Inspection on 05/12/07 for Peacemills Care Home

This inspection was carried out on 5th December 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 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 01/12/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Peacemills Care Home Perry Road Sherwood Nottingham NG3 3AQ Lead Inspector Andrew Sales Unannounced Inspection 5th December 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 Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Peacemills Care Home Address Perry Road Sherwood Nottingham NG3 3AQ 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) 0115 960 2539 0115 985 6616 peacemills@btconnect.com Community Care Plus Ltd Anna Baldwin Care Home 40 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (40) of places Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Date of last inspection 31st January 2007 Brief Description of the Service: 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, which is owned by Community Care Plus Limited, was opened in 1991 and consists of a two-storey purpose built building. There are 36 single bedrooms (35 with en-suites) and two double bedrooms (with en-suites). 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. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and a visit to the site was conducted on 5 December 2007 at 10.00am. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. Where possible, we include evidence from other sources, notably District Nurses and Social Workers. We also use information gathered throughout the year, to support our judgements. This may include notifications from the provider, complaints or concerns and the pre-inspection questionnaire, which the provider returned to us prior to a visit to the service. To seek the views of residents, we issued resident’s surveys but did not receive any back. The primary method of inspection used during the visit to this service was ‘case tracking’. This involved selecting three residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. We also spoke with two other residents, who were able to give us their views about the service. We also spoke with two members of the care staff and the activities co-ordinator, who were also very helpful. We spent part of the day discussing records, documents and policies with the deputy manager. All of the key standards were inspected on this occasion. What the service does well: Peacemills provides a domestic and comfortable environment, which is very well maintained and furnished. The manager and staff are very committed to providing good standards of care for the residents. The food is well thought of and residents feel respected and enabled to socialise in a manner that is comfortable for them. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 6 The staff strive to provide consistent and good standards of care and the service continues to comply with the National Minimum Standards. All of the residents spoke highly of the staff saying, the staff are very helpful and kind and, it is very nice here, I’m really glad I chose to come here. Some residents stated that the food was “lovely” and that they liked the social activities and stimulation provided. Relatives are kept well informed, were supported by the staff and managers and said they were ‘always made welcome’. The residents feel they are consulted on matters relating to the running of the home, and receive regular newsletters, which details any forthcoming events and news. The residents spoke positively about their private and communal accommodation. 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. Peacemills Care Home DS0000002298.V355067.R01.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 Peacemills Care Home DS0000002298.V355067.R01.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): 3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are fully assessed prior to moving into Peacemills and they are confident that the home is able to meet their needs. EVIDENCE: All the assessments we looked at were detailed and enabled staff to find out what people needed and what their preferences were, prior to meeting them. We spoke with four people. They all feel that the service is well co-ordinated, they are kept well informed and have access to information, help and advice. They also said the staff were polite and very helpful, this was also supported by observations made throughout the inspection. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 9 The staff we spoke with, demonstrated a sound understanding of the needs of older people and a thorough commitment to their role. They described in detail the assessment and review process, the benefits of good management support and the comprehensive training on offer. People told us that they felt the home’s care staff were well trained and ‘excellent’ in their approach. We looked at the induction program and training schedule. This will help to ensure that staff are able to meet the needs of people admitted. People told us that the staff are well trained and felt they were in competent hands. The staff commented that the induction to the homes procedures and following training equipped them to provide a good standard of care. The home does not provide intermediate care. Peacemills Care Home DS0000002298.V355067.R01.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 personal care needs of residents are planned for and met by knowledgeable and well-trained care staff who strive to make sure residents using this service are treated with respect. EVIDENCE: The care plans have been completely redesigned and record information for all activities of daily living and personal care required. They are very detailed and extremely informative. Assessments and care plans contain suitable action plans for support staff. Resident’s plans contain details of each individual’s health care needs, including tissue viability and continence risk assessments. There is evidence that people have been appropriately referred to health care professionals. Care plans viewed, contained records of visits by district nurses, General Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 11 Practitioners and other professionals. Healthcare professionals were observed visiting on the day. We saw that plans of care are reviewed by managers and key support staff on a regular basis. We observed risk assessments in relation to maintaining independence and risks for all areas of daily living. Staff who spoke with us demonstrated a good understanding of the care planning process and the management of risk. The homes medication administration systems are well maintained. There is a policy and procedures for receiving, recording, storing, handling, administering and disposing of medicines. The home is registered with the local pharmacist and support and advice is obtained as and when needed. We observed medication records and noted evidence of medication reviews and updates. We saw medication being signed for before being administered to a resident. This must change to ensure residents receive the right medication at the right time and to avoid any errors. From discussions with staff, we do not assume this is a widespread practice. The people we spoke with were able to describe what they were supported with and how the staff approached this. All the feedback we received from people suggests that the staff are courteous and understanding when supporting them with any task, whether personal care or practical tasks and that the standards overall were ‘excellent’. Some people were keen to point out that staff would always do extra tasks when asked, but were always mindful of their independence. We observed care staff throughout the day undertaking a variety of support tasks with a professional and courteous manner. Staff commented that they felt the home promoted the independence of people consistently, throughout the induction, training programs and policies and practices. Peacemills Care Home DS0000002298.V355067.R01.