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Inspection on 26/07/05 for Priory Court Nursing Home

Also see our care home review for Priory Court Nursing Home for more information

This inspection was carried out on 26th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 has an excellent activity programme, with Activity Organisers who are enthusiastic and committed to providing a varied programme. Staff are well trained, and work hard to deliver care. There are good induction procedures for staff. The home is well organised with a wide range of policies and procedures to safeguard residents. Those residents interviewed said that they are happy with the standard of accommodation, and have no complaints about the home. There are good systems for seeking the views of residents and relatives.

What has improved since the last inspection?

The home has had no requirements from the previous two inspections.

What the care home could do better:

The home needs to demonstrate that residents or their representatives are involved in the care planning process, so that their views are accurately represented. Hospital style beds must be provided for those residents who require them, to enable staff to meet their needs satisfactorily. The environment is homely and comfortable for residents, but some carpets require replacement. Bathrooms and shower rooms do not have adequate ventilation. Staffing levels need reviewing because of increasing dependency levels, so that residents needs are fully met, and staff said that morale is low at present.

CARE HOMES FOR OLDER PEOPLE Priory Court Nursing Home Priory Road Stamford Lincs PE9 2EU Lead Inspector Mick Walklin Unannounced 26 July 2005 09.00 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 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. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Priory Court Nursing Home Address Priory Road Stamford Lincs PE9 2EU 01780 766130 01780 766148 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) Trinity Care (Brookfield) Ltd June Walters Care Home 62 Category(ies) of Old Age (OP) - 62 registration, with number PD (Physical Disabilty) - 3 of places Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The maximum number of service users in the home with nursing needs does not exceed 22 and the maximum number of service users with personal care only, does not exceed 40. Date of last inspection 5th January 2005. Brief Description of the Service: Priory Court Care Home is purpose built and was opened in 1998. The home provides nursing and personal care for 62 persons. This includes old persons aged 65 years and over and up to 3 physically disabled persons under the age of 65 years. The home is one of a number of homes owned by Southern Cross Healthcare Services Ltd. It is within half a mile of the centre of the town of Stamford and within easy reach of a wide range of services and facilities. Car parking is available in the grounds of the home. There are also garden and patio areas. All accommodation apart from 2 double bedrooms is single and most have en-suite facilities. Accommodation on the first floor is served by a lift. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 8 hours. A tour of the premises was conducted with the manager. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A range of other documents were inspected. 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. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 7 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 standard(s) 1, 3 & 5. There are good arrangements for the assessment and introduction of residents to the home, so that they have sufficient information to enable them to make a choice about where to live. There are good arrangements for the assessment and introduction of residents to the home. EVIDENCE: Following an enquiry, the manager conducts a pre-admission assessment to ascertain that the persons needs can be met. The Statement of Purpose recommends that prospective residents, relatives and friends visit prior to the admission, and placements are for a four-week trial period. Referrals for respite care and emergency admissions are accepted, providing satisfactory pre-admission information can be obtained. A guide to the home, called a Service user Guide, is sent out to prospective residents with the contract. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 8 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 standard(s) 7, 8, 9 & 11. Care plans are of a generally good standard, ensuring that residents needs can be met. There are satisfactory arrangements with local health services to meet residents health needs, but the replacement of beds on the nursing wing with hospital style beds needs to be completed. EVIDENCE: The care plans of those residents case tracked were of a good standard, providing staff with clear guidelines regarding the care required. Care plans are reviewed on a monthly basis. There is no evidence that residents or their representatives are consulted about the care plan, and two relatives confirmed that they had not been involved. However, the manager said that this would be discussed at reviews. Arrangements with local health services are satisfactory but the Commission is currently investigating a complaint from a relative relating to the provision of care by the home. There is currently a programme of replacing beds in the nursing wing with adjustable nursing beds, but staff complained that the beds due for replacement were unsatisfactory for meeting the needs of residents. It is required that all residents receiving nursing care are re-assessed, and nursing beds provided as required. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 9 Medication administration and storage was inspected on the nursing wing and found to be satisfactory, but it is recommended that a sign be affixed to the door of the clinical room, reminding staff that the door must be locked at all times. The wishes of residents in the event of death are clearly recorded on the care plan. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12 & 13. There is a varied activity timetable to ensure that residents are stimulated. EVIDENCE: Two Activity Organisers are employed, and one described her role enthusiastically, explaining how resident participation had increased. They aim to provide at least eight different activities per week, and some residents said that they enjoyed participating in these. Activities over the forthcoming 2 weeks include keep fit, bowls, a quiz, visiting singers and tea and cakes with a community group. There is a supply of large print books and audiotapes, games and art materials, and the Activity Organisers have their own budget for materials. The home has use of a minibus, shared with two other homes, and individual outings can also be facilitated. Detailed activity diaries are kept for individual residents, and a bi-monthly newsletter is now produced for residents. One resident complained that her wheelchair would not fit on the minibus, so she was unable to participate in outings, and this information was passed to the manager. