Inspection on 14/01/08 for Spion Kop Care Home

This inspection was carried out on 14th January 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Spion Kop Care Home 08/01/09

Spion Kop Care Home 24/09/07

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

CARE HOME ADULTS 18-65 Spion Kop Care Home 72 - 74 Park Lane Pinxton Nottinghamshire NG16 6PS Lead Inspector Bridgette Hill Unannounced Inspection 14th January 2008 09:20 Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 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 Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 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 Adults 18-65. 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. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Spion Kop Care Home Address 72 - 74 Park Lane Pinxton Nottinghamshire NG16 6PS 01773 862813 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) Pauline Waddoups Mrs June Thorpe Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is 4. 2. Date of last inspection Brief Description of the Service: Spion Kop is large converted house situated on the outskirts of Pinxton. It is registered to accept 4 service users aged 18 - 65. The service has chosen to accept only male service users as detailed in the Statement of Purpose. The home is not registered to give nursing care. Service users are accommodated in single bedrooms, one of which has an en suite bathroom. The home is of a domestic style and has a large lounge with a snooker table in it and a separate dining area. The home is not suitable for service users with mobility difficulties as all rooms are on the first floor accessed by stairs. The fees charged at the home are £720 - £750.00 per week, this does not include hairdressing and chiropody. This information was given at the visit on 24th September 2007. An information pack is made available to each service user in their bedroom. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an announced visit which focused on assessing compliance to previously listed requirements and on assessing all key standards. As part of the inspection a sample of residents care files and a range of documents were examined. A tour of the building was conducted. During the visit opportunity was taken to have discussions with management, and one resident. It was not possible to speak to other residents as they were either sleeping or not well. Opportunity was also taken to speak with a visiting Care Manager. The person in charge at this visit was the Manager June Thorpe What the service does well: What has improved since the last inspection? It was evident that the Manager had worked hard on addressing the requirement listed on the last inspection report. The range of training offered to staff had improved and a focus had been placed on ensuring staff had a knowledge of mental health issues in order to develop the staff team. A skills based induction pack has also been introduced and staff were working through this. Some Health and Safety issues had been addressed including the development of a fire risk assessment and thermostatic mixer valves have been fitted on baths and showers. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have opportunity to visit the home, are assessed by staff and given a range of information in order that they can make a positive decision about moving in the home. EVIDENCE: The preadmission assessment form had been updated since the last visit and we looked at a recently completed example. This considered the mental health needs of the resident. One care Manager was spoken with who confirmed that residents were given opportunity to visit the home before moving in. It was also said that a trial period was set of 3 months. Terms and conditions contracts were in place for residents which told them of the details of their staff, what was included and the charges and notice periods. An information pack was available to each resident in their bedroom that contained the Statement of Purpose and Service User Guide. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area good This judgement has been made using available evidence including a visit to this service. There are care plans and risk assessments in place for each resident to ensure staff are conversant with and able to meet the needs of service users. EVIDENCE: A sample of two residents care files were examined to assess how standards were being met. The care plans we looked at covered the range of need that were identified. Some in place for mental health were well detailed whilst others were not as specific as they could be about how the mental health problems directly affected the resident. Examples of this were Logs were written by staff on a daily basis, these were well detailed on how the resident had spent their day and what support staff had given. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 10 A range of risk assessments were in place and there were care plans in place to describe how risks were to be managed. A policy was in place stating residents rights to look at their care plans. One resident said they knew they could look at them but did not wish to. Residents had varied abilities and interests and it was evident that each resident was regarded as an individual as each person spent time doing the things they wished to. The Manager said the home was visited regularly by Social Workers and Care Managers and residents were aware of how to contact them. Service users said they got up at the times they wanted and went to bed at a time of their choosing. In the resident care files we looked at the information relating to residents finances. All residents had full use of their personal allowance and assessments were in place of their ability to manage money. Some monies were retained in the home for safekeeping on residents behalf. The records and balances for these were checked. The records all contained double signatures in most cases one of these being the residents. Monies were held separately for each resident and the balances checked were all correct apart from one which was out by one penny. Where plans were in place to help residents with budgeting this was documented in care plans. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The choices and preferences of residents were respected by staff and residents enjoyed varying lifestyles. EVIDENCE: Some residents independently used public transport to access day centres and local shops. There was also the use of a car at the home to help residents go out. There was no set structure to any activities offered. Some residents files contained details of leisure preferences and life histories. The activities and outings documented appeared to be based individually for each resident with shopping trips. Residents purchased clothes for themselves whilst on shopping trips and participated in some general tasks in the home such as laying tables. These were documented in daily logs. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 12 The privacy of residents was respected and staff knocked on doors and waited for a response before entering. Where help, typically prompting was required with hygiene this formed part of a care plan. One Care manager spoken said that they had noted improvements with residents taking pride in their appearance since being at the home. Residents were given forms each day to indicate their choice of menu. A cooked breakfast was available each day if residents wanted it. One resident said he had eaten a cheese sandwich for lunch which they said was exactly what they had asked for. Records were kept for meals served these indicated that many traditional meat and vegetable style meals were served. Local supermarkets were used for food purchases and residents went to the shop with staff if they wished to. The kitchen was clean and domestic in style and was accessible for residents to make drinks or practice cooking skills, some residents chose to do this others didn’t. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Individual arrangements are in place to meet residents healthcare needs. There are some aspects of poor recording of medications which has the potential to adversely affect residents. EVIDENCE: We looked at residents care records that had space for recording visits to doctors and any other outpatient or health related visits. Arrangements were in place for Community Psychiatric Nurses to visit residents where this was assessed as being needed. The Manager reported having good relationships and regular visits from Care Managers. Residents were weighed on a monthly basis We looked at the storage and administration of medicines at this visit. Since the last visit the medication cabinet had been secured to the wall. A separate supply of individual medications was available for all residents. The medication administration records were all handwritten but did not contain any signatures from staff who completed them or the signatures of a second staff member to verify them. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 14 One resident administered medications whilst being observed by staff. There were documented risk assessments which had been signed by the resident in place for this. The resident said they knew what their medication was and what it was for. The staff were recording on the medication administration records that they had administered the medication however this was not accurate to the practice taking place. The standard relating to post death wishes was not fully assessed but a form was in one care file which described the residents wishes. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff were trained and procedures in place to handle any complaints or allegations appropriately. EVIDENCE: Each resident had a pack in their room which contained a range of information including the complaints procedure. No complaints had been received at the home or at the Commission for Social Care Inspection since the last inspection. No safeguarding adult allegations have been raised since the home opened. Training records indicated that all staff had received training in safeguarding adults. The Manager had also completed a course in investigating allegations of abuse which was facilitated by Derbyshire County Council. The safeguarding adult procedure was one which had been purchased and whilst it did refer in parts to referral to other agencies was not specific in detailing the referral process through to Derbyshire County Councils locally agreed safeguarding adult procedures. A whistle blowing policy for staff was also available to inform them how to raise any concerns they had. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home provides accommodation for residents in a domestic style house which was found to be comfortable and clean for residents to live in. EVIDENCE: The home is a large domestic style residence with all residents accommodated in single rooms. The kitchen was clean, tidy open to residents to make drinks and snacks and has been found satisfactory by the Environmental Health Officer. A dining area is available along with a large lounge which has a snooker table in it. Since the last visit a separate area in an adjacent building has been established as the residents smoking area. Residents all had there own room and took some responsibility for cleaning their rooms. Residents had personalised their rooms with their own belongings. The Care Manager spoken to said that the residents they were involved with Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 17 was pleased with their room and the privacy they had. One room had an en suite bathroom. Care staff had responsibility for cooking and cleaning in the home. We looked at records relating to fire safety checks which confirmed that regular checks of the fire alarm had been completed. A fire risk assessment was also in place detailing what measures were being taken to The laundry area is in a building separate from the main house. This is fitted with one domestic washer and dryer. Staff generally do the residents laundry for them and residents said that they were happy with the service received. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A range of training has taken place to ensure that the staff have the skills to meet residents needs. EVIDENCE: The home is a small one with currently 3 residents. The staffing levels were typically 2 staff between the hours of 9.00am and 5.00pm with 1 staff member for the evening shift who then sleeps in at the home. One relatives survey form indicated that the ‘staff seem very caring’. All residents were male as were the majority of staff. Key workers are allocated to residents who appeared to know who their allocated worker was. We looked at 2 staff files to establish if pre employment checks had been completed. Criminal records Bureau checks had been completed, application forms were in place and references from previous employers had been obtained. The date of one of the reference when compared to the date of commencing work indicated that this had not been received when the staff member started work apart from this all required checks were in place. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 19 Staff files contained certificates of what training had taken place and a training overview was available. There was an improvement in staff training since the last inspection. The range of training completed included food handling, medications, safeguarding adults, Health and Safety, schizophrenia, bi-polar disorder, Moving and handling, infection control and fire safety. Two staff had commenced National Vocational Qualification level 2 training. The home does not yet meet the standard of at least 50 of staff who are trained to National Vocational Qualification level 2 standard but are working towards this. Some training had taken place in house or by e-learning long distance courses. A skills based induction pack has been introduced since the last inspection and some staff had begun to work through this. Some training had been completed on mental legislation and some documents were in care files to assess residents capacity to make decisions. The Manager had obtained a copy of the General Social Care Council Code of Conduct Booklet for staff to read. Some staff supervision records were documented though these seemed to concentrate on what training had been completed and did not reflect on aspects of practice or performance. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,40 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has been open for a short time but work has been completed to ensure it develops and is run in the best interests of residents. EVIDENCE: The home is a relatively new one having only been registered in the last year with residents being accommodated since September 2007. The Manager of the home said they are enrolled on a registered managers course and also in the process of completing a course in mental health. It is evident at this visit that progress has been made against a number of previously listed requirements and the Manager submitted an improvement Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 21 plan. There has also been regular communication with the Commission for Social Care Inspection to update us where requirements have been met. The policies and procedures were looked at generally. These have been purchased in by the home and were not wholly descriptive of practices in the home as they had not yet been amended to reflect this. The Manager said that this was in the process of being completed. We discussed and looked at the quality assurance systems in place. In residents files there were some forms where residents had been asked about the service. The responses indicated that residents were happy with the service, the questions asked residents if they felt safe, if their privacy was respected and if they had control of their own finances. One relative survey had also been completed and one comment on this was ‘we think it is a lovely place’. The survey form was made available in the visitors book if anyone wanted to complete one. Some staff meetings were documented on a 2 monthly basis. An audit of the home covering a wide range of areas had started but not yet completed. A kitchen audit had been completed in November 2007 no problem areas were identified. Some risk assessments had been completed as required at the last inspection report, these included ones for legionella and radiators. Action had been taken to address the risk of legionella with chlorination of tanks and running of rarely used outlets however the risk assessment was poor in identifying the potential risks evident. The risk assessment for the radiators was brief and did not consider all the potential risks to residents of burns from radiators. Whilst the thermostatic controls on radiators had been turned down these could be turned up by anyone in the home and provided no real protection against potential burns. The radiator in the bathroom was found to be too hot to hold a hand against, this is a particularly high risk area. Where full body immersion was possible in bathrooms thermostatic mixer valves had been fitted and temperature checks of water were documented monthly all were within an acceptable range. The Manager reported that there had not been any accidents reported for staff or residents since the last inspection. A sample of service records were looked at which indicated that all checks had been completed. No certificate was available for portable appliance checks but stickers were evident on appliances to evidence they had been checked. The Manager said they would get a replacement copy of the portable appliance certificate. Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 2 x 2 x Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 23 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 YA20 Regulation 13(2) Requirement Record keeping for the handling of medications must be clear, signed and reflect the practice of staff when assisting residents with medication The provider must ensure staff do not commence employment until all required checks and documentation are satisfactorily in place as detailed in Regulation 19 and Schedule 2 Some improvement evident, 1 deficit found at this visit Previous timescale 15/10/07 3 YA42 13(4) A legionella risk assessment must be available and identified actions implemented to reduce potential risks to service users Partly met at this visit as measures in place but poor risk assessment completed Previous timescale 30/11/07 4 YA42 13(4) A risk assessment for the radiators must be completed and DS0000069743.V355943.R01.S.doc Timescale for action 29/02/08 2 YA34 19 29/02/08 30/03/08 30/03/08 Spion Kop Care Home Version 5.2 Page 24 any identified actions taken to ensure service users are not placed at risks of burns Partly met at this visit Previous timescale 30/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 Good Practice Recommendations The safe guarding adult procedure should be explicit in describing at what stage there is referral to locally agreed multi agency procedures Where staff supervision takes place these should consider aspects of practice and performance to ensure staff are fully able to meet residents needs The policies and procedures in the home should be reviewed to ensure they are reflective of the homes practices and philosophies 2 3 YA36 YA40 Spion Kop Care Home DS0000069743.V355943.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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