Inspection on 23/06/05 for Shannon Court

This inspection was carried out on 23rd June 2005.

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

Shannon Court 20/02/07

Shannon Court 25/02/06

Shannon Court 25/01/05

Shannon Court 21/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Chirnside House

Rosehill Residential Home

Ruskin Lodge

Ruskin Lodge

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

CARE HOMES FOR OLDER PEOPLE Shannon Court 112 Radcliffe Road Bolton Lancashire BL2 1NY Lead Inspector Rukhsana Yates UnAnnounced 23 June 2005 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. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shannon Court Address 112 Radcliffe Road Bolton Lancashire BL2 1NY 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) 01204 396641 01204 384412 Mrs Christine Flood Mrs Julie Morrison Care Home with Nursing 59 Category(ies) of DE Dementia 19 Years - 65 Years : 1 Place registration, with number DE(E) Dementia - over 65 : 43 Places of places OP Old Age : 15 Places Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Within the maximum registered number 59, there can be up to 15 (OP) Older People, 43 DE(E) Adults with Dementia over 65 years, 1 (DE) Adults with Dementia. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 25 January 2005 Brief Description of the Service: Shannon Court is a privately owned care home providing personal and nursing care for up to 59 older people, many of whom have dementia related care needs. The home is situated close to Bolton town centre, off the main Bolton to Bury road. It is within easy reach of bus routes and shops. Accommodation is on three floors with lift access. All bedrooms are single, many with en-suite facilities. The home does not have a garden, but there is a pleasant enclosed patio with garden furniture that is well used in fine weather. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over 6 hours. The focus of the inspection was the service provided to residents with dementia. Most of the day was spent talking to 3 residents, 2 relatives, two staff members and the deputy manager. The ways in which staff talked with and supported residents during the day and at lunchtime were observed. The remaining time was spent reading care plans and other paperwork relating to the care and safety of residents. What the service does well: What has improved since the last inspection? The ongoing redecoration helps to improve the surroundings for residents. The home now has two people employed to help residents to take part in activities, which will improve the quality of their time at Shannon Court. This means that residents can use the therapy room more often. The room is used to help residents to relax and to have a massage by staff who have been trained to do this. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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) 3 Each person considering moving to Shannon Court has their needs assessed before admission. The admission process ensures that new residents, or their relatives, know what to expect of the service from the outset. EVIDENCE: Records and discussions confirmed that the manager or deputy manager visits prospective residents, in their own home or in hospital, to assess whether the home can meet their needs. Care files contained community care assessment documentation from the referring social worker for those funded by the social services department. Care plans were developed from the initial assessment. For residents with dementia related needs, mental health assessments had been carried out by health professionals and consultants involved. The residents consulted were unable to remember the details of their admission, but relatives spoken with said they had looked at other homes before making a decision about a move to Shannon Court. They continued to be satisfied with their choice and confirmed that they had been given an informative written guide to the home and its services. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 and 8 Each resident’s personal, health, social care needs and risk assessments are included in their care plan. However, specific needs, and actions to be taken to address them, should be clearly identified to promote staff understanding and to enable appropriate care to be provided. EVIDENCE: The care plans covered a wide range of physical and mental health, personal, social and emotional needs. They included some information about residents’ preferences, and their past and present interests and hobbies. Records showed that care plans have been reviewed each month, and all risk assessments had also been evaluated monthly. There were improvements required in the care plans examined in terms of dementia related care. Some written interventions were too generalised to be meaningful. For example, statements included “Needs careful nursing techniques to help her to remain calm” and “Needs careful strategies to deescalate tension” without real guidance about reasons for presenting behaviours and how staff should react to them. Residents’ behaviour was described, for example, “prone to repetitive speech”, “aggressive outbursts”, “will not listen to reason”, but without a context or clear understanding of the Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 10 reasons for such behaviour. Staff members observed and interviewed confirmed the need for a much better understanding of dementia from an individual and person-centred point of view. For example, they were unable to interpret some behaviour in terms other than “attention seeking”. Physical health care needs were well met overall. However, the need to ensure accurate records of dietary requirements are maintained was highlighted. This refers to intake charts for those with poor intake, and to specific issues. For example, one resident who was unable to manage eating chips was served chips during lunch. Accidents were recorded and audited at the end of each month to inform risk assessments. Good working relationships with consultants, the CPN and other healthcare professionals were reflected in records and comments from staff. Residents who were able to express their views of the home said they were satisfied, but many required assurance and therapeutic intervention directly related to their experience of dementia, and were unable or unwilling to talk about the home. Staff were seen to reassure and help to orientate residents to the best of their ability, but for reasons given above, would benefit from more insight and expertise in dementia care in order to maximise the effectiveness of their input. The deputy manager was aware of the improvements needed and, in discussion, was clearly committed to addressing them in order to improve residents’ well being. