Inspection on 06/04/09 for Tapton Court Nursing Home

This inspection was carried out on 6th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tapton Court Nursing Home 24/02/10

Tapton Court Nursing Home 12/02/10

Tapton Court Nursing Home 14/04/08

Tapton Court Nursing Home 18/04/07

Tapton Court Nursing Home 26/04/06

Tapton Court Nursing Home 01/11/05

Tapton Court Nursing Home 26/04/05

Tapton Court Nursing Home 02/11/04

Tapton Court Nursing Home 20/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tapton Court Nursing Home 63 Tapton Crescent Road Crosspool Sheffield South Yorkshire S10 5DB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janis Robinson     Date: 0 6 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Tapton Court Nursing Home 63 Tapton Crescent Road Crosspool Sheffield South Yorkshire S10 5DB 01142660648 01142661345 care@amocura.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Amocura Limited care home 69 Number of places (if applicable): Under 65 Over 65 69 dementia Additional conditions: 0 The service can admit service users between the age of 60-65 years provided that their care needs can be met. Date of last inspection Brief description of the care home Tapton Court is a purpose built home situated in the Crosspool area of Sheffield, which was first registered in 1996. Nursing and residential care is provided for up to 69 older people of both sexes with mental health problems. The home is a two-storey building with a passenger lift, and is fully accessible. Communal lounges and dining rooms are situated on each floor. All of the bedrooms are single, and all are provided with ensuite toilet facilities. Sufficient bathing facilities are in place. A central commercial type kitchen and laundry serve the home. A car park is available. There is easy access to local facilities, such as shopping centres, public houses and bus routes. Information about the home is provided to people. Copies of the most recent inspection report, and statement of purpose, are available from the home. Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced inspection carried out by Janis Robinson, regulation inspector who was accompanied by Marina Warwicker, regulation inspector. Prior to this inspection the manager completed an Annual Quality Assurance Care Homes for Older People Page 5 of 27 Assessment (AQAA), which detailed what the service was doing well, what had improved since the last inspection on the 14th of April 2008, and any plans for improving in the next twelve months. Questionnaires about the home were sent to staff, health professionals and people living at the home. Three staff and four people living at the home returned their surveys. Information from these is included in the main body of this report. The home was visited on the 6th of April 2009. The manager and area manager were spoken with about the running of the home. Some qualified and care staff were spoken with about working at the home. Two care staff were formally interviewed about their skills and experience. People living at the home were spoken with about the support they received. Interactions between staff and people living at the home were observed. A selection of records were examined, including three peoples care plans and records related to the running of the home. An inspection of communal and some individual rooms took place. At the time of this inspection fees ranged from 364 to 523 pounds each week. What the care home does well: What has improved since the last inspection? Care plans had been updated so that specific information was available to staff on the actions required to meet identified needs. The care staff spoken with appeared knowledgeable about individuals needs. A programme of adult safeguarding training had been booked so that staff had essential knowledge to keep people safe. Staff recruitment records contained all of the required information and detailed full employment histories. Staff were up to date with mandatory training so that they had the skills to keep people safe. Care Homes for Older People Page 7 of 27 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to visit the home, and written information was provided to people so that they could make an informed choice. Peoples needs were assessed prior to moving in to the home to make sure these could be met. Evidence: A service user guide was available at the home, which was seen. It included a range of information. People spoken with said that they had been provided with copies of the service user guide. Three care plans were checked in detail. Each contained a copy of the homes own assessment document, alongside a copy of the social workers assessment. The manager stated that she carried out all assessments by visiting people in their own Care Homes for Older People Page 10 of 27 Evidence: homes, or in hospital. The manager confirmed that no person would be admitted to the home without an assessment taking place. The three assessments seen were comprehensive and set out all aspects of a persons care needs and preferences. The information included on the assessment forms was detailed in the care plans seen. People spoken with said that they had been able to visit the home before choosing to move in, to look around, view the accommodation and meet other people living at the home and staff. