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Inspection on 23/02/06 for Southfield Court Care Home

Also see our care home review for Southfield Court Care Home for more information

This inspection was carried out on 23rd February 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 provides a safe comfortable friendly environment in which the service users can live. Staff maintain the service users health and personal care needs. There is a range of social activities on offer, which suits the needs of the service users. Competent staff are employed by the home in sufficient numbers to meet the service users needs. Service users views on the care that they receive are sought and any issues are addressed. Staff interact appropriately with service users

What has improved since the last inspection?

The nurse call alarm cords have been replaced since the last inspection. Staff have received training in Adult protection and moving and handling The cleanliness of the home has improved. A social activities coordinator has been employed.

What the care home could do better:

Care plans should be more specific in their detail especially surrounding service users nutrition state. Address the odour on the first floor corridor. Ensure the correct codes are used when omitting service users medication. Make the results of the quality questionnaire available to the service users and their families. Service users should have individual accounts and their monies should be available at weekends.

CARE HOMES FOR OLDER PEOPLE Southfield Court Care Home Off Southfield Road Almondbury Huddersfield Yorkshire HD5 8RZ Lead Inspector Stephen French Unannounced Inspection 23rd February 2006 08:30 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 Southfield Court Care Home DS0000044509.V283740.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. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Southfield Court Care Home Address Off Southfield Road Almondbury Huddersfield Yorkshire HD5 8RZ 01484 432433 01484 432441 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) www.fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) Mrs Michelle Prime Care Home 50 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (24) of places Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Six named persons under 65 years of age Ten unnamed persons between the ages of 55 and 65 years within the categories Dementia (DE) (5) and Physical Disabilities (PD) (5). 5th September 2005 Date of last inspection Brief Description of the Service: Southfield Court is a modern, purpose built care home providing nursing care for older people. The ground floor provides accommodation for up to twentysix general nursing care service users, and the first floor is for up to twentyfour service users suffering from dementia. The home is situated behind the shops in Almondbury village. It is approximately two miles from Huddersfield but within a couple of minutes walk of all local amenties, including the bus stop. There is a garden, including a secure area where service users may sit. There is ample parking at the front of the home. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 23rd February 2006. A number of core standards were assessed during the previous inspection therefore this inspection concentrated on the remaining standards. A selection of service users and staff files were examined, and the homes policies and procedures were looked at. A tour of the home was conducted which included a number of service users bedrooms and communal areas. Staff and service users were spoken to and the inspector would like to thank the manager and staff for their hospitality and cooperation during the inspection. The manager has worked hard to increase the standards of care within the home and has been instrumental in implementing measures to ensure service users are cared for appropriately. Staff moral within the home was good and staff spoken to said that there was a more positive feeling amongst staff and that training within the home had increased. Service users spoke highly of the care that they received and appeared content, and their personal appearance had been attended to. What the service does well: The home provides a safe comfortable friendly environment in which the service users can live. Staff maintain the service users health and personal care needs. There is a range of social activities on offer, which suits the needs of the service users. Competent staff are employed by the home in sufficient numbers to meet the service users needs. Service users views on the care that they receive are sought and any issues are addressed. Staff interact appropriately with service users Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 6 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. Southfield Court Care Home DS0000044509.V283740.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 Southfield Court Care Home DS0000044509.V283740.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): Not assessed during this Inspection EVIDENCE: Southfield Court Care Home DS0000044509.V283740.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): 7,9,10 Each service user has a care plan which identifies the personal and health care needs of the service user. On the whole the administration of medication is carried out safely and service users are able to keep control of their own medication if they wish. Service users said that the staff treat them with respect. EVIDENCE: Each service user has a care plan, which has been developed from information gathered from the community care and pre admission assessment. Staff also discuss with the service user and their relatives what support they require. Five service users care files were examined and these included such things as risk assessments for moving and handling, nutrition and skin integrity. Care plans had been developed following risk assessments being completed, which had identified service users at risk. However one file examined identified the service users nutritional status was compromised, but the care plan which was Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 10 in place was not specific in the actions staff were to take to prevent further deterioration in the service users health. Another care file examined stated in the daily records that a service users GP had visited and diagnosed a service user as having a red swollen ankle but there was no care plan in place, which would ensure that staff evaluated the situation and had discussed preventative measures to prevent further deterioration. Qualified nursing staff are responsible for the administration of medication. If a service user wishes to self medicate then a risk assessment would be completed. The service user would be able to retain their medication in a lockable facility within their room and the staff would supervise the service user to ensure medication is taken. Medication seen on the day of inspection was stored correctly. Three service users stock of medication was checked against the medication administration records held by the home and the balances tallied. Should any medication be omitted then the nursing staff enter a code, which identifies why the service user had not taken the medication. It was noted on one medication sheet that the code ‘F’ had been entered onto the sheet but the inspector could not determine what this code meant. Staff must ensure that the appropriate code is used for medication not given. Service users spoken to said that the staff treated them with respect and upheld their privacy when completing personal care tasks. Southfield Court Care Home DS0000044509.V283740.