Inspection on 09/08/05 for Tarvin Court Nursing Home

This inspection was carried out on 9th August 2005.

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

Tarvin Court Nursing Home 14/06/06

Tarvin Court Nursing Home 29/11/05

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 CH3 7DG Lead Inspector Gill Matthewson Announced 9 August 2005 10.15 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 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 F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tarvin Court Nursing Home Address 4 Tarvin Road Littleton Chester CH3 7DG 01244 332538 Telephone number Fax number Email 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) Both of places Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 28 service users in the category OP (Old age, not falling within any other category) 2 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 3 Date of last inspection 30 September 2004 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 ensuite 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 F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 five hours and included a tour of the building, inspection of records and discussion with nine service users, five members of staff and two visitors. 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? Information for residents has improved, in that details of all facilities have been included in the information given to prospective residents. Also, a breakdown of fees payable and by whom has been included in the residents’ contract. Two more staff have achieved an NVQ Level 2 in Care. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 6 The environment has been improved with the provision of new bedding and curtains. A stair lift has been installed to provide easier access to four of the bedrooms and hold open devices have been fitted to enable those residents who wish to, to keep their bedroom doors open without increasing the fire risk. A sluicing disinfector has been installed to reduce the risk of cross infection. 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 F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 standard(s) 1,2&3. Prospective residents are assessed prior to admission and are provided with most of the information they would need about the home to enable them to make a choice. They are also provided with a written contract or statement of terms and conditions on admission. 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. However, it did not set out the aims and objectives of the home or philosophy of care. See Requirement 1. Each resident was provided with a contract on admission, which included the terms and conditions of residency and a breakdown of fees payable and by whom. 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 F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 standard(s) 7,8&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. Residents’ social care needs are not always addressed. 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. However, although residents’ life histories were recorded, there was very little information regarding residents’ social interests and no plans of care to address social or recreational needs. See Requirement 2. 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 F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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. Two residents had pressure sores, but these had benn present on admission from hospital. 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, district nurse, dietician, diabetes nurse specialist and urology nurse practitioner. Residents confirmed that staff treated them with respect and were mindful of their privacy and dignity. Staff were trained to speak to service users in a courteous and helpful manner, addressing them by their preferred name. They were observed knocking on service users’ 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’, ‘one gave me a shower this morning, she was marvellous’. 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. Some of the ladies said that staff were very good at assisting them to do their hair or apply make-up. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 standard(s) 12,13 &15. Residents can maintain contact with family and friends, but the programme of activities provides little stimulation for them. Meals are varied, nutritious and well balanced but do not always suit the taste of some residents. EVIDENCE: Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 13 Residents confirmed that the daily routines were flexible. Some residents liked to get up late morning, and were left undisturbed until mid morning drinks were served. There was a monthly activity programme 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. 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. None of the care files reviewed had a social care plan. See Requirement 3. Residents and visitors confirmed that visiting was encouraged at any reasonable time. 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. Residents spoken with were not enthusiastic about the food. Most said it was ‘alright’, one said it was ‘mediocre’, another said ‘sometimes it is very nice, but other times it’s not’. On the day of inspection the main meal consisted of a choice between gammon with parsley sauce or liver in gravy with broccoli, carrots and boiled potatoes, followed by semolina. This was well presented and the gammon was both tender and tasty. See Recommendation 1. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 standard(s) 16 Residents are confident that any concerns will be taken seriously. EVIDENCE: The home had a satisfactory complaints procedure and records were maintained of all complaints, including any investigations and action taken. The complaints procedure was displayed in the home’s entrance and in the service user guide. Residents were aware of how to make a complaint and felt sure it would be taken seriously. There had been no complaints since the last inspection. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 standard(s) 19, 22 &26 The home provides a safe, comfortable, well-equipped and clean environment for the residents. EVIDENCE: A decoration and maintenance programme was in place and the building and grounds appeared well-maintained and safe. New curtains and bedding had been purchased since the last inspection. A stair lift had been fitted to provide easier access to four of the bedrooms. Due to this being an older property, the sun room area was not wheelchair accessible. However all residents could access the lounges and the dining room. Grab rails had been fitted and a range of moving and handling equipment was available. This included four portable hoists and two fixed bath hoists. Doorways and corridors were of adequate width for wheelchairs. A nurse call system was installed in all areas. Some new profiling beds had been purchased. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 16 The home was clean and tidy throughout, apart from one bedroom carpet that was stained. See Requirement 4. A sluicing disinfector had been provided for disinfection of commode pans. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27&28 The numbers of the staff are sufficient to meet the needs of the residents and training is ongoing to ensure that staff have the necessary skills. EVIDENCE: At the time of the inspection, the home was providing care and accommodation for 23 residents. The home had a full complement of staff. 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, three were working towards it and two were waiting to enrol. When these staff have attained the qualification, the home will be meeting the standard that 50 of care staff are trained to this level. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31&33 The manager providing leadership, guidance and direction to staff to ensure that residents received consistent care. 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: At the time of the inspection, the registered manager had been in post for sixteen months. She was a first level registered general nurse who had also attained a Diploma in Health Education. She had previously been the Deputy Manager of another home for 4 years. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 not occurred. See Requirement 2 and Recommendation 1. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 2 x x x x x Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 21 Yes 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 OP1 Regulation 4(1)(a) Requirement The registered person must include in the statement of purpose a statement of the aims and objectives of the care home.(previous timescale of 30.11.04 not met) The registered person must include instructions as to how the residents social needs are to be met in the care plan. The registered person must consult residents about their social interests and , having regard to their needs, provide facilities for recreation. The registered person must, at appropriate intervals, consult with service users and their representatives about the quality of care provided at the care home, supply a report to the Commission and make it available to service users. (previous timescale of 30.03.05 not met) Timescale for action 31.10.05 2. OP7 15(1) 30.09.05 3. OP12 16(2) (m&n) 31.10.05 4. OP33 24 31.10.05 Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 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. Refer to Standard OP12 Good Practice Recommendations A customer satisfaction survey should be carried out that includes questions on the quality of the food. Tarvin Court Nursing Home F51 F01 S18817 Tarvin Court V242934 090805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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. 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