Inspection on 29/11/05 for Tarvin Court Nursing Home

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tarvin Court Nursing Home 14/06/06

Tarvin Court Nursing Home 09/08/05

Tarvin Court Nursing Home 30/09/04

Tarvin Court Nursing Home 14/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Tarvin Court Nursing Home 4 Tarvin Road Littleton Chester Cheshire CH3 7DG Lead Inspector A Gillian Matthewson Unannounced Inspection 12.00m 29 November 2005 th 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 Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tarvin Court Nursing Home Address 4 Tarvin Road Littleton Chester Cheshire CH3 7DG 01244 332538 01244 336533 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) Ashbourne Homes Limited Mrs Linda May Coleman Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of 28 service users in the category OP (Old age, not falling within any other category) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The registered manager must complete the Registered Managers` Award (NVQ Level 4) by 31 December 2005 9th August 2005 3. Date of last inspection Brief Description of the Service: Tarvin Court is a care home providing nursing and/or personal care and accommodation for up to 28 older people.The home is located in Littleton on the outskirts of Chester, approximately two miles from the city centre, on a main bus route.Accommodation is on two floors. Some accommodation is in the original Victorian building and some in a purpose built extension. The home has a passenger lift. There are 22 single rooms and 3 double rooms, 23 having en-suite facilities. Day space consists of one main lounge, a sun room, a small sitting room, a dining room and a sitting area in the hall.Parking space is available at the front of the building and there is a garden and enclosed patio area at the rear of the property. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out as part of the Commission’s regulatory programme. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over six hours and included a tour of the building, inspection of records and discussion with five residents, five members of staff and three visitors. Residents and visitors were very complimentary about the staff, but were disappointed in the lack of opportunity for recreational activities. Feedback was given to the registered manager at the end of the inspection. What the service does well: What has improved since the last inspection? Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 6 Information for residents has improved, in that details of the homes philosophy of care and aims and objectives have been included in the information given to prospective residents. 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. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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 Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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 Prospective residents are assessed prior to admission and are provided with the information they need to enable them to make a choice about whether they wish to reside there. EVIDENCE: Residents confirmed that they (or their relatives) had been given a copy of the guide to the home when they went to look round the home before admission. There was also a copy in every bedroom. It contained various useful information, including details of the services and facilities and terms and conditions of residency. An additional brochure contained information about the registered provider, including the company’s philosophy of care and aims and objectives of the home. There was evidence (from documentation kept in the home) that prospective residents were always assessed prior to admission by the home manager or a senior nurse, to determine whether the home could meet their needs. The assessment covered all aspects of the person’s health, personal and social care Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 9 needs. Residents requiring nursing care were also assessed by nurses employed by the Primary Care Trust, to determine the level of NHS funding to be provided. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 10 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 & 10. Residents health and personal care needs are set out in a plan of care and are fully met in a manner which maintains their dignity. Residents’ right to privacy is respected. The recording of the administration of medication does not demonstrate that residents are receiving their prescribed medication at all times. EVIDENCE: A sample of three care plans, relating to residents who had been spoken with, were examined. They contained a full range of assessment documentation, risk assessments, and plans of care. They also contained details of visits from GPs and other professionals and records of review meetings that had been held. Care plans in relation to health and personal care were fully completed, up to date and were reviewed on a monthly basis. Residents’ life histories were recorded, together with information regarding residents’ social interests. All three care plans had been signed by the resident or their representative to demonstrate that they had been drawn up in consultation with them. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 11 There was evidence from care plans and from speaking with residents and staff that health needs were met. Residents’ needs were assessed in relation to nutrition, continence, mobility and risk of pressure sores. Equipment necessary to aid mobility and for the prevention and treatment of pressure sores was provided. Care plans contained evidence that arrangements were in place for residents to obtain the services of other health care professionals when required. The residents whose care files were reviewed had received consultations or treatment from a range of health care professionals including optician, dentist, chiropodist, GP, continence adviser, community psychiatric nurse and urology nurse practitioner. The arrangements for storage and disposal of medications were satisfactory. Residents who self – administered medication had had a comprehensive risk assessment to ensure that they were safe to do so. Medication administration record (MAR) sheets contained appropriate instructions for the administration of the medicines prescribed by each resident’s GP. However, records of administration were unsatisfactory. For example, several prescribed medications had not been signed as given at certain times on 21st & 22nd November, and there was no explanation as to why they may not have been given. See Requirement 1. Residents confirmed that staff treated them with respect and were mindful of their privacy and dignity. Staff were trained to speak to residents in a courteous and helpful manner, addressing them by their preferred name. They were observed knocking on residents’ doors and waiting for permission to enter the room. Staff were observed serving drinks, tidying residents’ rooms and chatting with residents. They were respectful and had a good rapport with the residents. When asked about the staff, residents made comments such as ‘ the staff are very good’, ‘ they are kind and helpful’. Residents confirmed that they were able to wear their own clothes and use their own toiletries and could meet with their visitors in private. It was noticeable that staff took particular care to assist residents to look their best. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 12 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 & 15. Residents can exercise personal autonomy and choice and maintain contact with family and friends, but the home provides little stimulation for them in the way of social or recreational activities. Meals are varied, nutritious and well balanced but do not always suit the taste of some residents. EVIDENCE: Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 13 Residents confirmed that the daily routines were flexible and they could have a lie in and go to bed when they wished. There was a monthly activity programme displayed in the hall that included walks, old time music, bingo, painting, crafts, soft ball games and baking. A church service was held in the home every Sunday and a Roman Catholic priest visited monthly to give Holy Communion. A hairdresser visited the home monthly, and also a mobile library. The home had access to a minibus for outings. However, when questioned about activities, residents said that there was very little to do and the activity programme was not followed. One of the care staff had six hours per week to dedicate to social activities. However, if she took a resident out to the shops that could take up half that time. This situation remained unchanged from the previous inspection in August. See Requirement 2. Residents and visitors confirmed that visiting was encouraged at any reasonable time. The home was able to arrange advocacy for any resident who did not have a representative. Residents were able to personalise their rooms as they wished with small items of their own furniture, ornaments, pictures and any other mementoes. Residents were offered three full meals per day, and hot and cold drinks and snacks were offered in between. Breakfast was served at 9am, lunch at 12 midday and tea at 5pm. Residents could have a cooked breakfast if they wished. The main meal was served at midday, with a lighter meal at teatime, and sandwiches at 9pm. Menus covered a four week cycle, and the chef reviewed and altered them 3 or 4 times a year. Residents said they were asked for a choice from the menu the day before and could choose whether they ate in the dining room or their own room. Tea was served during the inspection. Residents were offered soup to start, then a choice between ham salad or corned beef hash followed by tinned peaches and ice cream. Residents spoken with on this inspection said the food was adequate but ‘nothing special’. In the report of the last inspection it was recommended that the registered provider consult with residents about the meal provision, but no consultation had taken place. See Recommendation 1. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Staff have knowledge and understanding of adult protection issues, which protects residents from abuse, but the manager requires knowledge of local procedures. EVIDENCE: The home had satisfactory policies and procedures in place to meet this standard, including prevention of abuse, whistle blowing and protection of vulnerable adults. Staff were trained at induction and attended ‘Resident Welfare’ training, which covered issues of abuse and whistle blowing, on an annual basis. However, the home did not have a copy of Cheshire County Council’s adult protection policies and procedures and the new manager was unaware of them. See Recommendation 2. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 15 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 & 26. The home provides a safe, comfortable, well-equipped and clean environment for the residents. EVIDENCE: The home was clean and well-maintained. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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 & 30. Recruitment practices afford protection for residents and the numbers of the staff are sufficient to meet their needs. However, the induction programme does not equip staff in the early stages of their employment with all the skills they need to adequately care for residents. EVIDENCE: At the time of the inspection, the home was providing care and accommodation for 24 residents. Staffing levels consisted of four care staff from 8am to 2pm, three from 2pm to 8pm and two overnight. In addition, there was a registered nurse on duty twenty four hours a day. This was adequate to meet residents’ needs. The home also provided domestic, laundry and catering staff, plus a handyman and an administrator. Three of the 14 care assistants had an NVQ Level 2 in Care and three were were due to commence training in January. When these staff have attained the qualification, the home will still fall short of the standard that 50 of care staff are trained to this level. See Recommendation 3. Three staff files were reviewed. These contained all the required information and documentation for the protection of service users. Staff were provided with the General Social Care Council Code of Conduct and Practice. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 17 Although the staff training programme covered the Skills for Care induction standards, this training was not provided in the induction period and it could take twelve months for new staff to complete the programme. See Requirement 3. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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. Quality assurance systems were in place, but residents’ views on the service were not actively sought to ensure that the service provided was in accordance with the residents’ wishes. EVIDENCE: The previous manager left the home in October and the new manager commenced employment in the home on 30th September 2005. She is an experienced nurse who has worked as a home manager in Canada. She has not yet submitted an application to CSCI for registration as manger of the home. See Requirement 4. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 19 The home had a quality assurance programme policy, but it had not been fully implemented at the time of the inspection. Regular audits were carried out in relation to health and safety, documentation, medication, food safety, training, housekeeping, quality of care, infection control, facilities, activities and customer care. Residents’ meetings were held quarterly and owner’s visits were carried out monthly. However, the policy stated that customer satisfaction surveys would be sent out annually and results would be published. This had still not occurred. See Recommendation 1. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X x Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? 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 OP9 Regulation 13(2) Requirement The registered person must ensure that any medication administered is signed for or any reason for non-administration is recorded. The registered person must consult residents about their social interests and , having regard to their needs, provide facilities for recreation. (timescale of 31/10/05 not met) The registered person must ensure that staff receive training in accordance with the Skills for Care induction standards within the first three months of employment. The registered person must ensure that the new manager submits an application for registration to CSCI. Timescale for action 31/12/05 2 OP12 16(2) (m&n) 31/01/06 3 OP30 18(1) 31/03/06 4 OP31 8&9 31/01/06 Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 22 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 Refer to Standard OP15 OP18 OP28 Good Practice Recommendations A customer satisfaction survey should be carried out that includes questions on the quality of the food. Staff should have access to Cheshire County Council’s adult protection procedures. Steps should be taken to increase the level of staff training to ensure that a minimum of 50 of the care assistants achieve an NVQ Level 2 in Care. Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Tarvin Court Nursing Home DS0000018817.V258540.R01.S.doc Version 5.0 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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