Inspection on 19/05/05 for Petersham Centre Care Home

This inspection was carried out on 19th May 2005.

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

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

Other inspections for this house

Petersham Centre Care Home 16/09/08

Petersham Centre Care Home 31/10/06

Petersham Centre Care Home 02/05/06

Petersham Centre Care Home 11/10/05

Petersham Centre Care Home 08/12/04

Petersham Centre Care Home 20/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Petersham Centre Care Home Petersham Road Long Eaton Nottingham NG10 4DD Lead Inspector Bridgette Hill Unannounced 19 May 2005 09:30 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Petersham Centre Care Home Address Petersham Road, Long Eaton, Nottingham, NG10 4DD Telephone number Fax number Email 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 909 8735 0115 909 8742 Derbyshire County Council Gillian Diane Carter Care Home 22 Category(ies) of Learning disability (22) registration, with number of places Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8.12.04 Brief Description of the Service: Petersham Care centre is a purpose built single storey building located in a residential area.It is run by Derbyshire County Council and provides services for residents with learning disabilities. The home is separated into 3 units, some service users reside in the home on a long-term basis whilst other service users access the home for short-term respite care. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced one which took place over 7 hours. During the inspection the Manager, 1 staff member, 2 residents, 2 visitors and a placement officer were spoken with. Various records including care planning records were examined the findings are recorded in the body of this report. There has been ongoing correspondence and communication with the provider regarding the requirements listed following the draft of this report being completed. Opportunities have been offered for further information to be provided prior to publication. What the service does well: 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. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Arrangements for service users introduction to the home are well established and ensure service user are able to make a positive decision about admission although assessment procedures on the ability to meet needs rely on external professionals rather than formal in house assessment by staff. EVIDENCE: The Service User Guide and the Commission for Social Care Inspection reports were freely available in the reception area. The Service User Guide was in a picture format suitable for service users with literacy difficulties. Referrals for short stay placements only were currently being accepted. The file of a prospective new service user was examined. This indicated that multi agency assessments were available. Pre admission stays were offered and there was documented evidence of family contact. Pre admission visits to the service user were completed. One service user was due to make a pre admission visit to the home on the day of the inspection. There was no formal assessment procedure undertaken by staff at the home to ensure that the home was able to meet the service users needs, this has been identified as a recommendation at previous inspections. Multi agency reviews including psychology have been held and a decision reached that one service users needs can no longer be met at the home. All Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 8 professionals involved are documented as supporting this decision. Ongoing meetings and options were being explored. There were no completed Terms and conditions of residency contracts seen in service users files. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9,10 Service user care plans had developed significantly and recorded in detail how assessed care needs were to be met. EVIDENCE: A sample of 3 care records were examined. Service user care plans were typed easy to read. Service user care plans considered service user capabilities and routines. Instructions on how care needs were to be met were well detailed. Discussions with staff confirmed a good knowledge of service users and their needs and displayed a positive approach towards the service users. One service user care plan was not signed by the service user . Staff spoken to said the service user in this instance would have the capacity to discuss/read the plan and sign meaningfully. Confidentiality of care files was maintained and staff appeared to be aware of confidentiality issues when speaking about service users by ensuring doors were closed to ensure others did not hear confidential information. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 10 The date of admission was missing from two files. Photographs of service users were on file. Some risk assessments were in place but these were not always comprehensive for example road safety and potential risks to staff and service users due to the challenging behaviours of some service users. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 Service users were given various opportunities to enable them to improve skills and engage in leisure activities. This was found to be affected on occasions by inadequate staffing levels due to the dependency needs of service users. EVIDENCE: Care plans were found to be well personalised and gave an overview of service users preferred routines. It was also documented where a service user had a preference regarding the gender of the care staff helping them with personal care. Activities at the home included trips out locally to shops, nights out to concerts, bowling, cinema and a disco at the home. Day time activities were attended by service users at various day centres. Life skills and various leisure activities were enjoyed there. One family said there was good communication between staff from the home and themselves and they knew the name of an allocated link worker. They said Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 12 they were happy with the care received by their relative and that their relative thoroughly enjoyed their time at the home. Assessments regarding service users ability to hold the key to their rooms were available in care files, this meets a previous requirement. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20,21 Work had been undertaken to ensure service users post death wishes were ascertained. The administration and recording of medications possibly place service users at risk of not receiving treatments. EVIDENCE: A form had been devised since the last visit regarding service users post death wishes. Completed examples of these were available in care files. The storage and administration of medicines was inspected. The instructions on medication administration records did not always correlate with the instructions on the label on the item. One medication administration records was handwritten but had not been checked and signed by a second staff member. A specimen list of staff signatures was available. A fridge for drugs was available but not currently used. One topical preparation was not named or dated on opening. Where stocks of medications were transferred on there was not a system to add the stock carried forward onto the new stock. One medication for a service user was not recorded on the medication administration record. Staff had received training in the storage and administration of medicines some of this training had been completed in 2003. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Adequate procedures are in place and have been followed when Protection of vulnerable adults issues have been raised however sufficient actions are not always being promptly taken to ensure service users are protected. EVIDENCE: A booklet was available on how to make complaints, this included timescales and the address of the Commission for Social Care Inspection. One complaint was currently ongoing. In the past 12 months 6 complaints had been received. One was from a service user, 5 were from relatives. Records indicated that written responses were sent to complainants and where actions to be undertaken were identified for example staff training, this had been undertaken. Protection of vulnerable adults procedures were in place and two meetings had been held in the past year regarding issues raised. Outstanding action was still required to ensure the health and safety of service users were being protected. An update on the actions taken was sought from the homes Manager on 7th June 2005. To date no specific actions have been taken this is of some concern and must be addressed urgently. Not all staff had received training in the Protection of vulnerable adults. A sample of service users monies were examined the balances and records were accurate. Not all transactions had double signatures. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30 Communal areas of the home are generally well maintained however bedroom areas required refurbishment in order that service user were accommodated in a wholly comfortable and well maintained environment. EVIDENCE: The home is divided into 3 units with each unit having its own lounge/dining space. All bedrooms in the home have less than 10 square metres of space. The Fire officer assessed on a visit on 20.4.05 that the home satisfied fire safety standards. Some units had been removed from a kitchenette area this left uneven flooring exposed and required making good. One toilet/bathroom had an odour evident possibly from the flooring, as the edges were not sealed. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 16 Service users spoken to said they liked their bedrooms. The bedroom of long term service users were well personalised and reflected their tastes and interests. Not all bedrooms had lampshades fitted. Bedrooms were basically furnished and there was some damage to furniture for example missing handles. One bedroom was very warm and there was no capacity to adjust the temperature in each individual bedroom. Work had recently been undertaken to the staff call system and these were found to be accessible to service users. The home was found to be clean and tidy. The laundry was tidy and suitable for purpose. At the time of the visit a lock was being fitted to the laundry door. An external company did some laundry mainly towels and linens. The design of the building and location of laundry meant staff had to take dirty laundry through communal areas to the laundry. An external route was available but staff did not use this. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 Staffing levels have not been adjusted and increased in relation to the dependency of service users, this will potentially place service users at risk and affect the quality of care received. EVIDENCE: Care records and discussions with staff revealed that due to the dependencies of some service users it was not possible to offer some activities to service users. Staff spoken to said that they tried to fit in social needs but this was sometimes difficult. A visiting professional said that night staff levels were increased to accommodate some service users needs. They also reported that on occasion’s short term care visits had been cancelled due to staffing problems. Staff records confirmed that staff were receiving supervision on a regular basis. There are currently 8 out of 25 staff who hold at least NVQ(National Vocational Qualification) level 2 in care. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 18 Records indicated that some annual updates in moving and handling training have not been completed, this is an outstanding requirement. Some training updates had not been completed for example basic food hygiene. A sample of three staff personnel records were examined. The only deficit evident was that 2 files had only 1 reference on file. Conversations with staff and records examined confirmed that staff did receive supervision. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,41,42,43 There is a stable and reportedly approachable management structure in place at the home. EVIDENCE: Opinion from staff, families and staff stated that the Manager was found to be approachable and flexible. The public liability insurance certificate was displayed and in date. Records for establishing financial liability were not requested. Fire training records indicated that night staff were not receiving bi annual fire safety training. All other fire records were satisfactorily maintained with regular checks being undertaken. A system had been developed to identify when annual servicing was required. Records examined regarding gas appliances did not give adequate information Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 20 to assess if required works had been completed. Staff spoken to were also unable to give this information. This is an outstanding requirement. All other service records were up to date. Staff and relatives spoken to said the manager of the home were very approachable. A system for recording when maintenance services were due had been introduced. All relevant safety checks had been undertaken although it could not be established if some identified works for a gas appliance had been completed. Some records required to be in place for example dates of admission and staff references were not in place. These are identified in relevant sections of this report. An application is pending to add an additional category to the homes registration to accommodate the service users being cared for who have a physical disability. This is to meet a previous requirement. Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 3 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 2 2 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x 2 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Petersham Centre Care Home Score x x 2 3 Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 2 3 C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 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 4 Regulation 14(2)(b) Requirement The Provider must not continue to offer care to Service Users where it has been assessed that the Service users needs can no longer be met. Alternative arrangements must be made swiftly but sensitively There must be a contract in place between the service user and the Provider, which details the services to be provided, and the terms and conditions of residency. service users files must contain all the aspects listed in 3 Service user plans must include risk assessments and plans for limiting risks Timescale for action 30.7.05 2. 5 5 3. 4. 6 9 schedule 3 13 Old timescale Jan 04, new timescale 30.7.05 30.7.05 Old timescale Oct 2004 new timescale 30.8.05 Old timescale 30.7.07 new timescale 30.7.05 5. 20 13 The pharmacy label on the medication and the MAR chart must match. If instructions are different from that on the label it must be made clear on the MAR chart why they are different. Prescriptions for new supplies of medication must be checked to ensure that all details, including the administration instructions, C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Petersham Centre Care Home Version 1.30 Page 23 are correct. 6. 20 13 17 If a Medication Administration Record (MAR) chart is handwritten by a member of staff this must be signed and dated by them. This must then be checked, signed and dated by a second member of staff. Topical preparations must have the name of the person for whom they are prescribed recorded and have a date of opening stated There must be a system to ensure that information from one MAR chart is transferred over to a new MAR chart. Where service users have capacity the service users care plan must be made available to them and signed by the service users Where required actions are identified to ensure vulnerable adults are protected these must be promptly completed All staff must receive training in the protection of vulnerable adults. Financial transactions must contain double signatures. It is good practice if one of these is the service user where they are able to sign meaningfully Floor coverings in bathroom/toilets must be replaced - some have been done but not all Where furniture is in poor repair this must be rectified/replaced 30.7.05 7. 20 13 17 30.7.05 8. 20 13 17 9. 6 15 10. 23 13 Old timescale 28.2.05 new timescale 30.7.05 Old timeescale 31.1.05 new timescale 30.8.05 30.7.05 11. 12. 23 23 18 13 30.9.05 Old timescale Jan 2004 new timescale 30.7.05. Old timescale April 1004 new timescale 30.8.05 Old timescale 31.3.05 Page 24 13. 27 16 14. 26 16 Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 15. 16. 17. 26 28 30 16 16 16 Lampshades must be provided in service users bedrooms The flooring in the kitchenette area must be made good Unpleasant odours must be eradicated new timescale 30.9.05 30.8.05 30.7.05 Old timescale 31.1.05 new timescale 30.8.05 30.10.05 18. 32 18 19. 33 18 20. 21. 34 35 19 18 The Provider must implement an action plan to meet the standard that at least 50 of care staff hold at an national vocational qualifacion level 2 in care or equivalent Staffing levels must be sufficient to ensure service users assessed needs are met and that risks to service users are minimised Staff checks must be in place to meet the regulatin 19 Annual updates must completed for Moving and Handling training 30.7.05 30.8.05 Old timescale Jan 2004 new timescale 30.8.05 30.9.05 22. 35 18 23. 42 17 A system must be inplace to ensure staff must receive regular traiing updates as required (for example basic food hygiene) All records must be maintained and kept up to date as required by Schedules 3 & 4 24. 25. 42 42 23 23 Staff undertaking night duty must receive bi annual fire safety training The work identified on the gas Old safety inspection report must be timescale completed 31.1.05 new C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Old timescale June 2004 new timescale 30.7.05 30.8..05 Petersham Centre Care Home Page 25 26. RQN The Provider must not accept services users for admission who are not included in the category for which the home is registered timescale 30.7.05 Old timescale Aug 2004 new timescale 30.8.05 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. 2. Refer to Standard 2 20 Good Practice Recommendations A pre admission assessment format should be developed The quantity of medication remaining when a Medication Administration Record (MAR) chart is completed should be carried over into the quantity section of the new MAR chart. Dirty linen should not be carried through lounge/dining areas 3. 4. 30 Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 Page 26 Commission for Social Care Inspection South Point Cardinal Square Nottingham Road Derby, DE1 3QT National Enquiry Line: 0845 015 0120 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 Petersham Centre Care Home C52 C02 S35770 Petersham V227108 190505 Stage 4.doc Version 1.30 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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