Inspection on 11/08/05 for Qu`Appelle

This inspection was carried out on 11th August 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.

Other inspections for this house

Qu`Appelle 04/07/06

Qu`Appelle 24/01/06

Qu`Appelle 19/01/05

Qu`Appelle 30/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE QuAppelle 32 West Street Bourne Lincolnshire PE10 9NE Lead Inspector Vanessa Gent Unannounced 11 August 2005 10.00 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. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service QuAppelle Address 32 West Street Bourne Lincolnshire PE10 9NE 01778 422932 01778 422932 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) Tarsem Sunnar Care Home 19 Category(ies) of Dementia over 65 (DE(E) - 4 registration, with number Old Age (OP) - 15 of places QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19/01/05 Brief Description of the Service: Qu’Appelle is a two storey semi-detached, period house with an adjoining cottage. It is situated in a residential area within 500 metres of the centre of the town of Bourne with its shops and local amenities. The home is registered to provide personal care for up to nineteen people of both sexes over the age of 65 years, four of whom have a diagnosis of dementia. There are eleven single and four double bedrooms, none of which is ensuite. All bedrooms have a hand wash basin. Communally, there are two lounges, a sun lounge and a dining room on the ground floor. Access to the first floor is via a stair lift. There are three communal bathrooms and seven toilets on the two floors. A garden is available to residents at the rear of the property. Limited car parking is available on the road outside the home and unlimited parking on roads near to the home. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over eight hours. The main method of inspection used is called case-tracking which involves selecting a proportion of residents and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. The inspector spoke with at least ten of the twenty-eight residents, four relatives, a regular visitor, a healthcare professional and one of the four care staff on duty as well as the acting manager. A partial tour of the home took place. Throughout this report, the term ‘acting manager’ is used as the Commission is awaiting the receipt of the application to register as manager of the home. What the service does well: What has improved since the last inspection? The service user guide and statement of purpose have been updated, a copy of the service user guide and a terms and conditions contract, with the number of the room occupied, is now provided for each resident. Involvement of newly admitted residents or their representative in the care plans is now obtained and they and the staff completing the care plans, sign and date them. A new bathroom has been installed on the ground floor, with equipment provided to assist the residents’ bathing. A comprehensive training plan has been set up with ongoing training undertaken by staff as necessary and staff are now supervised on a regular basis. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 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. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3 Good progress has been made to improve the admission process and ensure that the home can meet the needs of new residents. EVIDENCE: The statement of purpose and service user guide have been updated to include the information required to enable prospective residents to decide whether the home is suitable for them. The terms and conditions contract is now completed, with the fees payable and the room to be occupied, signed and dated. Pre-admission assessments were in the care plans examined and formed the basis of those care plans, showing involvement of the prospective residents and their relatives. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 The needs of residents are identified in the care plans and met, to ensure their health and welfare. The staff’s practice for the administration of medications does not ensure the safety of the residents at all times. EVIDENCE: Care plans examined showed that initial assessments are in place although these need dating. In one of the care plans examined, more risk assessments need to be in place, such as for prevention of falls, pressure care and nutritional needs. The care plans of a recently-admitted resident are comprehensively completed and contain a good amount of details about the needs and desired lifestyles of the resident, with nutritional needs and dietary preferences recorded as well as social activities involved in. The staff have good liaison with healthcare professionals such as the district nurse, community tissue viability nurse, the nutritional advisor and the GP for a resident who has a tissue viability health need. Visits, advice and treatments are well-documented, as are visits of the chiropodist, dentist and optician. Pharmacy procedures are not always safe or provide good practice. The drugs are not stored in a separate, locked room although are kept in a locked cupboard. The temperature of the room and the drugs fridge in which they are QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 10 stored have not been recorded to ensure medications are maintained at the appropriate temperature. At mealtimes the medicines have to be carried, openly, into the dining-room to be administered and residents’ tablets were left on the dining table without supervision of being taken and without being signed for after ensuring they had been taken. Night sedation that is given out by night staff is not recorded in the controlled book register, which is recommended as best practice It is recommended that alterations are made to the practice of the recording and administration of night-time drugs to ensure safe practice. The dispensing pharmacy that supplies the medications inspects the home and trains the staff in drug administration. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 11 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, 15 The social activities programme provides interest and stimulation for the residents. Visitors are encouraged and made to feel welcome when visiting the home. The food given to residents accords with their choice and wishes and provides a nutritious, balanced diet. EVIDENCE: Activities that residents say they enjoy taking part in, are provided and encouraged by an activities organiser with the help of the other staff and are well-documented in the care plans. Varied monthly entertainments are enjoyed by residents, relatives and staff. Relatives say they are always included in the activities of the home, are welcome to stay for meals and they enjoy their visits the more because of the smiling, friendly staff. One relative said “the door is always open; visitors are always welcome; we are often invited to special functions”. Although choice is not automatically given at lunchtimes, the menu is displayed early enough in the day for residents to request an alternative choice and do so if they do not want the menu offered. Residents say there is always plenty of lovely food to eat, with lunches being three-course meals. Plenty of fresh vegetables are served and a variety of fruit is served at breakfasts and during the day. One resident said “it is hard not to put weight on, the food is so tasty”. