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Inspection on 27/02/07 for Pendleton Court Care Centre

Also see our care home review for Pendleton Court Care Centre for more information

This inspection was carried out on 27th February 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home carries out assessments of prospective residents before admission to the home to make sure the home can meet the residents` needs. The atmosphere within the home was relaxed and the staff were friendly. One resident said, "All the staff are very nice, I feel I am being well cared for". The home organises and supports the residents to participate in social activities within the home and outside the home. The home continued to maintain a good standard of cleanliness. The staff records showed that staff were receiving regular supervision to assist them to provide good care to the residents. A choice of menu was available at each mealtime and residents said they enjoyed the food provided.

What has improved since the last inspection?

Since the last inspection the registered nurses and the care staff had received some training in care planning where some slight improvements were noted. A full audit of the care plans had been carried out however the manager recognised that further training and improvements were required. The home had appointed a Care Manager, a Registered nurse to provide expertise and leadership for the residents to assist the manager to carry out her duties effectively. The management of the home`s laundry system has improved since the last inspection. The requirements made in the Environmental Health services visit in May 2005 have been addressed and the home received a bronze certificate at a recent inspection.

What the care home could do better:

The care plans and risk assessments require further development to ensure they reflect the health, personal and social care needs of the residents accommodated. A number of shortfalls remain in the recording of appropriate information which has the potential to put residents at risk. The home must make sure that residents are given their medication as prescribed and that there is continuity of supply of medication for all residents at all times. The home must make sure that it can account for all medicines received into the home and that staff are competent to administer medicines. A letter was received by the Commission on the 2nd March 2007 showing the actions taken by the home following the feedback given after the inspection. Staff must be monitored and observed to ensure they put into practice the training they have received.

