of 65 years. The home is registered to provide care for up to five people who suffer from dementia. The home has 40 single person rooms, which are referred to as flats all with their own en-suite toilet facility. A range of communal lounges, dining facilities and bathing facilities are evenly distributed over the two floors. Palmersdene does not provide nursing care or intermediate care. However, where service uses require nursing intervention, suitable arrangements are made with GPs to support such nursing practices through district nursing/psychiatric nursing services. The scale of charges is £370 to £411 depending on whether it is residential or EMI. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced key inspection involving one inspector and was carried out at 09:30 on the 3 May 2007. The purpose of the inspection was to assess the care practices in the home. The inspection process involved seeking the views of the service users and relatives/representatives. The process also included observations of staff practices and procedures, examination of documents and records and also discussions with staff and management. The registered manager is currently seconded by the provider for a short time to take charge of another care home within the company. In his absence, the deputy manager is acting as manger until his return. The atmosphere and environment within the home was friendly, relaxed and comfortable throughout the time of the inspection. A number of service users and visiting relatives were spoken with. All were very complimentary about the home, the staff and the care provided. Service users appeared cared for and comfortable with the staff. Staff were professional in their manner and in the care practices they were involved in. What the service does well: Service users spoke about the flexible arrangements to allow them to have a lie-in and also to have their meals in their room if they wish. The home continues to provide real choice of meals for service users to choose from. Service users are always offered cooked breakfast and continental style breakfast as alternative. The home has a good system for seeking the service users view about the quality of the meals provided, and this practice continues. The home uses this information to plan for the menu reviews and cooking arrangements. The provider offers good administrative support for the home, which allows the management to concentrate on care issues and staff development. The home is clean and maintained in very good condition. It is safe and comfortable environment and enhances the self-esteem of the service users. The provider provides good training for the staff, which equip them to carry out their duties effectively and efficiently. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 6 Relatives and service users spoke of respect staff show them and the professional way in which they carry out their duties. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of all service users are fully assessed by a social worker and also by the home before they move into the home. This process ensures that the care needs of the individual can be met by the home. It also provides confidence in the service users and their relatives that the home is capable of meeting their needs. Service users are invited to visit the home and to meet staff and other service users before deciding on coming to live in the home. This arrangement gives prospective service users the opportunity to have a feel for the place before moving in. EVIDENCE: Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 9 The home adheres to its written policy of obtaining full assessments from a social worker before admissions are arranged. The home also carries out their own assessment of the individual in their own setting to make sure that they can meet the prospective service user’s needs. These arrangements give confidence to the social worker, the home, the prospective service user and the relatives that the home is able to support and care for the person before they move in. The service users commented positively on these arrangements. Relatives also commented positively and said they found the assessment process reassuring. They said the process provided them with the opportunity to ask questions and seek reassurance about residential care. The home’s service user guide provides good information for prospective service users. The relatives confirmed that they were offered the opportunity to visit the home and they did so with their relatives before making up their minds. Service users also described the arrangements for them to see the home and how the visit helped them decide on coming to live at Palmersdene. This provided a positive adjustment into residential care for some of the service users. Staff stated that in the case of a few service users who have memory problems, it had not been always appropriate to arrange pre-admission visits as this causes unnecessary anxiety for those service users. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The newly introduced care plans fully identify the social and healthcare needs of the service users. The detailed plans enable the staff to provide care that is effective and consistent. The home has good procedures in place for the safe administration of medicines. This promotes and health and welfare of the service users. EVIDENCE: The home has introduced a new care plan format. This sets out detailed care needs of the individuals and action plans are formulated to address them. The new care plans have only just been started so there had not been the Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 11 opportunity to review how effective they are. There are provisions for the new system for regular review of the plans. There are suitable arrangements for meeting the healthcare needs of the service users. There are individual record of contacts with healthcare professionals, including GPs, psychiatrist, chiropody service, dentist, optician and other healthcare services. The home uses district nurses for advice and treatment of pressure area care, tissue viability, and other medical support. This promotes the service users rights to proper healthcare. Relatives and service users confirmed that their healthcare