Inspection on 01/12/08 for Peacemills Care Home

This inspection was carried out on 1st December 2008.

CSCI found this care home to be providing an Good service.

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

Peacemills Care Home 05/12/07

Peacemills Care Home 31/01/07

Peacemills Care Home 12/01/06

Peacemills Care Home 12/07/05

Peacemills Care Home 09/11/04

Peacemills Care Home 18/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Peacemills Care Home Perry Road Sherwood Nottingham NG3 3AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Meryl Bailey     Date: 0 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Peacemills Care Home Perry Road Sherwood Nottingham NG3 3AQ 01159602539 01159856616 peacemills@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Community Care Plus Ltd Name of registered manager (if applicable) Anna Baldwin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: Community Care Plus Limited is registered to provide accommodation and personal care for service users of both sexes whose primary needs fall within the following categories: 1. Dementia over 65 years DE(E) up to 40 2. Dementia (DE) up to 5 3. Service users in the category DE to be aged 50 years and above. The maximum number of service users to be accommodated at Peacemills Care Home is 40. Date of last inspection Brief description of the care home The last inspection of this home was 5 December 2007. Peacemills is a care home providing personal care and accommodation for 40 older people. The home is located on the outskirts of Sherwood, a residential district in Nottingham approximately 3 miles from the city centre. There are a small number of local community shops near to the home and Sherwood itself has many other amenities including shops, pubs and restaurants, and a community centre. The home consists of a two-storey purpose built building. Care Homes for Older People Page 4 of 25 care home 40 Over 65 40 5 Brief description of the care home There are 36 single bedrooms (35 with en-suites) and two double bedrooms (with ensuites). There is a car park to the rear of the property and a small garden. The fees for the service range from £267.24 - £352.08 per week depending on dependency needs. There are additional charges for hairdressing and chiropody. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the providers capacity to meet regulatory requirements and minimum standards of practice and it focuses on aspects of service provision that need further development. We reviewed all of the information we have received about the home since the last report of our key inspection in December 2007. Services are now required to fill in a document called an Annual Quality Assurance Assessment (AQAA), in which the registered manager identifies what the service does well and what they need to improve. We received a completed AQAA form prior to this inspection. We considered Care Homes for Older People Page 6 of 25 this in planning the visit and deciding what areas to look at and the information has been taken into consideration within this report. We carried out the inspection visit with one inspector. It was unannounced and took place on one day in the daytime, including lunchtime. The main method of inspection we used is called case tracking which involved us choosing a sample of people who live at the home and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We looked at staffing records and other records connected with the running of the home. A partial tour of the premises included shared areas and a sample of bedrooms. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering this home can be confident that their needs will be assessed before they move in, so that staff at the home can meet the identified needs. Evidence: There were pre admission assessments within the case files seen. These covered all areas of health and personal care needs. Further risk assessments regarding risks of developing pressure sores and moving people had been carried out as soon as people moved in. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care is planned and risks are assessed so that appropriate actions can be taken to meet needs. Peoples respect and dignity is maintained when staff offer them support. The absence of some medication records and defective cool storage also poses potential risks of people not receiving their medicines as prescribed. Evidence: There were individual care plans for each person and these were concise and in response to needs identified in assessments. Staff spoken with said that they look at the plans and follow them as well as following verbal instructions and that they communicate with one another about how to meet specific needs. The care plans had been reviewed and updated regularly. The team leaders were responsible for reviewing plans and there were supervision notes on staff files to show that the manager supervised staff appropriately in maintaining the care plans. There were daily notes recorded when significant events had occurred. Individual risk assessments for moving people resulted in clear directions to staff and Care Homes for Older People Page 12 of 25 Evidence: equipment was in place where it was needed to relieve pressure. We saw turning charts completed by night staff. One person was in bed during the inspection and we saw appropriate attention being given. There were notes about contact with doctors, district nurses and other specialist services. We observed one of the staff administering medication and appropriate procedures were being followed to make sure people received their medication safely. The staff person initialed the record chart after giving tablets. We looked at previous Medicine Administration Records and found that they had been completed most times, but in one week (10 to 17 November 2008) there were several gaps when no initials or code was used to confirm whether or not medication was given. The Team Leader informed us that the manager had already found these gaps and had taken action to investigate what had happened that week. There were no gaps for the two weeks prior to this inspection. All medicines were held securely. There was a refrigerator to keep some medicines cool, but we saw that ice had formed and the temperatures recorded on a daily basis were inconsistent and showed that the contents of the refrigerator were not always stored at the recommended temperature. We observed staff speaking individually showing respect towards people at all times. People told us that they thought staff were respectful, describing them as very kind and helpful. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home benefit from a lifestyle that includes structured activities to stimulate and develop their skills and interests. Evidence: An activities worker was employed at the home and was present during this inspection visit. She demonstrated that there were a range of activities available from her records kept in an Activities Journal that is completed each day. This included group and individual games and puzzles on a daily basis and some regular weekly activities of quizzes,flower arranging and Arts and Crafts. A social history was completed for each person so that activities could be offered to meet individual needs and interests. During the morning we saw four people playing dominoes and others involved and watching the Christmas decorations being put up. Christmas music was played and people were encouraged to sing along. There was a record of a meeting held on 25 November 2008, which was attended by eighteen people living at the home. Christmas activities were discussed at that meeting. People told us there had been three trips on a narrow boat during the year and some had been shopping individually with one member of staff. The activities worker also told us that she accompanied groups of four to pub lunches. The team leader said that there Care Homes for Older People Page 14 of 25 Evidence: were monthly church services. The main meal for the day was served and there was a choice of chicken or vegetable pie with potatoes and vegetables. There was also Cherry pie or strawberry flan. People had already made their choices, but most could not remember and could not see the menu on the chalkboard. Most people seemed to enjoy their meal and comments ranged from Its usually alright, the gravy is too thick to Meals are lovely here. A mixture of fresh, frozen and tinned foods was used. People needing assistance were helped by staff sitting next to them. