Inspection on 09/05/06 for Southlands

This inspection was carried out on 9th May 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.

Other inspections for this house

Southlands 10/05/07

Southlands 07/12/05

Southlands 11/07/05

Southlands 10/03/05

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOMES FOR OLDER PEOPLE Southlands 21 Main Street Off Greenside Close Long Eaton Nottingham NG10 1GU Lead Inspector Claire Williams Unannounced Inspection 9th 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 Southlands DS0000035734.V293948.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. Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Southlands Address 21 Main Street Off Greenside Close Long Eaton Nottingham NG10 1GU 01629 580000 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) Derbyshire County Council Yvonne Kristine Fowkes Care Home 23 Category(ies) of Dementia (3), Learning disability (1), Mental registration, with number disorder, excluding learning disability or of places dementia (3), Physical disability (2), Sensory impairment (3) Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: Southlands care home is a detached house in a residential area of Long Eaton, within walking distance of the town centre. The home provides social and personal care for 23 people aged 65 years and over. The home also provides 3 day care places. The facilities are on 2 floors. All accommodation is in single rooms; bedrooms do not have en suite facilities. Access to the first floor is by stairs and a passenger lift. The home has two large lounge and dining areas, a quiet room/library, and a lounge where residents can smoke. Residents have access to well maintained garden areas. The fees for the home commence from £289.70 Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over an eight hour period. The inspection involved assessing key areas as defined by the CSCI. The inspector spoke with 10 residents and 2 relatives and examined four files using the Case tracking methodology. The inspector joined the residents for their lunchtime meal and a tour of the building was undertaken. Time was spent observing residents and staff interaction, and the inspector spoke with 3 staff members and examined three files. The Registered Manager of the home assisted with the inspection. Following consultation with the people living at this home, it was agreed that they would be referred to as ‘residents’ for the purpose of this report What the service does well: What has improved since the last inspection? What they could do better: The Registered manager would benefit from having access to a pre-admission assessment in order to assist her to undertake a needs assessment on individuals without a Care manager. The moving and handling risk assessments need to be reviewed regularly to ensure residents receive the required support. The medication practices need to be improved to ensure both the staff and residents are safeguarded. The staff and residents would benefit from having the grounds secured as the public use the grounds as a short cut, Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 6 and at times there are people in the grounds at night. The residents would benefit if the three services that currently use the home as their office base were relocated as this results in a lot of people accessing the home, and limited office space for the management and staff team. The residents would benefit from having the toilets replaced and redecorated, as they look worn and uninviting. A delegate of the provider needs to complete detailed reports of the unannounced visits undertaken in order to check the quality of the service provided. The staff team would benefit from having some training around working with people with learning disabilities and mental health issues as the home caters for people with these needs. 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. Southlands DS0000035734.V293948.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 Southlands DS0000035734.V293948.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, 4, and 5 (Standard 6 not applicable) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents and relatives are provided with the information they need to help them make decisions about the home. The needs of new residents were assessed and it was assured that their needs could be met. EVIDENCE: In each of the lounge areas there was a reference guide, which contained a copy of the statement of purpose and service user guide. Visitors and residents confirmed that they had received a copy of the service user guide. These documents were only available in written form therefore individuals with sight impairment and learning difficulties would not be able to access this information. There was evidence in the residents files, examined that pre-admission assessments had been completed. During a discussion with the Registered Manager it became apparent that a pre-admission assessment was not available at the home for the Registered Manager to assess someone’s needs prior to admission if they did not have a Care Manager. Southlands DS0000035734.V293948.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. Residents’ personal and social needs were met, and the care was provided with respect and sensitivity. Resident’s healthcare needs were generally met although the medication practices could put residents and staff at risk. EVIDENCE: Four residents’ files were examined as part of the case tracking methodology used. Each file had a care plan in place that provided the basis for the care to be delivered. The plan set out the action that needed to be taken by care staff to ensure that residents’ health and personal care needs were met. Within the files there was information of individuals social needs and hobbies. There was evidence to support that the plans were reviewed and updated to reflect changing needs, and a brief record was made following monthly reviews. Residents had signed their plans in agreement but there was no evidence to support that residents are involved in the monthly reviews. Residents were assessed to identify their risk of developing pressure sores and appropriate action was taken including obtaining relevant equipment where necessary. A nutritional assessment was undertaken on admission and regularly reviewed. Moving and handling assessments were in place, but the assessments in two of the files had no evidence to support that they had been Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 10 reviewed. Weight gain or loss was monitored. Records showed that residents had access to GPs, dentists, chiropodists and other community health service. A private chiropodist visited the home at the time of the inspection. Daily logs were completed on a regular basis giving an overview of individual’s well being. Residents and there relatives stated that the staff team are “nice”, and “deliver good quality care”. Residents felt that the staff treated them respectful, and that their privacy and dignity was always maintained. A comment was made that a staff member was previously witnessed being “patronising to a resident”, this was discussed with the Registered Manager. Observations of the staff interacting with the residents confirmed their knowledge about individual needs. Relatives stated that “they always feel welcomed into the home” and confirmed that they are kept well informed. The Registered Manager was described as being “wonderful and really supportive by the relatives”. The medication practices and storage was examined. The inspector was informed that only the manager and the deputies administer the medication and all had attended training, although an assessment of their competency in this area had not been completed. The Registered Manager had attended a workshop the previous day concerning the new code of medication practices facilitated by a pharmacist. A discussion was held about the current practices as the medication was signed for on the medication chart, before the resident had taken it. The inspector found one gap that had not been filled in, and two people had not countersigned some of the handwritten medication instructions. Variable doses were recorded and creams and ointments were signed as given. The Registered Manager stated that a list homely remedies was not available as the decision was made that if any resident required a homely remedy they would visit the doctor for this so that it could be prescribed. Southlands DS0000035734.V293948.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, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents felt the home met their social, cultural, religious and recreational preferences. Residents had a choice of food and dietary needs were catered for. Contact with family and friends was supported and encouraged. EVIDENCE: Residents spoken with confirmed that the home met their expectations and that the routines were flexible in that they could choose how they wish to spend their day. A list of activities was displayed on the notice board, and these were provided on a daily basis during the afternoon period. Residents stated that they are consulted on the provision of activities and regular meeting were held for this purpose. Residents were excited about the forthcoming wedding of a couple that met in the home and this was well discussed within the home, and all was looking forward to this event. The couple stated how supportive the staff and the Registered Manager had been in organising their ‘special day’. The inspector was invited to have a meal with the residents. Although the menus was not displayed the Registered Manager had made preparations for this and said that they should be up within the next few weeks. Residents are asked their preference during the morning period and they confirmed that Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 12 choices were always available. Some residents felt the meals provided were “nice” and “of a good standard”, whereas other residents felt the meals “were not that good”. Ongoing meeting and discussions are held concerning the menus. The inspector examined the menu and noted that Irish stew and beef stew were the main option on days after each other. Although no complaints have been received about this and residents didn’t seem to mind it was recommended for these meals be split up so that the menu was varied. A brief tour of the kitchen was undertaken and was found to be satisfactory. The cook works alone and does not have an assistant, which has created difficulties at times due to all of the tasks that are required to be completed. The Environmental Health officer visited the home in February 2006, and requirements and recommendations were made in relation to the new food hygiene legislation that came into force in January. The Registered Manager informed the inspector that work is in progress to meets the areas identified. The inspector gave the Registered Manager a copy of the publication written by the CSCI on “improving meals for older people in care homes” which was devised following consultation with older people. Southlands DS0000035734.V293948.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 good. This judgement has been made using available evidence including a visit to this service. Residents and visitors have the opportunity to complain if they wish to do so. Staff members were aware of their responsibility concerning protection of residents from abuse. EVIDENCE: There was a written complaints procedure displayed within the home. This was also available in the literature provided for residents and relatives. Complaint record shows that there had been 9 complaints made at the home since the last inspection visit. These were mainly raised by residents concerning issues within the home. All of these complaints had been investigated and responded to satisfactory. The Registered Manager confirmed that all staff had attended adult protection training. Staff members spoken with were clear about different kinds of abuse and what they should do if an allegation was made to them. The inspector was informed that there had been no incidents or allegations in the home since the previous inspection visit. Southlands DS0000035734.V293948.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): 19, 20, 21, 22, 23, 24, 25, and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was generally well maintained and decorated with comfortable communal and bedroom areas. EVIDENCE: Residents stated that the home was homely and comfortable. They informed the inspector that several areas had been redecorated recently and that they were consulted about the colour scheme. The bathroom areas would benefit from being redecorated and the toilets replaced as some were showing signs of age and had cracks forming. Some of the toilets were also quite low and were not centrally located in the toilet making them difficult to access for people with mobility difficulties using aids. The inspector was given permission to enter resident’s bedrooms, which were personalised accordingly to individual preferences. Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 15 External areas still require repainting and maintenance. This has been highlighted in the previous three reports. The inspector was informed that the public use the grounds to access another street, and this has been long standing practice. However this does impact on the resident’s lives and health and safety as anyone can access the grounds especially at night time where some members of the public use it late at night. In addition to this three other services have access to the home and use rooms for their business. This also impacts on the residents, as is an invasion of their privacy, as they have no say or control over who enters the home. This results in the home being very busy at times with the varying people coming in and out. Southlands DS0000035734.V293948.