Inspection on 25/04/08 for Princes Court

This inspection was carried out on 25th April 2008.

CSCI found this care home to be providing an Good service.

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

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Princes Court Hedley Road North Shields Tyne & Wear NE29 6XP Lead Inspector Mary Blake Key Unannounced Inspection 09:30 25 , 30 April & 20th May 2008 th th 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 Princes Court DS0000070975.V362210.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. Princes Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Princes Court Address Hedley Road North Shields Tyne & Wear NE29 6XP 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) 0191 296 3354 0191 296 3373 www.southerncrosshealthcare.co.uk Southern Cross BC OpCo Ltd Mrs Gillian Saint Care Home 75 Category(ies) of Old age, not falling within any other category registration, with number (75) of places Princes Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 75 The maximum number of service users who can be accommodated is: 75 New service 2. Date of last inspection Brief Description of the Service: Princes Court Nursing Home is a three storey, purpose built facility situated in the Royal Quays residential area of North Shields. The home is well served by public transport. The home has a car park to the front from which there is ramped access to the main entrance. There are grassed sitting areas, which are accessible to, and for the use of, people who use the services and visitors. The home is registered to provide care to fifty five persons in the category of old age and dementias requiring personal or nursing care. There is also a twenty bedded unit providing Continuing Care, which is care, funded by the National Health Service. The home charges fees of between £379.74 and £481 per week depending upon the needs and requirements of the individual people who use the services. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the people who use the service. The home provides information about the service through the service user guide, which is available through the home Princes Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. An unannounced visit was made on the 25h April 2008 with a further announced visit on 30th April 2008. The Pharmacy inspector visited on 20th May 2008. The Manager was present throughout the inspection. Before the visit: We looked at: • Information we have received since registration in November 2007. • How the service dealt with any complaints and concerns since registration. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff and other professionals, including surveys. • The Annual Quality Assurance Assessment (AQAA), which is a selfassessment document, was sent to the home for their completion, but was not returned to CSCI. “Have your say” questionnaires were sent out to people who have used or had interest in the home, none of which were returned to us. During the visits we: • Talked with people who use the service, relatives, staff and the manager. • Looked at information about the people who use the service and how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills and training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe and comfortable. • Checked what improvements had been made since the last visit A CSCI Pharmacist also made an inspection of the service. We told the manager what we found. Princes Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The Manager has addressed all of the previous requirements and recommendations, which were made when the home was under the previous ownership. This is the first inspection under the new ownership of the home and new systems are being introduced in a range of areas. The new care plan format has identified individual personal and health needs clearly enabling staff to more easily follow the plan and meet the needs of people who use the service. The gardens and sitting area have given people who use the service more opportunity to enjoy being outdoors. Princes Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 7 Staff have undertaken specialised training to enable them to have a greater understanding of the care needs of people who have dementias. The provider is developing the quality assurance systems and ways of improving the service they provide to people. 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. Princes Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 8 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 Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to the home are generally appropriately managed and people who use the service know how their needs will be met. EVIDENCE: Princes Court has a Statement of Purpose and a Service Users’ Guide to provide people who use the service and potential service users with information about the home. The Service Users’ Guide is being reviewed and updated. An additional leaflet is available for people who are receiving Continuing Care. All people who use the service are having their contracts reviewed to reflect the new ownership. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 10 The care plans all have pre-admission assessments. These had been completed by either the manager or by a senior member of the staff team. The people who use the service also have a care management assessment, which is provided to the home on admission. An individual care plan is produced from these documents. Continuing Care admissions are organised directly with the hospital and are generally well managed. One recent admission was for overnight stay for a person moving into another care home and wasn’t within the normal admission process. The manager was aware and this was to be discussed at the next multi disciplinary meeting to prevent further inappropriate admissions. As part of the preadmission process people who use the service had visited the home, including with their relatives if they wished, had meals, stayed overnight and met other people who use the service and the staff. In this way they got to know the home before moving in. People who use the service commented, “I am not sure how long I have been here but I was made to feel very welcome when I arrived”. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive care and support that is well planned and takes into account their diverse needs whilst promoting their privacy and dignity. EVIDENCE: All people who use the service have a care plan which includes an assessment of their needs and a plan of how these should be met. Southern Cross documentation includes risk assessments for prevention of falls, wound care, and moving and assisting as well as assessment tools for clinical areas such as continence promotion. These had been completed to a good standard, which reflected the health needs of the people who use the service. The care plans were up to date and contained the information to assist the staff to care for the people who use the service. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 12 The Manager had ensured that all recorded information is reviewed and summarised on a monthly basis. The people who use the service receive personal support the way they prefer and their physical and emotional health needs are met. Staff were confident when giving care and are supported by effective training in areas such as moving and handling. People who use the service and their relatives commented, “the staff are there if I need them” “they help me but support me to do my own thing”. The individual health needs of people who use the service are identified and people are supported to access community health services such as doctor, district nurse, dentist, and optician. People receiving continuing care have the support of a Consultant Physician and a specialist palliative care team. People who use the service and their relatives commented, “Keeps me fully informed about dads care” “The staff always respond” “ I feel comfortable with the support I receive”. Staff training has been undertaken to provide awareness and additional support for health related needs. The Pharmacy inspector reported, “There is evidence of good practice in medication ordering systems and the management of controlled drugs. Storage arrangements in the home could be improved to protect medicines from theft or being tampered with, to improve accessibility and to ensure that medicines requiring refrigeration are stored in line with the manufacturers recommendations so that they remain safe to use. All handwritten entries on medication administration charts should be signed, dated and countersigned by an appropriate witness to reduce the risk of error when copying or amending medicines information”. People who use the service feel their privacy and dignity is respected and that they are listened to and what they say is acted upon. Staff receive training that helps them to made sure that everyone is treated with respect, and as an individual. Staff help people make their own decisions and provided information and assistance when it is needed. Staff were friendly toward the people who use the service and were attempting to engage them in conversation. They have a good knowledge of the needs of the people living in the home and the nursing staff are giving good direction and leadership to help them in the day-to-day delivery of care. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 13 Health and social care professionals commented, “Staff are aware of health changes in the clients I have at the home. They will act confidently to seek support” “Supports end of life care within the home helping clients die with dignity and supporting their relatives”. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are part of the local community and participate in leisure activities. They are supported to retain personal and family relationships and their rights are respected in their daily lives. EVIDENCE: People who use the service are offered the opportunity to join in a range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. pubs, cafes and restaurants, shops etc. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. The social activities coordinator helps develop and support the social interests of people who use the service. A programme of activities was available and being referred to by people who use the service. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 15 People who use the service commented, “It is nice to get out and about” “I enjoy my time in the garden” “looking forward to the singer” “enjoyed our trip out”. Staff assist and encourage people who use the service to maintain family links and previous friendships, respecting the individual’s wishes. Relatives commented, “Can bring things in they like to do” “staff help if we want to go out together” “we can visit whenever it is ok for dad”. Staff seek permission prior to entering individual rooms and were communicating well with people. People who use the service were observed to move freely around their part of the home. The redecoration and refurbishment of the Edward Unit had been designed to support people who have dementias and appeared to be working well. The menu is currently under review. People who use the service were positive about the choice and range of food available. The dining arrangements had improved with new décor, furniture, carpets and furnishings in dining rooms. Mealtimes were seen to be a relaxed and sociable occasion, with nicely laid tables and with good staff support. People who use the service commented, “Lovely food” “I enjoy my food at the home” “choice if you don’t like what is on the menu”. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of people who use the service, and their relatives are listened to and acted upon. People who use the service are protected from abuse, neglect and self-harm EVIDENCE: The complaints procedure is available in the service users guide and a copy is available at the front entrance and displayed at the front entrance of the home. There have been no complaints or protection issues since registration. People who use the service and relatives spoken to understood how to make a complaint, and could identify the way this would be dealt with. Staff have undertaken training on the Protection of Vulnerable Adults and there is further training planned. Staff were aware of the whistle blowing policy and felt able to raise concerns if necessary. The manager was aware of the need to protect all people who use the service. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 17 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, 22 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The facilities are designed to meet the needs of people who use the service. It is homely, well maintained and clean. EVIDENCE: The home is comfortable and attractively furnished. The bedrooms are attractive and homely and reflect individual styles and tastes. The home has sufficient and suitably equipped bathrooms but may benefit from specialised baths for people who have higher dependency. Many of the carpets, furniture and furnishings had been replaced throughout all of the units and the general maintenance was good. There are plans for further refurbishment. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 18 The development of the outdoor garden areas has provided additional areas and was being enjoyed by people who used the service. The home was very clean and tidy. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are adequate numbers of appropriately skilled and experienced staff to care for the people who use the service. The recruitment processes in place protect people who use the service. EVIDENCE: Staffing rotas showed that there are enough staff on duty to meet the necessary staffing levels although there have been shortages where staff have been escorting residents on hospital visits. The escort policy is currently under review. Generally people who use the service and their relatives were positive about the staff support and attitude, although some concerns were raised about he number of staff available. People who use the service commented, “The staff are very caring and understanding” “lovely people” “make time for me”. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 20 Relatives commented, “Communications are good” “Dealing with individual residents with patience and compassion” “sometimes very busy” “there to listen and help”. Recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for all staff. The home has an induction programme and the manager is currently developing the training programme for all staff working in the home. Staff spoke knowledgably about the individual needs of people who use the service. Staff had undertaken refreshers in mandatory training. Staff said that they are undertaking or had completed National Vocational Qualification in Care level 2 (NVQ) or over, with fifteen staff having NVQ 2 or above. Staff have undertaken Yesterday, Today and Tomorrow training which is aimed at working with people with dementias. Staff meetings are used to provide additional in-house training. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is consistent and effective and offers leadership to the staff; this improves the life of the people living in the home and protects them from harm. EVIDENCE: The manager is an experienced care home manager who has worked at the home for a number of years. The leadership in the home both in the way the care is being delivered to the people who use the service and the overall organisation is good. This includes the organising of training and staffing, and ensuring that the home was being well maintained and equipped. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 22 Relatives commented, “The manager and the staff are always very friendly and helpful in every way” “The care home is managed very well”. Health and social care professionals commented, “The manager and the staff are most attentive during difficult/crisis times which they (people who use the service/relatives) appreciate” “Manager and the staff have a good working relationship with the palliative care team”. Personal allowances are well managed and audited. Accident and risks assessment are appropriately documented with good links established with the local health falls prevention programme. The health and safety audit and maintenance of the home were satisfactory. The manager completed the Annual Quality Assurance Assessment but the provider did not return it to the Commission for Social Care Inspection. This document reflects the standard of the service being provided and the way the manager/provider plan to improve it further. Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement a) Medication must be stored securely, safely, in line with any legal requirements and at temperatures recommended by the manufacturer. This will prevent any tampering with medicines and possible theft. b) A system for the safe handling of all medication with a limited use once opened must be in place. This makes sure that medicines are safe to administer. c) Stocks of medication must be checked regularly and ordered in a timely fashion. This will make sure that people receive their medication as prescribed and the treatment of their medical condition is not affected. Timescale for action 01/07/08 Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 25 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 OP9 Good Practice Recommendations a) Handwritten entries and changes to MAR charts be accurately recorded and detailed. Staff should sign and date handwritten entries they make on the MAR charts and each entry should be checked and countersigned by a second person to reduce the risk of error when copying information. This makes sure that the correct information is recorded so that the person receives their medication as prescribed. b) All medicines requiring refrigeration should be kept in fridges designed for the storage of medicines. Fridges should be locked and the key held with the other medicine keys when not in use. Fridges should be defrosted and the temperature regularly monitored, preferably using a maximum/minimum thermometer. An appropriate recording sheet should be used to facilitate temperature monitoring of the treatment rooms and the fridges. This will demonstrate that medicines are stored within the appropriate temperature range and so are safe to use. c) Medicine administration policies should be updated to reflect recent guidance on the use of anticoagulants. d) Controlled drug storage should be increased to provide adequate space for the quantities of controlled drugs held. To provide a refurbishment programme for the replacement of corridor carpets To review the bathing facilities for use by people who have high dependency 2 3 OP19 OP22 Prince`s Court DS0000070975.V362210.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Prince`s Court DS0000070975.V362210.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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