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured their concerns and complaints will be taken seriously. Evidence: Since the last inspection there had been eight complaints made to the manager at the home within twelve months. There was a file kept that showed that they had been dealt with according to policy and procedure and all but one had been resolved within 28 days. The Commission has not received any concerns about the handling of these complaints. The complaints procedure was displayed on a notice board and we also saw a copy in the Service User Guide. Staff spoken with were aware of what was meant by safeguarding people from abuse and said they would report to the manager any suspicions or concerns. There were copies of certificates on staff files to show they had received training in Safeguarding Adults in May 2008. The manager had already contacted us about a concern that had recently been raised with her and she had made appropriate contact with the Nottingham City Adult Care Team, who investigated, but found no evidence of any harm. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and people living there benefit from a comfortable and clean environment. Evidence: We saw all shared areas and a sample of bedrooms that all appeared well maintained. Signs and photographs were put on doors to help people identify their own rooms and other facilities. Seating in the main lounge was grouped to provide smaller sitting areas. There was a choice of type of chair to sit in. The bedrooms we saw were individual and people told us they had what they needed in their own rooms. The laundry was appropriately equipped and we saw appropriate cleaning schedules. Cleaning was ongoing and the home was generally clean and fresh throughout. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are on the premises at all times to meet peoples needs. The current recruitment practice is not sufficient to guarantee that people are protected. Evidence: The rota showed there were four care assistants, including a team leader, caring for 39 people in the day time and three care assistants at night. There was an additional team leader who was deputising for the manager for the day. There was also a cook during the morning and a kitchen assistant in the afternoon. The activities worker and administration staff were employed in addition to this. The layout of the building meant that the majority of people spent their day within one area. We observed staff talking individually with people and no one appeared to be waiting for attention to their needs. Staffing records showed that full checks by the Criminal Records Bureau (CRB) had been completed for each member of staff and references were obtained prior to people starting work at the home. However, there was no written assessment to confirm that the some information received had been thoroughly considered in the decision to employ people as appropriate to work in the home. The team leader contacted the registered manager by telephone who said that she had made an assessment, but not written anything down. Care Homes for Older People Page 18 of 25 Evidence: The Annual Quality Assurance Assessment that was completed by the registered manager in October 2008 stated that 3 of the 16 permanent care assistants employed at the home had completed an National Vocational Qualification in Care at Level 2. We saw records to show that new staff receive induction training. There were copies of certificates on care assistants files for recent training related to the safe working topics of Fire Safety, Moving and Handling and Health and Safety. Some had also attended training about the Mental Capacity Act and Team Leaders had been trained in Person Centred Care. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements ensure efficient running of the home and systems are in place to monitor the quality of the service people receive. Evidence: The manager is registered with the Commission. She was not available during this inspection and a Team Leader was given short term responsibility for management. She was in contact with the registered manager by telephone during the inspection. The completed Annual Quality Assurance Assessment (AQAA) form was sent to the Commission when we asked for it. Quality was regularly monitored in the home with the use of questionnaires. The team leader told us that people living there and relatives were encouraged to complete the questionnaires and place anonymously in a box. There were records of meetings held every two months to allow people and their families to feedback to the manager any issues or ideas they may have. Eighteen people attended the last meeting in November 2008. The record showed that Care Homes for Older People Page 20 of 25 Evidence: Christmas arrangements and Home Improvements were discussed. The manager stated on the AQAA form that she speaks individually with people that do not attend the meetings. Some people we spoke with confirmed they often speak with the manager. Management of peoples financial arrangements was written down within their case files, showing who had responsibility for these. We looked at the practical arrangements for looking after peoples money and checked some amounts held. Balances were accurate and there were clear, signed records of all transactions. As already stated in the previous section, within the staffing records we found evidence that staff had been trained in working safely. There was an accident book for writing down any accidents to staff or people that live at the home. We found that this had not been used as designed to protect personal information. Forms had been completed, but left in the book. There was no clear indication of action taken by the manager following the accidents, although staff had written about some in the daily notes. We found records of regular safety checks and servicing of heating and electrical systems and appliances had all been carried out within the last year. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 All medicine records must be 27/02/2009 completed in full and cool storage must be appropriately monitored and adjusted. This is to ensure people receive their medicines safely as prescribed. 2 29 19 Make a written assessment of all information received when recruiting staff to demonstrate that they are fit to be employed in the care home. This is to ensure the protection of people living in the home. 27/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 Display the menu clearly using photographs of the meals available. Page 23 of 25 Care Homes for Older People 2 3 28 38 Support more staff to attain a National Vocational Qualification at level 2 in Care. Staff should remove accident forms from the record book once completed and the manager should assess if sufficient follow up action has been taken before filing the forms. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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