needs are met through the arrangements for them to have access to healthcare facilities. All staff who are responsible for the administration of medicines have had safe handling of medication training. The home has proper arrangements for the storage and administration of medicines in the home. The drugs administration system was examined and there were no discrepancies. The effective drugs administrative system promotes the health and welfare of the service users. Risk assessments have also been carried out for those service users for whom it is thought necessary. The risk assessments are followed by risk management plans to ensure that all staff are aware of how best to manage a specific risk. Service users confirmed that the staff treat them with respect and promote their right to privacy. Comments from the service users include “the staff always knock on my door before coming into my room”, “they treat you with respect here”, “they are often busy but they always stop to talk to you”. Visiting relatives also stated that the staff treat them with respect and dignity. One visitor stated that the staff always keep them informed about her mother’s progress. A number of staff commented on the arrangements for caring for people with dementia. Staff stated that the dementia awareness courses they been on have been helpful in enabling them to understand the needs of the service users better. Staff described the care routines and the general support given to the family and the wishes of the service users who may need help in making their own decisions. Staff have good understanding of the need to provide an environment that the people who have memory problems are able to function better. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Organised social and recreational activities are purposeful and in line with the lifestyle and culture of the service users. This promotes their sense of wellbeing and satisfaction. The service users are supported to maintain contacts with their families, friends and the local community. Such support has enabled the service users to continue to maintain close relationship with their loved ones and the community from which they come from. The service users receive nutritious diet, which contributes to their health and wellbeing. EVIDENCE: Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 13 The new care plan format allows staff to give particular attention to the social care needs of the service users. The care needs of the service users have been clearly identified and methods of addressing those needs have been stated. There is evidence of service users’ religious and recreational needs being fully met. Service users confirmed that they enjoy the activities organised for them, including visits to the home by the local vicar. They also confirmed that they are free to join in social activities if they wish and that they are not made to join in activities if they do not want to. A number of art and craft materials and board games are available for service users to use, which has enhanced the recreational opportunities for them. One service user commented on how the staff continue to support him to maintain his interest in gardening. He said he has been provided with the necessary tools to enable him to enjoy his hobby. Relatives commented that they are aware of the activities that the staff organise for the service users. These include individual trips to the local the shopping centre and the occasional social outings and in-house social activities. Relatives stated that they are able to visit at anytime convenient to them. They said the flexible visiting times make it easier for them to visit more often. Service users confirmed that the daily routines are organised flexibly to allow them to express their preferences. The service users cited meal times and bed times as examples of such flexibility. The service users stated that although there are set times for meals, they can have their meals at separate times or in their room if they wish. This allows individuals to make positive choices about some aspects of their routines. There is a four-week rotational menu in operation in the home. Past menus indicate that the home provides wholesome and nutritious meals for the service users thus promoting good health. Service users were very complimentary of the food. They confirmed that they are provided with good choice and that there is always plenty of food for them. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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 this service. The policies and practices in the home protect the service users from abuse. The home has a complaints procedure that is understood and available to all the service users and their relatives. The procedure and the associated training of staff in protection of vulnerable adult protect the service users from all forms of abuse. EVIDENCE: The home has a written complaint procedure, which is regularly reviewed by the company. Summary of the complaint procedure is included in the Service User Guide and the terms and conditions of residence. There is also a “Whistle Blowing” policy in place and copies of these procedures are also posted in the foyer for service users and visitors to see. Some of the service users and relatives indicated that they are aware of the procedure and would know how to complain if they had a need to do so. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 15 Staff have had training in protection of vulnerable adult and also on the home’s whistle blowing policy. The provider’s adult protection policy is in line with the South Tyneside Council adult protection policy. Staff had good knowledge of the policy and also described what action they would take if they suspect any form of abuse. The home has a system for the recording of complaints they receive. A concern received from a relative was logged in the complaints book and there were entries in the book on how the matter was resolved. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides accommodation and equipment that meet the needs of the service users. This promotes independence and also the self-esteem of the service users. The home is clean and maintained to good standard. All areas of the home are maintained including attention to safety of the environment thus promoting the welfare of the service users. EVIDENCE: Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 17 The home is purpose-built and it is designed to accommodate older people, some of whom may have mobility problems. Access into and within the home remains good and meets the needs of those service users who have mobility problems. Service users who have walking aids such zimmer frames or wheelchairs are able to go round the home with ease. There are specialist bathing facilities and shower rooms to meet the need of all the service users. All the flats have en-suit toilet facility. The home is close to local shops, other amenities, and to local transport routes. These have provided the opportunity for service users to continue to exercise independence and choice and to access to community facilities. Window restrictors have been fixed to all windows and all radiators have suitable covering. Checks of hot water at randomly selected bathing outlets confirmed that hot water did not exceed 43°c. thus protecting the service from accidental injuries. All the servicing records are up-to-date. These include lift servicing, water treatment, fire safety equipment, gas servicing and other maintenance. The home has written policies and procedures relating to safe handling of hazardous materials for staff to follow. The deputy manager indicated that staff have had training in health and safety, infection control and food hygiene. The home is clean and free from offensive odour. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. It was noticed that the laundry door was left unlocked at a time when it was not in attendance. This door must be kept lock at all times when it is not in use for health and safety reasons. The above safety measures, practices and policies ensured that service users live in safe and comfortable environment thus promoting the welfare of the service users. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 18 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. 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 this service. The home continues to maintain sufficient staffing levels that meet the needs of the service users. The good recruitment procedures in the home are robust and effective in safeguarding the safety and welfare of the service users. Care is provided by well trained and competent staff team that ensure a good service for the service users. EVIDENCE: Past rotas showed staffing levels being consistently maintained. Staff confirmed that the home has maintained the appropriate staffing levels which ensured that care needs of the service users are met. Service users and relatives also indicated that there are always sufficient staff on duty to meet the needs of service users. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 19 The home has long established staff team who have been provided with the necessary training to equip them for their job. The majority of the staff have attained NVQ Level 2 or above. Staff spoke of the good training they have received and the benefits to them and the service users. Staff stated that they have had training in moving and handling, first aid, fire safety training, food hygiene, challenging behaviour management, falls prevention and protection of vulnerable adults awareness training. More recently there had been good training for staff in dementia care and this is followed by long distance learning in dementia care for the staff that work on the first floor where the people with memory problems are cared for. The deputy manager confirmed that individual supervision arrangements are taking place more consistently. The records of the most recently appointed staff were examined. These contained evidence of good recruitment procedures being followed. This ensured that the service users are protected from possible abuse from people who would be deemed as not suitable to work with vulnerable people. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager leads a team of competent and committed staff who provide good quality service for the people they look after. The home has suitable arrangements that ensure service users monies are safe and properly accounted for, thus protecting them from financial abuse. There are good care practices in place that protected the safety and welfare of the service users and the staff. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 21 EVIDENCE: The manager has long experience of working in care setting for elderly people. He has social work qualification and has completed the NVQ Level 4 in management. The home has a good system in place for managing the personal allowances for the service users. Details of purchases and receipts are available for those whose monies are held by the home. The company’s Health and Safety policies remain in place. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). Servicing records confirm that all portable appliances have been tested. A record is maintained of regular water temperature tests in the home. Regular servicing of fire equipment, gas and electrical appliances have been carried out by the contracted companies. All the servicing records that were examined were up to date. These included servicing of hoists, water treatment, electrical installation and gas servicing. Up to date servicing and maintenance of these services and equipments ensure a safe environment for the service users and the staff who work there. Records examined indicate that fire precautions relating to weekly fire alarm testing and record of inspection takes place. There are records in the home indicating fire drills and fire instructions with staff. This has been encouraging and contributes to the safety and welfare of the service users. The home has a management quality system in place, which provides guidance to staff on quality assurance systems. Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23(2)(l) Requirement The laundry must be kept locked at all times when there is no staff member in attendance. Timescale for action 30/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Palmersdene DS0000000248.V337163.R02.S.doc Version 5.2 Page 25 - 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!