Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 11/07/05 for The Carlton Nursing Home

Also see our care home review for The Carlton Nursing Home for more information

This inspection was carried out on 11th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Carlton is a relatively small care home with a maximum of seventeen service users. The home and staff provide a warm and friendly environment, offering security and consistency. Staff try to work closely with relatives offering support to relatives as well as service users.

What has improved since the last inspection?

Since the last inspection staff have worked to develop the service users` plans. The plans seen during this visit, now clearly identify the service users` needs including psychological needs relating to their dementia.

What the care home could do better:

There has not been any refurbishment or redecoration since the last inspection. Some of the decor is looking worn and some items of furniture are shabby. A programme of redecoration and refurbishment should be introduced. The garden area could be a valuable resource for service users, however it is not safe for service users to access. Work must be done to make the garden area safe and accessible to service users. At present the registered provider is not carrying out monthly management visit to the home as required in the Care Homes Regulations 2001. These visits are required to enable the registered provider to monitor and assess the service and facilities that the home provides and then to act upon any issues identified.There was insufficient evidence in the home to show that essential health and safety checks had been carried out. These must be done as the lack of them is potentially putting service users and staff at risk.

CARE HOMES FOR OLDER PEOPLE The Carlton Nursing Home 25 Greenway Milnsbridge Huddersfield HD3 4RZ Lead Inspector Sally McSharry Unannounced 11July 2005 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. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Carlton Nursing Home Address 25 Greenway Milnsbridge Huddersfield HD3 4RZ 01484 655511 01484 655511 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) Carlton Nursing Homes Ltd Miss Vanda Jane Parr CRH Care Home with Nursing 17 Category(ies) of Elderly Dementia 17 registration, with number of places The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service Date of last inspection 24 March 2005 Brief Description of the Service: The Carlton provides both personal care and nursing care to service users over the age of 65 suffering from dementia. The bedroom accommodation is on the first floor of the home, which is serviced by a passenger lift. The bedrooms are all single rooms, some of which have ensuite facilities. The communal space is on the ground floor and consists of two lounge areas and a separate dining room. The home is within easy reach of Huddersfield. There is limited parking within the grounds of the care home adjacent to The Carlton. There is some on road parking. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on 11 July 2005. During the visit the inspector spoke to some service users, relatives and staff. A brief tour of the building was carried out and a selection of care records, staff records and health and safety checks and tests were audited. During this visit, management and health and safety issues were identified some of which have been brought to the attention of the registered provider in previous reports. These issues have not been satisfactorily addressed and the CSCI may take action to ensure the identified shortfalls are addressed. What the service does well: What has improved since the last inspection? What they could do better: There has not been any refurbishment or redecoration since the last inspection. Some of the decor is looking worn and some items of furniture are shabby. A programme of redecoration and refurbishment should be introduced. The garden area could be a valuable resource for service users, however it is not safe for service users to access. Work must be done to make the garden area safe and accessible to service users. At present the registered provider is not carrying out monthly management visit to the home as required in the Care Homes Regulations 2001. These visits are required to enable the registered provider to monitor and assess the service and facilities that the home provides and then to act upon any issues identified. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 6 There was insufficient evidence in the home to show that essential health and safety checks had been carried out. These must be done as the lack of them is potentially putting service users and staff at risk. 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 Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 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 The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 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 and 3. Service users are assessed before they are admitted to the home to ensure that the staff and the home are able to meet the prospective service user’s needs. EVIDENCE: An up to date copy of the home’s statement of purpose and service user guide is available in the entrance of the home. This gives information to service users and their representatives. Copies of pre-admission assessments were available. These assessments are carried out by a qualified member of staff and take place to ensure that the staff and the home are able to meet the service users’ health and welfare needs. The home does not provide intermediate care, however one service user attends the home daily for day care. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Service users’ individual health and welfare needs are set out in a care plan and there is evidence that service users’ health needs are being met in the home. Medications are appropriately managed. Service users are treated with respect and their privacy is maintained. EVIDENCE: Improvements have been made to service users’ plans since the last inspection. Plans now clearly contain service users’ specific psychiatric needs and how the staff are to manage these needs in the home. There is written evidence that service users and their representatives are aware of their care plans and have been involved in the care plan development process. Care plans and records also show that service users’ health needs are met either by the staff in the home or by other health care professionals accessed for the service user by the staff in the home. The management of medications continues to be satisfactory. Medicines are appropriately stored, recorded and administered. One service user has specific problems relating to how they take their medicines. A specific care plan has been developed with input from other health care professionals, relatives and staff in the home. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 10 Care plans clearly advised staff to allow service users choice in their daily activities. Some service users are assisted by independent advocates to help them maintain their independence and choices. Staff were seen to interact with service users sensitively and privacy was maintained when providing personal care. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, and 15. Activities are provided for service users, however the potential for activities could be extended if the enclosed garden area was made safe for services to access. Many service users maintain regular contact with their families and friends. Relatives, staff and independent advocates all assist service users to maintain control and choice in their lives. Wholesome and appetising meals are provided. EVIDENCE: Some activities are offered in the home and service users and staff were chatting and listening to music together. It was an extremely hot day when the inspector visited and service users were being offered cool drinks regularly. Some of the service users walk, within the home but are unable to access the garden as some of the paving stones and areas of the garden are uneven and would present a hazard to service users. Work must be carried out to make the garden safe for service users. Visitors called to see service users while the inspector was at the home. The visitors said that they are made to feel welcome and are able to call at any time. Although the cook was on sick leave at the time of the inspection an appetising meal had been prepared for lunch. One service user said the food provided in The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 12 the home was very good and that she liked the meals provided. Other service users made no comments regarding the meals provided. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Service users are protected from abuse and relatives visiting at the time of the inspection were confident in staff and felt able to raise any issues of concern. EVIDENCE: There have been no formal complaints recorded since the last inspection. Relatives who were visiting at the time of the inspection said if they had any concerns they would raise them with staff and they said staff were very easy to approach. At the last inspection it was recommended the whistle blowing policy be reviewed to make it more relevent to the care home. This has not yet been carried out and remains a recommendation of this report. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home could be maintained to a higher standard, however it was clean and tidy. EVIDENCE: There has been no refurbishment or redecoration since the last inspection. Some of the decoration is showing wear and some of the furniture provided is shabby. Recommendations have been made for a second time about the décor and some of the furnishings. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 15 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 and 30. Staffing levels in the home are sufficient to meet the needs of the current service users. Adequate recruitment processes are in place to protect service users. Staff training is ongoing to enable staff to meet the needs of the service users. EVIDENCE: There is usually one qualified nursed and three carers on duty during the day. At night there is one qualified nurse and one carer on duty. Domestic, catering and laundry staff are provided. A sample of staff recruitment files show that adequate checks are being carried out on new staff, however staff are not given a contract of employment. There is evidence that staff receive an induction when they commence work at the home and that training appropriate to the service users needs is being provided in the home. Six staff are working through a course in dementia care. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 16 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) 33, 35 and 38. The registered provider is failing to carryout monthly management visits to monitor the service provided, as required under regulation. Service users’ financial interests are safeguarded. There is insufficient evidence in the home to show that the health, safety and welfare of service users and staff is being promoted and protected. EVIDENCE: The registered provider continues to fail to monitor the service the home is providing on a monthly basis, immediate action must be taken to ensure such checks and a report are produced each month. A copy of the report must be forwarded to the CSCI each month. During this inspection there was insufficient documentation to show that appropriate health and safety checks have been carried out to ensure service users and staff are safe and protected in the home. An immediate action letter was left at the home requiring evidence be provided that the passenger lift has been suitably serviced, that the home has a valid gas safety certificate. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 17 The registered provider continues to fail to provide staff that are trained in first aid. Other health and safety dangers were identified and action must be taken to make the home safe. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 18 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 1 x 3 x x 1 The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 19 no 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 19 Regulation 23(2)(o) Requirement Timescale for action 30.09.05 2. 33 26 3. 38 13(4)a 23(2)c 4. 38 13(3-4) The registered provider must provide external ground which are suitable for and safe for use by, service users are provided and appropriately maintained. The registered provider must 01.08.05 produce a regulation 26 report each month. A copy must be given to the registered manager with a copy forwarded to the Commission for Social Care Inspection. The time scale of 11.08.04 and the 31.05.05 have not been met. The home must provide a 18.07.05 maintenance plan to the CSCI detailing when the maintenance to the passenger lift will be completed, a copy of the valid lift certificate must also be provided. The time scale of 11.08.04 and 31.05.05 have not been met. This information must be provided no later than the date indicated. Failure to provide this information may lead to enforcement action being taken. The registered provider and 18.07.05 registered manager must provide a valid gas safety certificate. Version 1.30 The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Page 20 5. 38 13(4) 6. 38 13(4) There must be a member of staff trained in first aid on each shift The time scale of 11.08.04 and 31.05.05 have not been met. The door plate from which a member of staff received a burn must be repaired again and made safe. 30.09.05 31.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 18 19 19 19 29 Good Practice Recommendations The whistle blowing policy should be reveiwed to make it relevent to the care home. The dining room looks bleak and it is recommended that this area be redecorated, a new floor covering be provided and new curtains. During this inspection there was a very old worn set of drawers in the main ground floor bathroom, these should be removed. A programme of redecoration and refurbishment should be implemented. All staff should have a contract of the terms and conditions of their employment. The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 The Carlton Nursing Home J51J01_62776_The Carlton_vn230807_110705.doc Version 1.30 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!