Inspection on 05/07/07 for Pendlebury Court Care

This inspection was carried out on 5th July 2007.

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

Pendlebury Court Care 13/07/06

Pendlebury Court Care 08/11/05

Pendlebury Court Care 01/06/05

Pendlebury Court Care 01/02/05

Pendlebury Court Care 23/09/04

Pendlebury Court Care 31/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Pendlebury Court Care St Mary`s Road Glossop Derbyshire SK13 8DW Lead Inspector Brian Marks Key Unannounced Inspection 5th July 2007 09:00 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 Pendlebury Court Care DS0000028409.V340319.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. Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pendlebury Court Care Address St Mary`s Road Glossop Derbyshire SK13 8DW 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) 01457 854599 Pendlebury Healthcare Limited Vacant Care Home 31 Category(ies) of Dementia (19), Old age, not falling within any registration, with number other category (31) of places Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2006 Brief Description of the Service: Pendlebury Court is a care home registered for 31 places for the care of older people, including 19 places for persons with dementia. The home is situated in the town of Glossop in the High Peak and is within walking distance of the town centre where there are many shops and amenities, including the post office, chemists and newsagents. The home offers single room accommodation, with 25 bedrooms having en suite facilities, and is split over two floors with communal and dining areas on each level. The home has a shaft lift. The current accommodation fee for Pendlebury Court is £333 - £380 per week. Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a Key unannounced inspection that took place at the home over a period of a day. Additionally, time was spent in preparation for the visit, looking at previous inspection reports and other relevant documents and preparing a structured plan for the inspection. At the home, apart from examining documents, care files and records, time was spent speaking to the manager, who was in charge of the home during the visit, and seven of the staff working during the day. The care records of four people who use the service were examined in detail and two of these were interviewed along with three others and two visitors who were at the home during the day. As the majority of people living at the home are suffering from varying degrees of dementia direct feedback was limited to those residents already mentioned. Some time was spent by the inspector informally observing the care being given by staff and of the interactions they were having with the people living at the home. No other inspection visits have been made to the home since the last Key unannounced inspection on 13 July 2006. What the service does well: What has improved since the last inspection? Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 6 The appearance of the home continues to be to a good standard, and a programme of redecoration has been started. A homely appearance has been created and bedrooms are personalised with the occupant’s photograph on the door. Progress has continued in staff training and increasing numbers of staff have completed the National Vocational Qualification (NVQ). Care staff vacancies have recently been filled. The appointment of a new manager has provided stability at the home and a lot of progress has been made in re-establishing a proper operation. 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. Pendlebury Court Care DS0000028409.V340319.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 Pendlebury Court Care DS0000028409.V340319.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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care needs of people coming to the home are properly looked at so that they can be reassured that the home is suitable for them to live in. EVIDENCE: The home does not provide intermediate care. The new manager has introduced a revised format for all care records and the files of the established residents that were looked contained admission assessment forms that briefly described the areas they needed help with. However, the records of another person who had been admitted the previous week held much more detailed description of the problems they are facing and also help and care the home was able to provide. All the records looked at had further additional assessments of areas of risk such as safe moving, skin breakdown and pressure sores, falls and nutrition. These allow for the development of caring activity in a planned way, and the latter – ‘risk assessments’ – allowed for an annual review to make sure they are based on up to date information. Further information on life histories and preferences is obtained through contact with family members, although this was not available Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 9 in some of the files examined and the levels of information did not give a full picture of the whole person. People wanting to come and live at the home are give opportunities to visit before coming to stay, as part of the assessment procedure. Pendlebury Court Care DS0000028409.V340319.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 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessment records promote safety and consistency in caring for residents and care is given in a way that respects individuality and privacy. Regular reviews of care are not taking place so that key areas of need may not be met, particularly where good health care is concerned. EVIDENCE: All residents have their own file containing care records and four of these were looked at in detail during this inspection. The care plans identify key areas that people need help with, as well as their preferences and abilities, and areas in which they are independent. Additionally, by incorporating information from the initial assessments of risk, care activities are identified. The newly introduced format for care records does not indicate that they are being routinely evaluated on a monthly basis and revised where necessary but the records do indicate that residents have been consulted within the care planning process. The care records examined indicate where residents require access to health care services such as chiropody, district nurse and GPs, but earlier in the year Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 11 a number of concerns were reported that indicated that this was not routinely happening particularly in relation to the care of pressure sores. The updated records and staff training will allow for better identification of health care needs but it was noted that the issues identified for one person at a recent stay in hospital had not been written up within the care plan although the manager and staff were individually clear about what was involved. This could once again lead to unsafe care being given. All residents or their relatives spoken to commented that staff care for them in ways that respect their dignity and privacy and this was echoed by entries in the care plans. Examination of the arrangements for the receipt, storage and administration of medicines to residents indicated these to be generally satisfactory. Medication is stored securely and the home uses the ‘Monitored Dosage System’ for administration; all entries are properly checked, signed and dated. It was noted that a medicine prescribed for occasional use by one person was being given daily and the GP had underwritten this for an increased dosage, which could lead to confused practice. There were no controlled drugs being administered at the home at the time of the inspection. All senior staff, as well as the manager, have undertaken medication training. Pendlebury Court Care DS0000028409.V340319.