Inspection on 10/05/06 for Canwick Court Care Home

This inspection was carried out on 10th May 2006.

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

Canwick Court Care Home 27/02/09

Canwick Court Care Home 09/07/08

Canwick Court Care Home 14/11/06

Canwick Court Care Home 24/10/05

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

CARE HOMES FOR OLDER PEOPLE South Park Care Home 78 South Park Lincoln Lincs LN5 8ES Lead Inspector Jean Cope Key Unannounced Inspection 10th May 2006 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 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. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service South Park Care Home Address 78 South Park Lincoln Lincs LN5 8ES 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) 01522 544595 01522 544230 Guardian Care Homes (UK) Limited Care Home 41 Category(ies) of Dementia (4), Dementia - over 65 years of age registration, with number (41) of places South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:The maximum number of service users in each category is as follows:30 - DE(E) (Nursing) 7 - DE(E) (Personal Care) 4 - DE (Nursing) - 1 aged 53 and over, 1 aged 59 years and over and 1 aged 64 years and over). The service user aged 53 years in the category DE is in respect of the person named in the Notice of Proposal to Register dated 16 December 2003. The Service User aged 64 years in the category of DE is in respect of the person named in the Notice of Proposal dated 6 August 2004. It is a condition of registration that the action plan submitted to Lincoln CSCI area office dated 13 June 2005 from Guardian Health Care Limited is fully complied with. All timescales identified must be met. The CSCI must be informed on a monthly basis what action has been taken to comply, and it is acceptable for this to form part of the Regulation 26 monthly report. 24th October 2005 2. 3. 4. Date of last inspection Brief Description of the Service: South Park Care Home is registered to provide nursing care and personal care for 37 people over the age of 65 with dementia and up to 4 people with dementia under 65 years of age. The home has an acting manager in place who is not registered. The home is situated to the south of Lincoln city and is served by a bus route and is within walking distance of the town centre. The property is a large detached Victorian building laid out over 4 floors. The top floor is for staff and an administration area. The first floor comprises of resident bedrooms and the ground floor has bedrooms and communal areas. The lower ground floor has the main kitchen and the residential care unit, which can accommodate 9 residents. This unit is called Heathlands and has its own entrance. The fees for the home range from £435 to £619.81p. a week. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of South Park, and through undertaking a visit to the home. The fieldwork visit took place over eight hours. 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 tour of the premises was undertaken. Other documents connected with the running of the care home were also inspected. Most of this site visit was undertaken in South Park, on the first floor. What the service does well: What has improved since the last inspection? The home has been refurbished and decorated and now provides a comfortable environment for residents to live in. Many of the requirements left at the previous inspection have been met. An activities co-ordinator has been newly appointed. A training programme for staff has been developed and opportunities to train on National Vocational Qualification Courses are being offered. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 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. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service The acting manager will only admit new residents if she is sure that the services provided in the home can meet their needs, however, as yet there is no written information for new residents and their relatives to enable them to make an informed choice. EVIDENCE: The management team are updating the home’s statement of purpose and service users’ guide. The acting manager said that she assesses any new residents and gathers information from themselves, their families and any health professionals involved. A service for intermediate care is not provided in the home. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident has a comprehensive plan of care, which carers look at to ensure that each individual resident receives the care they need. EVIDENCE: All residents case tracked were accommodated on the first floor and had comprehensive care plans, which included risk assessments. Staff were able to give a good account of residents’ needs and confirmed they had seen care plans. Many of the residents living in the home are too frail to become involved in developing their care plans. Visiting relatives confirmed that they were not aware of their relative’s care plans. There were records on file to show that health professionals had been involved in residents’ care needs when necessary, which was also confirmed by relatives. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 10 Medications in the home are already pre-packed in monitored dosage systems by the home’s pharmacist. Only qualified nurses administer medications at present, but training is planned for senior care assistants in safe handling of medicines. The medication cupboard was tidy and there was no evidence of over stocking. Samples of medication administration records were checked and they had been appropriately signed off. The nurse on duty said that medications were given out on time in the home, but it was also her responsibility to administer medications to residents on the ground floor which took her away from her duties on the first floor for up to one hour a day. Residents were spoken to in a sensitive and kindly way and there was evidence that their privacy and dignity were respected. A chiropodist regularly visits the home. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 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 the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service An activities co-coordinator has been appointed to ensure that residents are able to participate in activities of their choice. Cultural expectations of residents are taken seriously by the organisation. EVIDENCE: Comment cards were received from several relatives of residents who said that their relatives were too frail now to participate in activities, but that they had done so in the past. The acting manager has appointed an activities co-ordinator who was seen playing dominoes with two residents downstairs. A carer also took a resident out in their wheelchair in the afternoon. The activities co-ordinator is slowly developing an activities programme, but at the time of the inspection only dice throw and music to movement were advertised. A hairdresser visits the home every two weeks and a communion service is held in the home on a monthly basis. Family and friends are made to feel welcome when they visit the home. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 12 A Polish care worker has been employed in the home and is key worker for a Polish resident. Since the carer has been employed there is evidence in care records that the resident has become more outgoing and has improved greatly. The carer was seen speaking in Polish to the resident and is also teaching staff in the home a few words in Polish to assist them to speak with the resident. The carer was able to give a good account of the background of the resident, which had also assisted staff working with him. The chef provides a menu, which changes every four weeks. Most of the food is home cooked and purchased from local providers. Residents are asked a day in advance about their choice of menu. All of the staff available were assisting to feed residents which took two hours, there were also two visitors assisting to feed their relatives, which took them an hour each. Staff were sensitive to residents’ abilities, were talking to them and offering drinks throughout. Some residents had to wait until others had finished being fed before they received their meal. During this time food is kept in a hot cupboard. The temperature of food was not being measured. The acting manager was advised that a food probe should be used to ensure the food is hot enough. