Inspection on 17/07/06 for Plessington Court

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Plessington Court 30/05/07

Plessington Court 06/12/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Plessington Court The Chapel House Chapel House Lane Puddington Cheshire CH64 5SW Lead Inspector Jayne Telfer Key Unannounced Inspection 17th July 2006 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 Plessington Court DS0000064346.V297620.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. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Plessington Court Address The Chapel House Chapel House Lane Puddington Cheshire CH64 5SW 0151 336 2123 0151 336 3833 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) Chapel House Care Limited Gaynor Benson Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (1) of places Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service is registered to accommodate a maximum of 19 service users in the category DE(E) (Dementia over 65 years of age) Within the 19 no more than one older service user (OP) may be accommodated to reside with their spouse/partner who has dementia Room 15 may only accommodate two service users that have made a positive choice to share and have an established relationship prior to admission, are married partners or are the same sex siblings/relatives 6th December 2005 Date of last inspection Brief Description of the Service: Plessington Court is a purpose built home for nineteen service users, aged over 65, with a diagnosis of dementia. The Home has eighteen bedrooms, over two floors. One room may be used as a double room for siblings or a married couple. Plessington Court opened in August 2005 and is located on the outskirts of the village of Puddington. It is quite isolated, surrounded by countryside. It shares grounds with Chapel House Nursing Home, which is owned by the same provider. Plessington Court has enclosed gardens which can be used by residents in good weather. Current fees: £442 to £480 per week. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection is the result of information gathered about the service from April 2006. Information included notified incidents, regulation 26 reports from the provider, resident and relative surveys and information completed by the home. The inspection also included a site visit which took place on the 17th July 2006. During the visit documents were examined, staff and residents were spoken with and discussions took place with the management team. What the service does well: What has improved since the last inspection? There is more visual information in the Home for residents, for example a user-friendly complaint procedure and a notice board informing residents of the day, date and menus. Plans to increase the visual information are in hand. Staff training has been formalised and clear induction and NVQ qualifications are available. A rolling training programme is being introduced as well as a training coordinator being employed. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 6 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. Plessington Court DS0000064346.V297620.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 Plessington Court DS0000064346.V297620.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home which will meet their needs They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: The service user guide is complete, however is not in a format which is userfriendly. It is recommended, as per the last inspection, that this document is made fit for purpose. Residents have contracts which state the terms and conditions of residency, and give clear information regarding fees and what is and is not included. All residents are admitted following a full needs assessment, and on admission have a 7-day assessment completed, which then forms the basis of the plan of care. Relatives are asked to complete a personal history for residents which give staff a picture of an individual’s life and personality. Staff commented that they worked with residents on a one to one basis following admission to get to know them as individuals, they also acknowledged the difficulty of moving into Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 9 a care home and stressed their own responsibility in making the transition as painless as possible. Good practice was noted with the admission of one resident in particular who came to Plessington Court on day care and was now in temporary residence in order to ease a difficult process. Plessington Court does not offer intermediate care. See Recommendation 1 Plessington Court DS0000064346.V297620.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their assessed needs. The principles of respect, dignity and privacy are, generally, put into practice. EVIDENCE: All residents had individual care plans which were signed, dated and appropriately reviewed. Relatives are invited to care plan reviews. Care plans are in a prescriptive format and are not person-centred. The language of the care plan can be complicated, for example ‘ disrupted homeostasis’. This leads to information being missed from the care plan, for example one resident has epilepsy and this is not discussed in the care plan. In addition, the daily records do not always reflect the individual care need. Risk assessments are included in care plans and these are appropriately detailed. Some records were difficult to read, however the manager had picked up this issue at the last staff meeting and was addressing it. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 11 There were some incidents in which health and personal care were not dealt with appropriately; one resident was given a bath when she prefers a shower and staff had recorded that she was ‘uncooperative’ and ‘did not understand what was going on’. The other incident involved a resident falling and fracturing her hip, the night staff failed to contact emergency services. Both incidents had been addressed by the manager who had issued policy updates to staff. A staff member was observed to feed a resident whilst standing over her; this is a dignity issue which was discussed at the last inspection. Relatives and residents are happy with the care being provided at Plessington Court and generally feel that all health and personal care needs are met to a good standard. Staff have access to training which enables them to meet the resident’s assessed health and personal care needs. Staff and the manager are knowledgeable about individual residents and their particular needs. Staff complete urinalysis and general observation charts for residents on admission and is it recommended that this is only done following discussion and with permission as it could be seen as invasive. Medication is stored appropriately. There is a need for pictures on some files. Stocks were appropriate and the medication returns are handled correctly. MAR sheets are in good order. Controlled drugs are stored appropriately and a controlled drugs register is in place and up to date. Following the site visit a check of medication found one tablet of a controlled drug missing. This incident was investigated appropriately and promptly and medication procedures were updated accordingly. See Recommendations: 2,3,4,5,6,7 and 8 Plessington Court DS0000064346.V297620.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their life style, social activity and keep in contact with family and friends. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Activities are organised by the staff team. One member of staff was particularly keen to develop activities and was observed engaging the residents in an exercise activity. She said that she had ordered plants and soil in order to engage some of the men in a gardening project. Visual information for residents had improved and the manager had plans to develop this further. Efforts have been made to involve relatives in activities and events and, as well as an open visiting policy, a recent cheese and wine evening had proven a success. The mobile library is clearly advertised and religious services are held monthly. Mealtimes were observed to be a positive event. Residents commented that the food was excellent and plentiful. Meals are well presented and well received. Tables were set attractively and appropriately. Regular drinks are available. The manager was developing a quality assurance tool regarding meals. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. 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. A clear complaint policy is available. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected EVIDENCE: The complaints process is adequately detailed and had been produced in a user-friendly format. There had been one complaint since the last inspection, this was unsubstantiated and had been handled appropriately. It is recommended that staff wear clear name badge so that residents and relatives can identify whom they are talking to or about should they wish to offer a compliment or make a complaint. Adult protection policies are in place and appropriate to the setting. Staff are aware of adult protection issues and have received training regarding both this and whistleblowing. See Recommendation 9 Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The environment is bright, clean and well maintained. Communal areas are safe, comfortable and attractive. Residents can choose to sit in the communal lounge, their own t=rooms or in a quiet lounge. Residents are happy with their rooms which are large and well maintained. Residents had been encouraged to bring in personal items. Fixtures and fittings are of high quality. Bedrooms all have en-suite facilities. Bathrooms are large and comfortable and provide specialist bathing equipment which is in good order. Air temperature is maintained appropriately, all rooms have individual thermostats and there are additional fans in the main lounge. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 15 The building is well lit, tidy and free from unpleasant odours. There is a clear infection control policy which staff have a good knowledge of. The driveway at the front of the building has recently been renovated. #The entrance to Plessington Court needs adequate signage and should be made more welcoming. The manager acknowledges this and is in the process of having signs made. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. 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. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. EVIDENCE: Residents and relatives spoke highly of the staff team. Rotas are appropriate and the home is sufficiently staffed with attention given to the busy times of the day. Staff have access to training and are encouraged to pursue NVQ qualifications, with 8 staff members having level 2 or above and 3 currently completing the course. Some members of staff are from Eastern Europe and have been encouraged to attend language courses to improve their spoken English. A rolling weekly training workshop is being developed in conjunction with Chapel House Nursing Home and a training coordinator is being employed. Staff feel encouraged to participate in training and feel that they can develop skills and improve their career at Plessington Court. There is a clear recruitment procedure and staff files contained appropriate information. Staff who had been recently recruited said that the procedure had been clear and straightforward. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager is experienced and qualified. Health and Safety requirements are met and documented appropriately and checks are in place to ensure the health and safety of the residents is met. Quality assurance processes are in place and are continuing to develop with the Home. EVIDENCE: The Registered Manager has all required qualifications and had a wealth of experience in the care sector. There is a good management support network, with the provider offering advice and support. The manager works some shifts on the floor with residents to enable her to get to know the residents and see how the staff team are working. Staff said that the manager is approachable Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 18 and fair. The manager attends the morning handover meetings and so is aware of all happening in Plessington Court. There are clear policies and procedures in place and health and safety documentation is in good order. The quality assurance process is in place, although it is still being developed. Quality Assurance questionnaires had been distributed to relatives and issues raised were addressed. Annual development plans are in progress, the home has been operating less than 12 months. A catering quality check is planned for the near future. Staff meeting are infrequent, the last having taken place in March, although the manager meets staff daily at handover meetings. Staff are not receiving one to one supervision and this may have an effect on personal and team development. See Recommendations: 8 and 9 Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 19 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 4 X X X 4 X X 4 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 2 X X 3 X 3 Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 20 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. Standard Regulation Requirement Timescale for action 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 3 4 5 6 7 Refer to Standard OP1 OP7 OP7 OP7 OP7 OP10 OP10 Good Practice Recommendations It is recommended that the Service User Guide be presented in a more user-friendly way. It is recommended that care plans contain all relevant health and personal care information. It is recommended that that language used in care plans be plain English and not jargon. It is recommended that the daily records be written in such a way as to reflect the individual needs of the resident. It is recommended that the manager ensure care records are legible. Staff should assist residents to eat in a discreet manner. It is recommended that urinalysis and general observations are only completed following discussion and permission from the residents and or their representative. DS0000064346.V297620.R01.S.doc Version 5.2 Page 21 Plessington Court 8 9 10 11 OP9 OP16 OP36 OP36 It is recommended that a photograph of each resident be placed on his or her medication charts. It is recommended that staff wear name badge to help residents remember who they are. It is recommended that staff be supervised as per the national minimum standards. It is recommended that staff meetings take place on a regular basis. Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Plessington Court DS0000064346.V297620.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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