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for residents to engage in leisure and social activities have continued to improve and they enjoy lifestyles, routines and meals that meet their requirements. EVIDENCE: The residents and visitors spoken to confirmed that they had a happy life in the home and were able to do much as they liked. An activities coordinator has recently been appointed to the home and she discussed her plans to improve the social life at the home; she was observed with groups of residents during the afternoon of the inspection. Residents confirmed that they had daily routines that suited them, and that they had the free run of the home. Contact with families is encouraged through an ‘open door’ policy, and a number were seen at the home during the inspection. Those spoken to were positive about relationships with the home’s staff: ‘They’re very approachable and always try and sort things out’. ‘We get involved with the staff and other residents and now take small groups out for visits. We’re going to Blackpool at the end of the summer with a big group’. Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 13 A brief visit was made to the kitchen and the person standing in for the cook described current arrangements. Good standards in the catering service have continued, although a regular menu was not being followed and repetition of meals could result. A choice was available at the main meals, and this was conformed by comments from the residents and relatives spoken to, who were very positive about the quality of food served. Arrangements are made by the cook for people with special dietary needs, and one resident who cannot have a complex range of foods – a gluten-free diet – described how her requirements were successfully followed. Pendlebury Court Care DS0000028409.V340319.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home responds to complaints made by people living at the home and their representatives according to a written procedure, and aims to protect them from harm. EVIDENCE: The home has a complaints procedure, which is available to residents and their friends and relatives and two complaints have been recorded since the last inspection. Earlier this year five concerns were passed to the Commission via local Social Services Office and two of these resulted in application of the statutory Safeguarding Adults procedures. The proprietor for the home was directly involved in discussions about dealing with issues arising from these concerns and was prompt in taking direct action to resolve the difficulties. One of the key outcomes arising from these difficulties was the transfer of the current manager from another home in the company’s group and she has been instrumental in making sure all staff at he home are aware of the current procedures and responsibilities for safeguarding vulnerable people in their care. The relatives of people living at the home who were spoken to confirmed this were comfortable about approaching the home’s management about any problems and are confident that they will always be listened to. Whilst examining the home’s written procedures it was noted that the details contained in them does not reflect Derbyshire’s joint procedures for the protection of vulnerable adults, and although the correct process was followed previously a confusing picture is being given. Awareness of this important Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 15 responsibility has been improved from discussions with members of the staff group. Pendlebury Court Care DS0000028409.V340319.R01.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home live in a clean comfortable and well-maintained environment. EVIDENCE: The home was purpose built in the early 1990’s and is spacious, light and airy with wide corridors and doorways for easy access. The home has continued to be maintained to a good standard and there has been an on-going programme of redecoration and refurbishment, starting with the communal areas, toilets and bathrooms. There is an outside patio area that gives a comfortable area for residents to use in periods of good weather. A visit to one of the bedrooms indicated very high temperatures of water being delivered from the sink and the only measure that seems to have been taken to control risks is notice referring to this on the wall. Referring to the temperature check records indicated that this is a feature of a small number of other hot water taps used by people living at the home and the risk of scalding is present. Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 17 Cleaning standards of the home and with the cleanliness of clothing worn by all residents were very good on the day of the inspection, and the manager commented favourably on the efforts that domestic and housekeeping staff put into their work to provide a good service. Pendlebury Court Care DS0000028409.V340319.R01.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 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The staff group is trained, experienced and competent but numbers of care staff on duty has recently been reduced and the home’s capability to meet needs of people living at the home may have been compromised. The safety of the staff recruitment system recently failed for a newly appointed member of staff so that residents’ safety may be affected. EVIDENCE: There were no vacancies in the staff group at the time of the inspection and staff roster indicated that the previous high use of agency staff has now been eliminated, providing consistency and continuity of care. Whilst staff described an unhurried approach to their work and they were observed sitting and talking with residents at different times during the inspection, the staffing roster indicated that the previous level of care staff on duty had been reduced from four to three on most shifts. Additionally one relative during the inspection and another afterwards expressed their concerns that the care staff group is sometimes ‘light and people are left unattended to’. This was reported to be