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 16 & 18. There are satisfactory arrangements for dealing with complaints, and for dealing with adult abuse allegations, ensuring that residents are protected. EVIDENCE: The complaints policy is displayed in the entrance hallway, and residents said that they would feel comfortable complaining to the staff or the manager. There have been six complaints since the last inspection. Five have been resolved by the home, and one is subject to an investigation by the Commission. Staff accurately described the action they would take in the event of a resident reporting that they had suffered abuse, and there are robust policies and procedures in place. Training on this subject is delivered by the manager. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 19, 21 & 23. The home is well maintained, providing a comfortable and homely environment for residents, but some carpets require replacement. Measures need to be taken to improve ventilation in bathrooms and shower rooms. EVIDENCE: Residents said that they were happy with the standards of decoration and maintenance, and can personalise their bedrooms to taste. A full-time maintenance person is employed, and a maintenance request book is situated in the entrance hallway, which visitors can use to report any problems. Carpets in the dining areas and some areas of the hallways require replacing, and the manager confirmed that this has been requested. Care plans document whether residents wish for keys to their bedroom doors. The home was clean and tidy at the time of the inspection. The home employs a Housekeeper, a Laundry Assistant and five domestic staff. A newly appointed domestic was clear of her responsibilities relating to the safekeeping of hazardous cleaning materials. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 13 Staff complained about poor ventilation in the shower and bathrooms. These rooms have no windows, and rely on small extractor fans for ventilation. A design solution for these problems should be looked into. One resident complained that she had sole occupancy of a double room, but another resident had now moved in, and Social Services would not provide funding for a single room. It is recommended that rooms are only shared by residents who have made a positive choice to share, and residents are offered the opportunity not to share as rooms become available. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 30. Staff are well trained, but staff numbers do not reflect the high needs and dependency of residents. This is contributing to low staff morale, and delays in attending to residents needs. EVIDENCE: All staff interviewed stated that there were not sufficient staff on duty to meet the high needs of residents, with particular problems at weekends. The manager explained that there are three care vacancies at present, which are being advertised, and the Deputy Manager post has not been filled. A relative stated that she had complained to the company about staffing levels being too low on the nursing wing, and call bells were not being answered promptly at the time of the inspection due to staff assisting other residents. Qualified staff have responsibility for medication and care planning, and felt that they should be supernumerary to the care staff establishment. These issues are due to be discussed at a staff meeting with the Operational Manager next month. Twenty-four staff are undertaking NVQ training. The company has a training officer, but the manager is responsible for formulating a training plan, and delivering some training. Staff said that training opportunities are good, and one said, “We get a lot of training”. New staff have a 12-week induction, and complete a comprehensive workbook. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 36, 37 & 38. The home is well organised, with good documentation and records to safeguard the interests of residents. EVIDENCE: There are accurate records relating to fire checks and residents possessions. General servicing records were not inspected. Staff supervision is occurring, but it is recommended that this take place every two months. As previously mentioned, staff said that morale is low, and they raised issues about feeling valued, which were fed back to the manager. Meetings for staff, residents and relatives are held at regular interviews, and heads of departments meet twice a week to co-ordinate the running of the home. There are regular audits and a monthly satisfaction survey is carried out, seeking the views of a proportion of the residents. The views of other groups involved in the home sampled at sixmonthly intervals. Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x 2 x 3 x x x STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 3 x x 2 3 3 Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 17 N/A 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 7 Regulation 15(1) Requirement The registered person must demonstrate that service users or their representatives have been consulted in the formulation of the plan of care. The registered person must ensure that all residents receiving nursing care are reassessed, and nursing beds provided as required. The registered person must arrange for the replacement of carpets in the dining areas, and areas of hallway that are showing signs of wear and tear. The registered person must seek advice as to design solutions to improve ventilation in the showers and bathrooms. The registered person must review staffing levels to reflect the dependency levels of service users, to ensure that they are adequate. Timescale for action 31/12/05 2. 8 12(1) 31/12/05 3. 19 23(2) 31/12/05 4. 21 23(2) 31/12/05 5. 27 18(1) 30/9/05 Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 18 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 9 23 Good Practice Recommendations It is recommended that a sign be affixed to the doors of the clinical rooms, reminding staff that the door must be locked at all times. It is recommended that rooms are only shared by residents who have made a positive choice to share, and residents are offered the opportunity not to share as rooms become available. It is recommended that staff receive supervision every two months. 3. 36 Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 0LA 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 Priory Court Nursing Home C53 C04 S2565 Priory Court V241121 260705 Stage 4.doc Version 1.40 Page 20 - 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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