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs were identified so that they could be met. Medication systems on the whole protect, but two specific concerns introduce some risk. Evidence: Three care plans were checked in detail. They were well set out and contained a range of information that covered all aspects of health and personal care. The plans included clear and specific detail on the staff actions required to make sure identified needs were met. Peoples preferences had been sought and were reflected throughout the plans. Each plan contained an agreement sheet to show that these had been written with the involvement of the person being supported. All three care plans were up to date and had been reviewed on a monthly basis. Risk assessments had been undertaken, which covered all aspects of daily living. Those seen had been reviewed and were up to date. It was routine practice for the qualified nursing staff to write care plans. However, all of the care staff spoken with said that they had free access to Care Homes for Older People Page 12 of 27 Evidence: peoples plans and could influence these if they felt they needed updating. The care staff spoken with appeared knowledgeable about individuals needs and preferences. All of the care plans seen contained full information on the persons health care. Details of any medical conditions were included in the plans and they all contained information on ongoing treatment, appointments and contacts. People spoken with said that their health care needs were met. One person said that they saw their GP when needed, and also saw a chiropodist, dentist and optician. A medication policy was in place and seen. Qualified nurses administered medication. Medication was stored securely. Medication administration records (MAR) were checked and found to be fully completed. However, a nurse was observed putting a liquid medication on a table next to a person, then leaving it unattended. The medication was not taken, but administration records checked detailed that the medication had been administered, not refused. All of the people spoken with said that staff were respectful and their right to privacy was upheld. The interactions observed between people living at the home and some staff appeared positive and inclusive. Some staff took time to chat to people and were seen to knock on doors and wait for a response before entering. People made some positive comments about staff, which included, Staff are nice I can spend time in the lounges or have privacy in my room if I want The staff here are very kind They look after us well Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were provided with choice in daily life. However, restricted activities limited opportunities to people. Evidence: The manager was recruiting an activities worker and interviews were planned for the week of this inspection. Care staff spoken with said that they arranged activities when they were able. These included card games, bingo and skittles. Some activities were done on a one to one basis, staff gave examples of walking and chatting with people. No trips out of the home had been provided for a significant period of time. Some visiting entertainers and parties had been arranged for the year ahead, for example, singers, summer fayre, bonfire and Christmas parties. People spoken with said that they would like trips out. People said that the routines at the home were flexible, they could get up and go to bed when they wanted. Visitors could come to the home at any time and people could spend time in their rooms with visitors if they wanted privacy. One visitor spoken with said that he was always made welcome at the home. Care Homes for Older People Page 14 of 27 Evidence: The menu was seen, which was varied. Choices were offered at the main meals of the day and the cook said that alternatives to the two choices offered were always available. Special diets were catered for. Plentiful food stocks were seen in the kitchen. The kitchen had a cleaning rota and the cook said that the kitchen equipment was in full working order. All of the people spoken with said that they liked the food and were happy with the choices offered. Staff confirmed that they had access to food at all times to provide snacks should they be requested. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and safeguarding procedures protected people. Evidence: A written complaints procedure was in place, which was seen. People were provided with information about how to make a complaint within the service user guide. The complaints procedure was also on display in the entrance area. The record of complaints was checked, these recorded the action taken and the outcome of the complaint. People spoken with said that they had no need to make a complaint, but if they did would go to staff or the manager, who would listen to them. An adult protection policy was in place. Staff spoken with understood the different types of abuse and were clear of the action to take if an allegation was made or if they suspected abuse. A programme of adult protection training was in place. Safeguarding training had been arranged for the week following this inspection, a notice was on display in the office to support this and care staff spoken with said that they would be attending the training. All of the people spoken with said that they felt very safe at the home. Care Homes for Older People Page 16 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Parts of the home were well maintained. However, some parts were not clean and had damaged decoration which did not provide people with a pleasant place to live. Evidence: An inspection of parts of the environment was undertaken, which included communal and individual accommodation. A maintenance worker was employed to maintain standards. However, some communal areas had not been well decorated and an odour was apparent throughout the home. This did not create a good impression or reflect some of the positive care work observed. A relative in their survey commented The odour on the ground floor is terrible. My relative lives on the first floor which is very clean One ground floor bathroom had been repainted, but tiled skirting was marked