particularly true in the evenings and weekends. The numbers of staff undertaking NVQ training has continued to increase and the majority have achieved level 2 or are enrolled to do so. This is well above the target requirements of 50 of the staff group and should be commended. All staff have recently completed training in the awareness of dementia care and a more advanced session is planned for later in the summer. Training Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 19 activities at the home are supported by increased trainer support supplied by the company. Staff spoken to felt that the new manager had also increased the level of training activities and there was a commitment to their continued development, and that standards of resident care is improved by doing so. There had been 2 new staff recently appointed since the last inspection and their recruitment files were checked. Major shortfalls were identified in one of these with no evidence that references and a check by the Criminal Records Bureau had been sought. A requirement for urgent action to remedy this was left at the home at the end of the inspection. Pendlebury Court Care DS0000028409.V340319.R01.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, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager has re-established good administration and management systems and is a safe place to live and work; however systems that monitor quality in the home’s operation and in the activities of the staff group need to be further developed to further establish consistency and safety.. EVIDENCE: The recently appointed manager was previously the registered manager of another home owned by the company, but has yet to apply to register with this home. She has made a good impact on the operation of the home since she started and has updated a number of administrative systems that have improved the running of the home. Staff were particularly favourable in their comments: ‘Things get sorted now where previously they were allowed to drift’. ‘The whole place is on the up’. Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 21 ‘The manager has introduced new care plans which are much better to use and care has improved’ Although the new manager has revised or introduced a number of operational systems the formal support of staff is still a ‘piece of work in hand’ and the manager reported that this would be restarted in the near future. She herself is supported to maintain the improvements in the home’s operation by the proprietor who regularly visits to monitor progress. However formal systems of quality monitoring have only just been commenced and are another piece of work the manager aims to achieve in the mid-term, so that they can plan carefully for the future direction of the home. From the written information supplied by the manager before the inspection, good standards of health and safety activity and equipment servicing have been maintained and observations made around the building indicated it to be hazard free. Pendlebury Court Care DS0000028409.V340319.R01.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X 3 Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(2) Requirement Timescale for action 31/10/07 2. OP8 15(2) 3. OP15 16(2)(i) 4. OP18 13(6) All care records must be reviewed regularly and revised where necessary so that care is given to people living at the home in ways that is based on up to date information. Where the health care needs of 31/08/07 residents changes their care records must be amended so that all staff are providing care in the same way and consistency and safety is maintained. The catering arrangements of 31/08/07 the home must allow for a variety of meals to be provided over a set period. These must reflect the general preferences of the people living at the home and give a clear choice at the main mealtimes, so that the dietary needs of everybody living at the home are met. The home’s procedures for 31/08/07 Safeguarding Vulnerable Adults must be revised to reflect the local statutory procedures so that the correct actions are taken in the event of concerns being made. DS0000028409.V340319.R01.S.doc Version 5.2 Pendlebury Court Care Page 24 5. OP19 23(2) 6. OP27 18(1) 7. OP29 19(1) 8. OP31 8(1) 9. OP33 24(1) Steps must be taken to make sure that the temperature of hot water available from the taps used by people living at the home does not present a scalding risk. Adequate steps must be taken to assess the overall care needs of the people living at the home and to ensure that the numbers of care staff on duty at all times is sufficient to meet those needs. The assessment process carried must be documented and copies of the documentation forwarded to the CSCI office for examination. The manager must apply to the CRB for an enhanced check and POVA1st clearance on behalf of the staff member named in the notice and apply to the 2 named referees for written references in respect of the same. This is to ensure that the right people are employed at the home and the safety of all residents of the home is assured. The manager must fax a copy of the completed CRB application and copies of requests for 2 written references to the CSCI office at Derby by 9.00 am on Tuesday 10/07/07. The manager must apply to register with the CSCI so that standards of operation of the home are maintained and to comply with the law. Systems must be developed that allow for the quality of the home’s operations to be regularly monitored; in this way any problems identified by the people living at the home can be dealt with and plans can be made for the continued development of the home. DS0000028409.V340319.R01.S.doc 31/08/07 31/07/07 10/07/07 30/09/07 31/10/07 Pendlebury Court Care Version 5.2 Page 25 10. OP36 18(2) Staff must be supported by a formal system of meetings with a manager at the home so that they can have individual opportunities to talk about their work and any problems they may have and to receive advice about ways of improving their performance and the ways in which they care for the home’s residents. 31/10/07 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 OP3 Good Practice Recommendations The life histories of all people living at the home should be developed to assist staff to support them as individuals with individual needs and to see them as complete people rather than just ‘residents with problems’. All key care documents should be signed and dated by the person completing them so that there is clear trail of accountability and responsibility. The administration practices for occasional use medicines should be reviewed with the GP when daily use becomes the norm, so that people living at the home receive the right treatment for all their health care needs. 2. OP9 Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Pendlebury Court Care DS0000028409.V340319.R01.S.doc Version 5.2 Page 27 - 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. 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