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): 12,13,14 The home offers appropriate social activities for this particular service user group. Visitors are welcome to visit the home at any time of the day or early evening. EVIDENCE: The home employs an activities advisor who works twenty hours per week organising social activities. Service users are able to join in activities such as cards, dominoes, arts and crafts and reminiscence therapy. Outside entertainers also visit the home on a monthly basis and staff take service users out to the local pub and places of interest. Service users spoken to said that there were adequate social activities on offer should they wish to be involved. Service users are able to receive visitors at any time of the day and early evening. Visits can take place in either their own room or in one of the communal lounges. The manager said that she was trying to get one of the local churches to visit the home but has found this difficult. Should a service user wish to go to church then a member of staff would accompany them. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 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 the following standard(s): 18 The homes policies and procedures protect the service users from abuse. EVIDENCE: The home has policies and procedures surrounding the protection of vulnerable adults, which the inspector saw. Staff receive training in this area as part of their induction as well as an annual update. Training records checked confirmed that most of the staff have recently attended an update on adult protection and the home has a comprehensive training package which staff complete. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 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 the following standard(s): 19,21,22,23,24,26 The home is maintained to a reasonable standard. A good range of adaptations and equipment is available to residents. There was an odour of urine on the upstairs corridor EVIDENCE: There is an ongoing programme of maintenance and redecoration in place and a maintenance worker is employed at the home five days per week. It was noted that some areas of the home are in need of re-decoration. This was discussed with the manager at the time of inspection. The grounds are well maintained and accessible to residents. The home provides communal space on both floors of the home, including lounges and dining rooms. Lighting throughout the home is domestic in character Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 14 A range of adaptations and equipment are available at the home including, grab rails and hoisting equipment. There are communal baths and toilets in close proximity to service users bedrooms and lounges. The ceiling in one of the bathrooms requires repairing as there has been a leak and it was noted that the shower screen in the wet room did not appear safe. There are a number of specialist baths to enable staff to assist service users who have mobility problems. There was an odour of urine on the first floor corridor and the manager reported that she had requested a new carpet. The rest of the home was clean and fresh. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 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 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): 27,29,30 The home is staffed by sufficient numbers of competent staff to meet the needs of the service users. The homes recruitment policies and procedures protect the service users from harm. EVIDENCE: The duty rota was checked for the months of February and March; the numbers of staff on duty were as follows. On the Willows unit there are five staff on the morning shift and four staff on the afternoon on Beach unit there are six staff on a morning and five on an afternoon. The manager said that staff holidays and sickness is covered by bank staff and agency staff is rarely used. Four staff details were examined and the files contained application forms, references and confirmation that checks had been made for each staff to ensure they did not appear on the criminal records bureau and protection of vulnerable adults register. New staff receive Induction training within six weeks of employment this ensures that they are aware of the needs of the service users and the policies and procedures of the home. They also receive moving and handling, fire awareness and health and safety training. At the moment 32.5 of care staff have an N.V.Q level two qualification. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 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 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): 31,32,33,36,37 The home is well managed and service users are given the opportunity to comment on the home and the care that they receive. Staff are appropriately supervised. Service users should be able to access their monies whenever they wish. These should be held in separate accounts. EVIDENCE: The manager is a qualified nurse and has completed her registered managers award. She has been employed at the home for nearly a year and has been instrumental in improving the standards of care. Service user and relative meetings are held three monthly to enable service users to air their views on how the home is run. The manager also informs Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 17 them of what is going to be done within the home such as redecoration, employment of staff and the introduction of a newsletter. Meetings are recorded and a copy of the minutes is displayed in the reception area. Service users views on the home and the care that they receive are sought annually by means of a questionnaire. The manager stated that any issues identified would be addressed. Questionnaires sent out in September 2005 were sent to Four Seasons head office to be collated but have not been returned to the home. These must be returned and the service users made aware of the outcomes of the survey. The manager is at present responsible for the formal supervision of staff, which they receive at least six times per year. She hopes to delegate this to the qualified nursing staff who will receive training in how to conduct supervision sessions. Records examined confirmed that staff are receiving supervisory sessions. Residents whose money is handled by the company is held in one account. Separate records are kept for each resident detailing all transactions. It was not possible for the inspector to check if records reconciled with individuals monies due to this being held in one account. The manager informed the inspector that interest on individual monies is paid annually. Should a service user require money during the weekend this would not be possible as the manager and administrator holds the keys to the petty cash. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x 3 3 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 x 2 3 3 x Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 20 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 OP26 Regulation 16(2)(k) Timescale for action The care home must be kept free 30/09/05 from offensive odours. Requirement 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 5 5. Refer to Standard OP7 OP9 OP19 OP21 OP33 OP35 Good Practice Recommendations Care plans should be further developed to ensure that they are specific to the service users needs. Staff should ensure the correct codes are used when medication ids omitted. The areas identified during the inspection should be redecorated. The ceiling in the bathroom identified should be repaired. The shower screen should be made safe. The results of the questionnaire should be made available to the service users Residents monies should not be pooled in one account. Facilities should be made available so service users can have access to their money at weekends. Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Southfield Court Care Home DS0000044509.V283740.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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