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. Residents feel they retain much of their independence after moving into the home. Resident’s maintain contact with family and friends. Residents are supported to access daily activities and access the local community. EVIDENCE: Residents told us they were happy with the level of activities within the home and outside. Resident’s commented that the philosophy of the home and the attitude of the staff enabled them to make choices and felt they were generally well respected. They also felt that staff were always willing to sit and talk with residents when they had time away from essential duties. The staff, residents and relatives told us that games and stimulation are provided regularly. Staff described how they encourage residents to participate in events and outings and take time to sit with those who are less able to Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 13 communicate. Planned trips and events are organised within the home. We spoke at length with the activities organiser who described daily, weekly and monthly activities she planned in consultation with the residents. During the afternoon we saw a movement to music event being held in the dining room. Staff told us that more activities have been organised this year to accommodate a more person centred approach for people who have Dementia. This includes flower arranging, garden club, knitting and puzzles specifically designed for people with Dementia. In addition to internal activities we were told there have been four general outings for residents, two boat trips, some trips out for meals and eight trips out where residents could benefit from one to one support from staff. Staff spoken with, were well aware of residents individual preferences and respect residents choice on occasions where they chose not to participate in events. Residents told us they thought the food was good and there were choices at all mealtimes. They said they can have soup or salad in the evening and were happy with what was available. We looked at the kitchen facilities, where appropriate cleaning schedules were in place and fridge and food temperatures were monitored and recorded. Peacemills Care Home DS0000002298.V355067.R01.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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded by the homes complaints and adult protection procedures. EVIDENCE: We looked at a satisfactory complaints policy and procedures, which are displayed throughout the home. We looked at complaints records, which are well maintained and very few complaints are received. Residents told us that they would raise concerns with the registered manager if they felt the need to. We looked at an appropriate Whistle Blowing Policy and a policy detailing Adult Protection Procedures. The homes policies and procedures for responding to suspicion or evidence of abuse, or neglect, are generally satisfactory. The home has comprehensive policies regarding resident’s money and financial affairs. Two staff told us they had received training in adult protection issues and were fully aware of their responsibilities to safeguard older people. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 15 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 is well maintained and decorated. Residents enjoy the comfortable and well-furnished communal and bedroom areas. EVIDENCE: We were shown around the home and found it to be well furnished and maintained, with a lot of natural light let in, which residents said they liked very much. We were shown many areas in the home, some of which have been redecorated. We saw a suitable number of assisted bathrooms and toilets with access for people with a disability. There are a number of mobility aids in use around the home and staff was able to tell us how individuals use them with staff support. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 16 All the residents told us how they are pleased with the bedrooms and communal areas. We looked at the laundry area, which is appropriately equipped. None of the residents had any concerns about their clothes being cleaned or going missing. We saw appropriate cleaning schedules in operation throughout the home including the kitchen and laundry. There are no malodours present in the home and residents said how important this was to them. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 17 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. Resident’s needs are met by well-trained and competent staff. EVIDENCE: Staff files contained all relevant recruitment documents. The manager confirmed that thorough pre-employment checks are carried out. Staff also told us that all these recruitment procedures had taken place. The residents told us that there were usually adequate numbers of staff in order to meet their support needs, and commented that the staff team are “wonderful” and “always willing to help”. We looked at the current rota. With the current numbers of residents it is recommended that the levels of care staff are closely monitored on a regular basis. We spoke again with staff and the manager and they described how extra staff were included on the rota at key times and that managers were always on hand for extra support. We looked at the rota which confirmed this and we have based our judgement on the overall experiences of residents and relatives. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 18 There is a low turnover of staff at Peacemills. Staff put this down to satisfaction in their work and a very supportive manager. This provides consistency for residents who say they have developed good relationships with staff. Staff files all contained evidence of training in all of the health and safety subjects, dementia awareness, National Vocational Qualification (NVQ) level 2, staff supervision and appraisal plans. The staff demonstrated a sound understanding of their roles and responsibilities and a great insight into the methods of promoting independence whilst supporting older people. They told us that they had attended numerous training courses and have regular updates in all of the mandatory Health and Safety training courses. From the comments and observations made, the staff team are held in high esteem amongst the residents for their commitment, attitude and support. There was evidence that staff receive supervision on a regular basis and staff members did confirm this during our discussions. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 19 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 home is managed well and there is leadership, guidance and direction to staff to ensure residents receive consistent quality care. This results in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: Residents told us the home was well run and the management team were always on hand for support and advice. Staff spoken with, confirmed that they felt supported by the manager and that they are approachable to discuss any issues. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 20 Staff spoken with spoke highly of the manager and deputy manager and stated they felt well supported within their job role. Residents stated that the home’s success is due to the culture of putting residents first and respecting their choices. A relevant policy with regards to the safe keeping of resident’s personal allowances is in place and followed. We checked one resident’s cash held with their accounts records, which were accurate. The staff confirmed they receive regular supervision and attend regular team meetings. Supervision records were observed. Residents stated that they felt they were consulted about day to day issues. Some records of appraisal were viewed. Staff files contained records of supervision and appraisal. Staff spoken with also supported this process. Staff files showed that they have undertaken training in mandatory health and safety subjects. Staff spoken with, were aware of health and safety procedures and commented positively on the training provided. Risk assessments were observed on individual files and are in place for the building and individual residents. Records for Health and Safety monitoring and the servicing of systems and appliances were inspected on this occasion and were found in general, to be up to date. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 21 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 X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 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 X 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 Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement Make sure medicines are signed for after administration. Timescale for action 30/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP27 Good Practice Recommendations It is recommended that staffing levels are kept under close review at all times. Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 Peacemills Care Home DS0000002298.V355067.R01.S.doc Version 5.2 Page 24 - 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!