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 12 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 The complaints procedure and the caring attitude of the provider, acting manager and staff ensure that the residents are safe and happy in their environment. EVIDENCE: The complaints procedure is clearly displayed. A relative said although they were aware of the complaints policy, “we have no complaints or moans – everything is wonderful”. No complaints have been received in the past twelve months, either by the home or to the Commission. Residents say they are happy living at the home; one resident said she has “been happy from the first day”. Comments include “wonderful, so caring”; “staff are lovely; will do anything for you. Never heard them with a sharp word”; “Really marvellous; the family are very happy with the conditions”; “do everything possible to make the residents comfortable”. Seventeen of the twenty staff have received training in Adult Abuse Awareness, the remaining three booked on the course in the near future. Staff say they would “always go to the manager if they had any concerns”. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 13 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, 20, 25, 26 Both communally and in their own bedrooms, the residents live in a pleasant environment that takes into account their wishes, choice and their needs, although some maintenance issues were identified that could put residents at risk. EVIDENCE: A relative and a social worker both said that the home is “lovely and clean and tidy”. Both communal rooms and bedrooms are pleasantly decorated and residents’ rooms personalised. Improvements are still ongoing in re-decoration and refurbishment, especially on the ground floor of the home. One relative said that the home is “ a bit like a rabbit warren and the lounge is quite small”. Some residents find that the lounges are small enough to be homely. “They’re comfortable and friendly.” Specialist equipment is provided where needed, as seen in the care plans and the bedrooms, to cater for the needs of the residents. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 14 A maintenance programme is in place but at 50 degrees C, the temperature of hot water at the sink outlets was higher than is safe for residents to put their hands under. The cleaner is taking an NVQ course and has taken infection control and other training to ensure she can provide a thorough service in the home. The sluicing and laundry procedures are adequate. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 15 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, 29, 30 Staff are on duty in sufficient numbers and skill mix to ensure the residents are cared for in a safe and positive manner. Staff are trained and supported appropriately in all aspects of their work to enable them to meet the needs of the residents at all times. EVIDENCE: An examination of the duty rota and talking to residents shows that enough staff are on duty at any time. Residents say that staff always have time for them and often smile and are jovial. Staff said they have sufficient time to care, to do activities and to support the residents. All documents required for the safe employment of staff are kept in the staff files. Some staff have NVQs at levels 2 and 3; some are currently taking the courses. Mandatory training is mostly up-to-date and ongoing, with courses booked for the near future. New staff receive a full induction which, one staff said, is comprehensive and enables staff to do their work with confidence. Care staff work in a good team, “are calm”, “joke readily” and “have a good rapport with the residents”, according to residents and relatives spoken with and as seen at the inspection. “Staff are absolutely lovely”; the resident “is very happy to live here”; “the staff are all stars – so patient and always smiling.” Staff have received adequate training to enable them to do their work satisfactorily. A number have already achieved or have commenced national vocational qualifications. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 16 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) 31, 32, 33, 36, 38 The home is well lead by a competent, experienced and committed manager. The care staff are a supported and supervised team. People living in the home are safe and confident in the management and staff. EVIDENCE: The manager is an enrolled nurse who has worked in various roles in the care sector and has a Teacher’s Award. She is currently doing her NVQ 4 in care, to be followed by her Registered Manager’s Award. Residents and visitors as well as staff commented that the manager is friendly, always available for them and they receive good support from her. Comments received include “she is always around”, “wonderful, so caring”, “she encourages visitors”, “a lovely atmosphere”, “the door is always open”, “nothing’s too much trouble”. Relatives said how happy they are with the care provided by “excellent” and “wonderful” staff and that “the home is second to none”, “the best”. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 17 A quality audit is not in place to ascertain the views of the residents and relatives. No client satisfaction surveys were available or had been distributed. The provider spends much time at the home but neither he nor the manager formally audits any part of the service provided. Since the last inspection care staff now receive regular formal supervision which supports their practice, to carry out their work with more confidence. Except for the water temperatures in residents’ sinks being too high for safe use, all other maintenance and health and safety practices at the home are adequate to protect the residents, visitors and staff, as seen maintenance records, staff training, fire safety and good communication between the manager, staff and relatives. QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 18 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 x x x x 2 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 Standard No 16 17 18 Score 3 x 3 3 4 2 x x 3 x 3 QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 19 No 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 9 Regulation 13(2) Requirement The registered person must ensure that medications are stored appropriately and staff are trained to and do administer medicines safely at all times. The registered person must ensure that the residents are protected by safe hot water temperatures in the wash hand basins in their bedrooms. The registered person must establish an auditing system to monitor progress made in the quality of care provided in the home. Timescale for action 30 September 2005 30 September 2005 31 October 2005 2. 25 13(4) 3. 33 24(1) 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 Good Practice Recommendations QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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 QuAppelle C53 C04 S52676 QuAppelle V243363 110805 Stage 4.doc Version 1.40 Page 21 - 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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