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 adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by a trained and competent staff team. Residents felt that the number of staff on duty was adequate in order to meet their needs. EVIDENCE: The inspector was informed that the number of staff on duty has continued to improve and a full complement of staff will soon be reached following a recent recruitment drive. The Registered Manager informed the inspector that she is waiting for individuals Criminal Record Bureau checks to be returned before staff could commence their induction. The Registered Manager highlighted the frustrations caused by the delay in these disclosures being returned. The provider’s human resource department do not undertake Povafirst checks, which could be used to ensure that staff members are not on the Pova register in order to enable the potential staff members to commence supervised induction at the home. The residents and their relatives spoken with stated that there was adequate numbers of staff in order to meet their support needs, and stated that the staff team are “marvellous” and do “a really good job”. The staff members spoken with stated that they felt that they had adequate time to met resident’s needs but felt that they still did not have “quality time with residents. The staff reported that the morning shift was at times hectic, and that if three care staff were duty form 7am this would relive some of the pressure. During discussion with the Registered Manager the inspector was Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 17 informed how the management team serve the breakfast to the residents, to enable the care staff to focus on supporting the residents. The staff team felt that they continue to have positive training opportunities and confirmed that they have completed all of the required mandatory training. The inspector was informed that 8 staff members had completed an National Vocational Qualification (NVQ) to level 2 and that 2 staff have commenced in this training. All of the domestic staff have completed an NVQ and the two of the deputies manager are currently completing an NVQ level 4. The inspector examined three staff files, which only contained copies of their CRB and some training information, which did not fully reflect the training undertaken. The inspector was informed that all other documents were held in their files at the human resource department. There was evidence that staff receive supervision on a regular basis and staff members did confirm this during discussions with the inspector. Southlands DS0000035734.V293948.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, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Manager provides effective leadership and manages the home in the best interest of the residents. The health, safety and welfare of residents and staff were generally promoted and protected. EVIDENCE: The Registered Manager has worked at this home for 4 years, and comments were made that she provides clear leadership and is supportive and approachable. The management team were described as “hands on”, as they assisted the care staff as and when required. There were clear lines of accountability within the home and those spoken with felt that there was an open and supportive atmosphere. Regular resident’s meeting were planned to discuss the running of the home and any issues, and regular newsletters are provided detailing general Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 19 information about the home and any forthcoming events. The Registered manager routinely consults all residents on a monthly basis in order to obtain feedback about the home. The money held in safe keeping for four residents was examined. The procedures in place protected residents and two people countersigned majority of the transactions. The money held cross referenced to the balance sheets, however one resident had one pound more than the balance on recorded on the financial records. The provider for the home undertakes an internal audit of all of the health and safety systems. The inspector viewed this document, which indicated that all systems were satisfactory. The inspector sampled some of the health and safety records and these confirmed that all of the required services and checks had been undertaken. The Registered Manager ensures safe working practices are maintained and that staff complete the required mandatory training and updates. The Fire Officer had recently visited the home in December 2005 and was satisfied with the procedures in place. The inspector was informed by the Registered manager that a Fire Risk assessment was in place. Although verbal confirmation was received that a delegate of the provider undertakes monthly visits there was not any records at the home of these visits for this year. Southlands DS0000035734.V293948.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 3 X 2 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 X 2 X 3 3 X 3 Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14 (1) (a) Requirement The Registered manager must have access to a pre-admission assessment that includes all of the required areas as specified in the National Minimum Standards. The moving and handling risk assessments must be reviewed at least annually or when needs change. Two people must countersign handwritten medication instructions. Staff must sign the Medication Administration records after the resident has taken the medication. A medication competency assessment must be devised and completed o all staff that administer medication. The exterior of the home must be kept in a good state of repair. (Requirement repeated since 30/09/05) The grounds must be made Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 22 Timescale for action 01/09/06 2. OP8 12 (1) (a) 01/09/06 3 OP9 13 01/09/06 4 OP19 19 01/09/06 5 OP33 26 protect the safety of staff and residents. A delegate of the provider must undertake monthly visits in accordance with this regulation and produce a report of the findings, which stored at the home. 01/08/06 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. 3. 4. 5. 6. 7 Refer to Standard OP1 OP7 OP15 OP19 OP21 OP27 OP30 Good Practice Recommendations The Statement of purpose and Service user guide should be made available in alternative formats to enable all residents to access the documents. The staff should encourage resident’s participation when undertaking monthly reviews of the care plans. The menus should be reviewed to ensure residents receive a varied diet. The menus should be displayed. Consideration should be made to relocate the three services that currently use the home as their base. It would be beneficial to replace and redecorate the toilets and bathroom areas. Confirmation that all of the required staff records are located at the human resource department should be placed on all staff files. Staff should undertake training in the following areas: Learning disability, and Mental Health. Copies of certificates should be placed on the staff files to support that the training has been achieved. The person completing Regulation 26 reports should date and sign the record. 8 OP33 Southlands DS0000035734.V293948.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Southlands DS0000035734.V293948.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. 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