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 and 15 The home has recently increased resources for activities. This, along with better information about personal histories, interests and choices, is intended to improve outcomes for residents over the coming months. Residents enjoy their meals. The home should look at ways of offering choices of meals to residents. EVIDENCE: Since the last inspection, the home has employed another activities organiser, so that there are now two full time activities organisers coordinating and recording their input. The home has a relaxation / sensory room, and a therapy room that is suitably equipped and decorated for residents to enjoy body and Indian head massage, with staff qualified in using these techniques. One resident consulted talked about her history and interests, but these were not reflected in her records. Another resident enjoyed listening to opera and jazz music, but did not have the facilities in her room to enable her to listen to her choice of music in her own space. She also liked writing letters but had no paper. These wishes were highlighted to the deputy manager. These examples, and the activities record showed that an improvement is needed in the number and type of activities offered according to each individual’s general and mental health needs. This need is recognised in the home, and both of the activities Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 12 organisers are to attend a training course about people with dementia in the near future so that they can work towards better outcomes for residents. Two residents consulted said that they did not have a choice in terms of what time they got up or went to bed. During the inspection, some residents were observed to be having a late breakfast, suggesting that rising times are flexible. The deputy manager said that residents choose when to get up, and that staff are instructed to respect residents’ wishes. However, in light of the comments made by residents, staff practices in the morning should be reviewed to ensure that residents are exercising choice with regard to the time they are assisted to get up and dress in the morning. The residents consulted said that meals at the home were good. The home needs to use photos or other formats to enable residents with dementia to make choices at mealtimes. It was apparent also that residents would benefit from having serviettes and cloth, rather than plastic, aprons during their meal. Records showed that nutritional assessments and intake charts needed to be accurately maintained. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 standard(s) 16 Residents and their relatives are encouraged to air their views, and the home responds to complaints thoroughly to ensure satisfactory outcomes. EVIDENCE: The home has a clear complaints procedure that is included in the service users’ guide. In discussions with visitors, it was apparent that they had confidence in the management in terms of dealing with any issues or concerns they may raise. One resident said “the staff are helpful. If you’ve a problem they do listen to you”. The evidence from complaints processed shows that they are thoroughly investigated, that records kept by the home accurately inform the findings, and that the manager seeks to maintain a high standard by responding promptly to areas for improvement highlighted by residents, relatives or the CSCI. Where residents were unable to exercise their rights directly due to mental health needs, advocacy arrangements were accessed, ranging from consultation with relatives and social workers, to the use of independent advocacy services. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 Shannon Court provides a clean, comfortable, well-maintained environment for residents. People in the home who have dementia would benefit from their living spaces being redecorated in plain schemes to promote their mental health. EVIDENCE: An ongoing programme of redecoration and refurbishment continues to be implemented. However, there are some areas that have heavily patterned wallpaper and carpets. These can, in some instances, increase the feelings of confusion and disorientation experienced by residents with dementia. It is therefore important that these are replaced with plain colour schemes, and this is recognised by the manager. All bedrooms are single. The home has a good choice of communal areas including lounges, conservatories, dining rooms and a “quiet room”. Although there is no garden, the enclosed patio has seating and plants to create a pleasant area enjoyed by residents and their visitors in fine weather. There was evidence if disability equipment provided to meet individual assessed Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 15 needs. Facilities include an assistance call system, portable hoists, pressure relieving equipment and assisted baths and showers. Records for environmental safety checks were not examined during this inspection, and will be inspected at the next visit. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 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 Staff numbers are sufficient and the staff group has good, effective management support. Staff members have the basic knowledge and skills they need, but the outcomes for residents with dementia would be improved by staff receiving training in dementia care that informs the way they support those residents. EVIDENCE: The staff rota showed that staffing levels are sufficient. The manager, deputy, a 3 nurses, a senior carer and 9 care assistants are on duty during the day. 2 nurses and 7 carers are on duty in the evening. There are two full time activities organisers. Staff members interviewed felt able to carry out their duties effectively within these staffing levels, and confirmed that their training and support needs are met. Residents and relatives said that staff are “helpful” and able to provide a good standard of care. Interviews with staff highlighted a need for them to have a better understanding of how to support people with dementia. For example, one resident’s behaviour was interpreted as “attention seeking”. This has been recognised by the management of the home, and although some dementia training is due to take place, a requirement is made for all staff to receive effective training to improve their practice and the outcomes for residents. In addition to nurses and care staff, the home employs cleaners, a handyman and laundry and kitchen staff. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 17 Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 18 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) These key standards were not inspected on this occasion. EVIDENCE: These standards will be assessed at the next inspection. Management arrangements remain consistent, and have been considered to be of a good standard at previous inspections. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 20 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. 2. 3. Standard 7 8 27 Regulation 12 12, 13 18 Requirement Residents assessments and behavioural interventions must be specific and accurate Residents dietary requirements must be accurately recorded, adhered to and monitored. Staff must receive training in caring for people with dementia. Timescale for action 3 October 2005 3 October 2005 1 December 2005 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. Refer to Standard 12 15 19 14 Good Practice Recommendations To improve the number and type of activities in accordance with residents therapeutic needs. To find ways of offering choice to residents at mealtimes Redecoration schemes to take account of the needs of people with dementia. in light of the comments made by residents, staff practices in the morning should be reviewed to ensure that residents are exercising choice with regard to the time they are assisted to get up and dress in the morning. Shannon Court F56 F06 S5699 Shannon Court V231038 230605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton BL6 6HG 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. 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