where paint had been applied haphazardly, creating an unkempt appearance. The wooden plinth to the toilet was not sealed and rust was apparent above the skirting in places. The ground floor sitting room had damaged decoration. Whilst bedrooms contained personal possessions, some seen were dirty, food debris was on floors and on seat cushions, dried faeces was seen on one toilet seat and floor and some bedroom carpets were stained. One bedroom chair had badly torn arms. Some occupied Care Homes for Older People Page 17 of 27 Evidence: bedrooms did not have name plates on doors to assist people in finding their rooms, some nameplates had been scratched out and replaced with other names which were illegible. One bathroom seen did not have a notice on informing people it was a bathroom. In the kitchen one cupboard door was ill fitting and did not close properly. Plastic drinking cups provided to people were very stained and old. The aprons provided to staff to wear on entering the kitchen were marked and stained. The inspector acknowledges that some of these issues had been identified and planned improvements were in place. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff training and recruitment procedures protected people. Evidence: The staffing rota was examined, which showed that staffing levels were being maintained. Comments about staffing were positive, and included, The staff are good He is my friend National Vocational Qualifications (NVQ) were available to staff. In the Aqaa the manager stated that of the 24 care staff, 8 had achieved NVQ level 2 or above in care. Three staff recruitment files were checked. They contained all of the required information and included a photograph, proof of identity and qualifications, an application form, two written references and an employment history. The files contained evidence that a Criminal Records Bureau (CRB) check had been undertaken at enhanced level. A programme of staff training was in place. Staff surveys and staff spoken with Care Homes for Older People Page 19 of 27 Evidence: confirmed that they had been provided with induction training. The training records checked showed that a range of relevant training was provided to staff, for example, dementia awareness. Care Homes for Older People Page 20 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed. Health and safety systems were adhered to so that people were protected. Evidence: A new manager had been recruited since the last inspection. She was a qualified nurse and had applied to register with the Care Quality Commission.The manager stated that she anticipated commencing the registered managers award within the next few months. The manager and administrator were well organised and all of the documents seen were up to date. A quality assurance system was in place. Monthly audits of systems within the home were undertaken by an area manager, records of which were seen. Annual surveys with people living at the home and their relatives were undertaken. The results of these were audited and published. The results of the most recent survey were on display in the entrance hall. Care Homes for Older People Page 21 of 27 Evidence: Spending monies were kept for some people. Records of these were sampled. Each transaction was recorded and receipts kept. Money was stored securely. Records seen and talking to staff showed that care staff had been provided with supervision at the recommended frequency, and regular staff meetings were held. Health and safety systems were in operation and records seen verified that systems were checked and serviced. Weekly fire alarm checks had been undertaken and regular fire drills took place. A programme of mandatory training was provided to staff, and all of the staff spoken with said that they had undertaken training in moving and handling, health and safety, fire, food hygiene and control of infection. The manager kept a matrix of training, which was seen. In January 2009 the home was awarded a risk management certificate from their insurance company following a risk surveyors visit. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Staff administering 08/06/2009 medication must ensure that medication has been taken so that safe procedures are adhered to 2 9 13 Medication must not be left unattended so that people are kept safe 08/06/2009 3 9 13 Accurate medication records 08/06/2009 must be maintained, where a medication has not been taken, this must be recorded as refused to keep people safe 4 12 16 Further activities that 30/06/2009 include trips out of the home must be provided so that people have choice 5 19 19 All parts of the home must be well decorated. The damaged decoration in the living room and identified bathroom must be repaired 08/06/2009 Care Homes for Older People Page 24 of 27 so that people are provided with a pleasant place to live 6 19 16 The home must be well maintained. All damaged and worn carpets must be cleaned or replaced. The damaged bedroom chair must be replaced so that people are comfortable 7 26 16 Old and stained drinking cups must be replaced so that people are provided with suitable equipment 8 26 16 Aprons provided to staff to enter the kitchen must be kept clean so that safe procedures are adhered to 9 26 16 All parts of the home must be kept clean and free from offensive odours so that people have a pleasant place to live 10 31 9 The manager must commence NVQ level 4 or equivalent so that she has the skills to undertake her duties 01/07/2009 08/06/2009 08/06/2009 08/06/2009 08/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 27 1 19 Bathroom and bedroom doors should be clearly marked to help people find their way. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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