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are protected by a staff group who have been trained to safeguard residents living in the home. EVIDENCE: This inspection was undertaken following concerns and information received by the Commission about staffing levels. Please see comments in the outcomes for 27 to 30. Comments received from residents and their relatives indicated that they were not sure how to make a formal complaint. The administrator is devising a complaints procedure which should be made available in the near future. Records viewed showed that care staff had received training on how to safeguard adults. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a newly refurbished home which was clean and odour free throughout. EVIDENCE: Since the last inspection the home has undergone a substantial amount of refurbishment and re decoration and is much more comfortable and homely. Staff said it was a much nicer place to work in and visitors commented on the vast improvement in the home. One comment card received said that the ‘home was a lot better than it was’, another one said that the home was, ‘much better since the refurbishment, but ‘needs some homely features’. Information received in March showed that a bath hoist had broken, and it had only just been repaired. This had impacted on residents as not all of them liked the other bathing facility provided. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 15 It was noted that the dining room has been partitioned off with a normal sized door. The turning space provided made it difficult to move the hoist around and staff, when questioned, confirmed that there had been an incident when the paramedics had found it difficult to manoeuvre a stretcher to take a resident to hospital. Most of the home was clean and tidy, but areas in Heathlands could have been cleaner. However, comments received by the Commission said that two relatives found that the home was always clean, with another two saying it was usually clean. Staff are provided with protective clothing and gloves and the nurse in charge had received training in infection control. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There is a committed staff team who try to ensure that residents needs are met, however, there are not enough staff on duty to ensure that residents are safe at all times. EVIDENCE: Please see comments in outcomes for 12 to 15 Later on in the afternoon, two residents were sitting in the dining room and were unattended for 20 minutes and unable to summon assistance themselves. Staff were busy in other areas. One member of staff brought a cup of tea in for each person, and then took five minutes assisting each resident. At this time the nurse in charge of the shift was called downstairs to assist the one member of staff caring for seven residents, as a resident had fallen which took her away from her caring duties on the first floor. All the residents case tracked were highly dependant on staff for all of their care needs. One resident was seen to require constant assistance from one staff member as they was at risk of falling but continually tried to stand up. Six staff members were interviewed and all of them confirmed that they did not believe that they had enough time to care for residents properly. Staff said that staffing levels have been reduced since January, even though the South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 17 dependency levels of residents had not reduced. Relatives spoken with also felt that there were not enough staff on duty. Staff were busy all the time, some of them not able to take their breaks. A relative said that they felt that residents ought to be offered more than one bath a week, when staff were questioned about this, they said that they were only able to offer baths in the morning because of staff reductions, and there were not enough staff available to offer more than one bath a week. One member of staff interviewed had received no induction or training, another staff member confirmed they had received no training since commencing their employment in January. However, the acting manager provided a planned programme of training for the future. Care staff are being offered opportunities to access National Vocational Training, one member has successfully completed Level 2, one is undertaking Level 3 and three staff are undertaking Level 2. Other staff members have expressed an interest in enrolling on the next course available. Recruitment records showed that staff had been safely recruited. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff and residents could be put at risk because regular servicing checks on fire and electrical equipment have not been undertaken, however they knew how to respond in the event of a fire. EVIDENCE: The home currently has an acting manager who is moving to another home in the group. A staff member said, that the acting manager had, ‘turned the place around’. Staff said that they ‘try to keep things going and work as a team’. Staff supervision has commenced with three staff members confirming that they had received it. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 19 There are secure arrangements for the safe keeping of resident’s monies and transactions are recorded. The organisation has undertaken an internal quality assurance audit using an outside consultant who spoke with staff, however, service users and their relatives were not consulted. Fire training has been provided for staff working in the home and the fire officer will be visiting in the near future to ensure the refurbishment is satisfactory in relation to fire regulations. Staff were able to give a good account of what they would do if the fire bell sounded and confirmed that the fire bells were tested on a weekly basis. Fire Extinguishers need to be serviced and portable electrical equipment needs to be checked. Hoists have been serviced appropriately. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 20 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation Requirement 15 The registered person must ensure that all residents’ care plans reflect their current care needs by involving their relatives or representatives wherever possible. 13(4)(c) A system must be put in place to ensure that food temperatures are recorded when food is being stored in a hot cupboard. A system must be put in place to ensure that food temperatures are recorded when food is being stored in a hot cupboard. The home must have a clear complaints procedure. The registered person must ensure sufficient numbers of staff are on duty to meet residents needs at all times. This remains outstanding from the inspection of 24/10/05 New staff must be provided with induction so they are aware of residents’ needs The provider must appoint a manager who must register with DS0000064152.V294160.R01.S.doc 30/06/06 2 OP38 30/06/06 2 OP15 13(4)(c) 30/06/06 3 4 OP16 OP27 22 18 30/06/06 30/06/06 5 6 OP30 OP31 18(1)(c)i 8 30/06/06 30/12/06 South Park Care Home Version 5.1 Page 22 7 OP33 24 8 OP38 13(4)(c) the Commission. A quality assurance programme must be put in place to ensure that the home is run in the best interest of the residents. Fire extinguishers and portable electrical equipment must be serviced appropriately. 30/12/06 30/06/06 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 OP1 OP19 Good Practice Recommendations The registered person should provide an up to date statement of purpose and service users’ guide, which is available for resident relatives and visitors to the home It is recommended that a design solution is found to the petitioned area in the dining room to ensure that emergency health professional can access residents’ rooms with a stretcher. South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby 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 South Park Care Home DS0000064152.V294160.R01.S.doc Version 5.1 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!