CARE HOMES FOR OLDER PEOPLE Pendleton Court Care Centre 22 Chaplin Close Salford Manchester M6 8FW Lead Inspector Elizabeth Holt Unannounced Inspection 27th February 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 Pendleton Court Care Centre DS0000006726.V331645.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. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pendleton Court Care Centre Address 22 Chaplin Close Salford Manchester M6 8FW 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) 0161 743 9798 0161 737 8080 None Southern Cross Care Homes No 2 Limited *** Post Vacant *** Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (56), Physical disability (2) of places Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The number of persons requiring nursing care at any one time shall not exceed 25 older persons, aged 65 years and over. That the number of persons requiring accommodation for personal care only at any one time shall not exceed 38 older persons aged 60 years and over within the overall maximum occupancy of 58. The service users requiring nursing care may be accommodated on the ground floor only. 2 named individuals requiring nursing care as a result of physical disability are accommodated on the ground floor. The registration will revert to older people if either of the service users leave or reach the age of 65. 14th July 2006 Date of last inspection Brief Description of the Service: Pendleton Court Care Centre is a care home registered to provide accommodation for up to 37 older people requiring nursing care and 21 places for older people requiring personal care only. The home is owned by Highfield Home Properties Limited. The home is a converted mansion house situated in an elevated position at the rear of a residential estate. The home provides accommodation on two floors in single en-suite bedrooms. A passenger lift provides access to each floor. The home is within walking distance of a local park and shops. The home is close to the local bus routes into Manchester city centre and Salford/Eccles and is close to the motorway network. The current scale of charges at the home are £355-52 to £425 per week. Costs in addition to the fee are hairdressing, chiropody(private) and newspapers. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and took place on the 27th February 2007. During the inspection time was spent talking to the manager, several of the residents, their relatives and some members of staff. In addition residents files, records and other relevant documentation were examined. On the day of this inspection the Pharmacist Inspector also visited the home to undertake a specialist pharmacist inspection and to discuss concerns raised by a visiting professional to the home. A number of concerns were identified and feedback was given to the Operations Director immediately following this visit. The requirements and recommendations made by the pharmacist inspector are included in this report. Since the last inspection three separate concerns have been raised by visiting professionals to the home and responses have been required from the Provider. Two complaints have been investigated by the home regarding staffing and social events however no further action was required. An investigation has been conducted by Salford Social Services with the involvement of the Commission for Social Care Inspection into two complaints under Adult Protection procedures since the last inspection concerning aspects of care practices. The outcomes to date involve a review of the care planning documentation, further training in Moving and Handling for the staff, an increase in the supervision of staff and improvements in the communication between residents, relatives and the staff in the home. The outcome of an internal investigation for one resident has not yet been received by the Commission. What the service does well: The home carries out assessments of prospective residents before admission to the home to make sure the home can meet the residents’ needs. The atmosphere within the home was relaxed and the staff were friendly. One resident said, “All the staff are very nice, I feel I am being well cared for”. The home organises and supports the residents to participate in social activities within the home and outside the home. The home continued to maintain a good standard of cleanliness. The staff records showed that staff were receiving regular supervision to assist them to provide good care to the residents. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 6 A choice of menu was available at each mealtime and residents said they enjoyed the food provided. 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. Pendleton Court Care Centre DS0000006726.V331645.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 Pendleton Court Care Centre DS0000006726.V331645.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 home undertakes an assessment of prospective residents’ care needs prior to their admission to ensure that residents’ needs can be fully met. EVIDENCE: The manager or a senior nurse would carry out the initial pre-admission assessment. In addition to this assessments from health and social services are included. The information was used to decide whether the home is able to meet the individual’s needs. Case tracking confirmed that pre admission assessments were carried out. The admissions process included a pre admission assessment, an enquiry form and then a social and physical assessment on the day of admission. The home did not provide an intermediate care service. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 9 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. Shortfalls in some health and personal care practices had the potential to put residents needs at risk. EVIDENCE: The manager said the home had carried out an audit of all care plans following a requirement made at the last inspection. Concerns raised following three Registered Nursing Care Contribution assessments since the last inspection highlighted the need for care plans and risk assessments to accurately reflect the resident’s assessed needs. A sample of care plans were reviewed during this site visit and as previously raised the specific action required for the staff to take to meet the resident’s needs was poorly recorded. Two care plans reviewed did not record the specific pressure relieving mattress to be provided. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 10 Moving and Handling risk assessments were not specific. The size and type of sling was not recorded in the care plans. The monthly evaluations were taking place however these were poorly recorded for example, “problem remains relevant”, “no change”. There was no reflection over the month of any events/significant changes included in this evaluation. Nutritional risk assessments were not well recorded and did not include the resident’s weight. The progress report for one of the residents was vague and the care plan was not updated to reflect the resident’s changing healthcare needs. Action was required during the site visit to seek appropriate professional advice to ensure this residents healthcare needs were being met in full. There was some evidence that the plans of care had been drawn up with the involvement of the resident/relative. At the time of the visit one wound was being managed by the District nurses and appropriate advice had been taken for a resident who had acquired a wound in hospital. The Home continues to handle medication poorly and because of this it is possible that residents’ health and safety is at risk from harm. The home has not maintained any improvements it may have made after the last inspection and residents are still at risk. The record keeping was very poor. The home was unable to evidence through clear and accurate record keeping that residents were receiving their medication properly. The home could not account for all the medication, which they had received. In some cases the staff failed to record how much medication was received by the home in other instances the staff failed to record exactly how much medicine they had given. One resident was prescribed Co-codamol tablets, a painkiller, the staff could not account for 47 of these tablets. The storage area for medication was cluttered and dirty and there was 9 months of unwanted medication stored in the clinical room. During the inspection the manager made arrangements for this room to be cleared and cleaned. Another concern was that medication, which had a short shelf life once opened, was not dated on opening and residents could receive out of date medicines, which could harm their health. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 11 The major concern was that residents were not receiving their medication as prescribed and that medicines were out of stock It was of very serious concern that not only had medication run out but that care staff and nurses were unaware that it was unavailable. Heart medication had run out for one resident for 22 days and another resident had been without a controlled drug prescribed for pain for almost a month. Several residents did not have some of their medication available to them for one or two days during the past month. If medication is not given as the prescriber directs residents could be at serious risk from harm. Because of the serious nature of the concerns regarding the handling of medication it is essential that all care staff and nurses administering medication are assessed as being competent to do so, this is so that the safety of residents is increased. Residents were shown respect and dignity based on their individual needs being respected. Staff were seen to knock on bedroom doors, provide privacy when delivering personal care and were heard talking to residents in a polite and respectful manner. One resident said, “ I get really well cared for here, the staff are lovely and very kind to me”. Pendleton Court Care Centre DS0000006726.V331645.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. Residents found the lifestyle in the home matched their expectations and preferences. EVIDENCE: Activities were provided and residents were encouraged to maintain contact with family and friends. Residents could exercise some choice over their daily lives and received a balanced and nutritious diet. The home had a display board showing photographs of recent social events. These had included a ball in a marquee in the grounds of the home in December 06, a New Year’s party, a Valentine’s Ball planned activities. Training had recently been provided for the staff and families to be involved in making a life history of their relative. The menus offered a variety of wholesome and nutritious meals. A recommendation was made that the menus displayed reflect the meals provided. One resident said, “I am really well fed and I can choose something Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 13 else if I don’t fancy the meal”. Another resident said, “the food is marvellous and the chefs are such lovely people. They ask me what I like and don’t like”. Staff had recently received specialist training to ensure all residents receive a well balanced diet. Pendleton Court Care Centre DS0000006726.V331645.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 has the systems and procedures in place that allow people to express their complaints/concerns and to protect residents from abuse. EVIDENCE: A policy was in place for the protection of vulnerable adults and staff were aware of how to put the policy into practice. Staff spoken to were aware of how to act in the event of an allegation of abuse and the manager has cascaded Adult Protection training to all staff. The home had a complaints procedure. The manager kept a record of complaints, which included details of the investigation and the responses. Staff commented they felt safe to Whistle Blow if the need arose. Since the last inspection three separate concerns have been raised by visiting professionals to the home and responses have been required from the Provider. Two complaints have been investigated by the home regarding staffing and social events however no further action was required. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 15 An investigation has been conducted by Salford Social Services with the involvement of the Commission for Social Care Inspection into two complaints under Adult Protection procedures since the last inspection concerning aspects of care practices. The outcomes to date involve a review of the care planning documentation, further training in Moving and Handling for the staff, an increase in the supervision of staff and improvements in the communication between residents, relatives and the staff in the home. The outcome of an internal investigation for one resident has not yet been received by the Commission however this report is awaiting completion. The home has an open door policy and a relatives’ “surgery” is held one evening each week. Pendleton Court Care Centre DS0000006726.V331645.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. The premises were safe, clean and comfortable for the residents living there. EVIDENCE: The home provides large grounds with access to garden areas. A programme is in place to redecorate and refurbish the home as an ongoing process. The décor and furnishings were homely in nature and the residents’ bedrooms were seen to be comfortable and personalised. During a tour of the building the premises were clean and tidy. Since the last inspection a bar had been made in the downstairs room and one of the residents said how this had created a great social event for him and other residents. Two of the bathrooms had been painted with large bright scenes. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 17 Residents and staff said how pleasurable it made the time they spent in this room since these scenes were painted. It was pleasing to see there was no backlog of laundry as seen at the last inspection and the new staff member employed was enjoying the challenge of keeping the laundry system orderly. Pendleton Court Care Centre DS0000006726.V331645.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 good. This judgement has been made using available evidence including a visit to this service. The number, deployment and training of staff appeared sufficient to meet the residents’ assessed needs. Robust procedures for staff recruitment were in place to protect residents. EVIDENCE: On the day of the inspection the staffing numbers and skill mix appeared satisfactory to meet the needs of the residents accommodated. There were times during the inspection that the lounge was left unsupervised and residents were requesting assistance. This was discussed with the manager and she was going to monitor this further to check the staffing levels were sufficient. Staff responded to the call system in a timely manner. Staff files contained the required information needed to be kept at the home. Documents that were available included application forms, references, Criminal Records Bureau checks (CRB) and training records. Recent concerns raised highlighted the need to ensure all staff had received updated Moving and handling training. A training matrix was available which showed the mandatory training carried out since the last inspection. Some of the care staff said they had recently had training in wound care management. Pendleton Court Care Centre DS0000006726.V331645.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems and procedures were in place to promote the health, safety and welfare of the residents. EVIDENCE: The manager is fully aware of her responsibilities and demonstrated her knowledge of the residents well, a completed application form to be registered with the Commission for Social Care Inspection has not yet been received however the manager has said this is in process. One resident said, “The manager is very kind and caring and would sort out any problems”. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 20 Policies and procedures were in place to protect the personal allowances of the residents accommodated. Fire safety checks were being carried out on a regular basis. Pendleton Court Care Centre DS0000006726.V331645.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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 X Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement A full audit of all care plans must be undertaken within the given timescale. Service user plans must demonstrate that the home is able to meet the residents needs. They must reflect all the residents assessed needs and provide current, relevant information regarding the interventions required in order to meet those needs effectively. Daily entries in the care plans must be clear and consistent. (The previous timescale of 04/09/06 has not been met in full.) 2. OP7 15 Risk assessments must contain appropriate detail and be included in the plan of care. (The previous timescale of the 04/09/06 has not been met in full). 11/05/07 Timescale for action 11/05/07 Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 23 3. OP9 13 The Registered Person must make arrangements for the recording, handling, safekeeping and safe administration of medicines. The registered person must ensure that nurses administering medication must be assessed as competent to carry out this task. The registered person must ensure that any medication which has been prescribed for a resident is provided for them and administered in strict accordance with the prescribers’ directions. All medication is accounted for at all times by means of an accurate audit trail. All records regarding medication are clear and accurate 30/03/07 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 strongly recommended that the staffing levels are reviewed to ensure the needs of the residents are met. Pendleton Court Care Centre DS0000006726.V331645.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Pendleton Court Care Centre DS0000006726.V331645.R01.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. 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