Inspection on 11/08/05 for The Charlton Centre for Alzheimer`s and Dementia Care

This inspection was carried out on 11th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Charlton Centre for... 19/08/09

The Charlton Centre for... 25/02/09

The Charlton Centre for... 28/08/08

The Charlton Centre for... 26/02/08

The Charlton Centre for... 31/10/07

The Charlton Centre for... 19/10/06

The Charlton Centre for... 29/11/05

The Charlton Centre for... 20/12/04

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

CARE HOMES FOR OLDER PEOPLE Carlinghow Nursing Home Carlinghow Hill Batley West Yorkshire WF17 OAE Lead Inspector Stephen French Unannounced 11 August 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. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Carlinghow Nursing Home Address Carlinghow Hill Batley West Yorkshire WF17 OAE 01924 47333 01924 444034 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) Charlton Care Homes Ltd Mrs Lindsay Hudson Care Home with Nursing 83 Category(ies) of Older People, Dementia over 65 registration, with number of places Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 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 20th December 2004 Brief Description of the Service: Carlinghow Nursing Home is registered to provide a service for up to forty-nine elderly people who require nursing care and up to thirty-one elderly people with dementia. The home is a large detached stone built property that was converted into a care home from the former Batley General Hospital. The home has three floors connected by a passenger lift. The home is situated on Carlinghow Hill close to Nightingale Cottage Nursing Home its sister home. Local ameneties are within ten minutes walking distance. The home is well served by public transport. There is ample parking space at the home. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 11th August 2005. Not all of the standards were assessed during this inspection. The inspection was conducted by two inspectors and took ten hours. During this time a tour of the building was undertaken which included a number of service users bedrooms, the kitchen and laundry. Fifteen service users care files were examined and five staff details were checked. A number of service users and staff were spoken to. The previous manager has been promoted within the company. The home is currently manager by the deputy manager who has applied to the Commission for Social care Inspection to register as the manager. His application is currently being processed. What the service does well: What has improved since the last inspection? Following the last inspection the home has redecorated the lounge on the Willows unit. New armchairs and a new carpet have been purchased and the lounge looks and feels very homely. The manager has commenced staff supervision and it was said that staff will receive at least six supervisory sessions per year. A number of thermostatic valves have been fitted to hand basins in areas used by service users, this will prevent accidental scolding. The home now has a formal quality audit system, which is carried out monthly. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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 Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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) 2,3 Service users receive a terms and condition of admission document outlining amongst other thing the fees payable and their frequency. Service users needs are assessed to ensure they can be met within the home. EVIDENCE: The home has a terms and conditions of admission document which is signed by the service user or their representative. Within this document there is information on the fees payable and what is and is not included in the fees. Completed contracts were seen for a service user who has recently been admitted to the home. Service users have a community care assessment completed by their social worker. This determines if the service user requires nursing or personal care. The manager of the home said that he visits prospective service users and completes a pre-admission assessment. This assessment enables the home to decide if they are able to meet the service users assessed needs. Following the assessment the home confirms in writing to the service user that they are able Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 9 to meet their needs and what room they will occupy. Completed assessments were seen for three service users. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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) 7,8,9 Problems identified through the risk assessment process are not always addressed, or reviewed leaving the service users potentially at risk. Staff do not follow the home’s policy on the administration of medication consistently. EVIDENCE: Fifteen service users’ care files were examined as part of the inspection. These contained information on the service users ability to carry out activities of daily living such as washing and dressing. The information in the care files also informs the staff of what help and support the service user requires. There were risk assessments in place for moving and handling, skin integrity and nutrition. It was noted that nutritional assessments, which identified service users as being at risk were not reviewed monthly or a care plan put into place to inform staff of what they are required to do to prevent further deterioration. A number of care files identified service users with behavioural problems but there were no care plans in place to assist the staff with dealing with the behaviour. There was evidence in the files inspected that staff access advise and information from members of the multidisciplinary team, such as the Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 11 tissue viability nurse, the mental health team and opticians, chiropodists and dentists. Daily entries in the care files were not very descriptive of the service users psychological or social well being. Since the last inspection the home has introduced a detailed wound care plan, which describes the size of the wound and what treatment is required. Qualified nursing staff are responsible for administering medication. A number or service users stocks of medication were checked against the medication administration records held by the home. It was noted that some of the stock balances did not tally with the records held. This was due to stock balances not being carried forward and medication either being signed for and not given, or given and not signed for. This is unsafe practice and could lead to errors being made. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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 Appropriate social activities are on offer, which meets the needs of the service users. Service users receive a nutritious varied diet. EVIDENCE: The home employs a social activities co-ordinator who is responsible for arranging all the social activities within the home. A list of the week’s activities is displayed on the notice board in the reception area. Coffee mornings are held regularly and service users bake cakes for these events. Following discussion with the manager it was evident that a lot more social activities are on offer than is advertised. Within the care files inspected it was noted that there was a record of activities in which the service user had been involved, however these were not up to date and did not reflect the actual number of times the service user had joined in an activity. It appeared that the home offered very little social stimulation to service users who were suffering from dementia. Service users are able to receive visitors at any time. Members of the local church visit monthly. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 13 The home operates a four week menu, which is currently under review. Service users said that the food was nice and that there was always a choice. A tour of the kitchen was conducted and there appeared to be adequate stocks of food and fresh fruit and vegetables. The temperatures of the fridges and freezers are recorded daily to ensure the safe storage of food. Service users were observed having lunch which was well presented and colourful. Staff assisted service users who had difficulty eating in a relaxed unhurried way. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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) 16,18 Complaints are handled appropriately and service users are protected from abuse by the home ensuring staff receive training in the protection of vulnerable adults EVIDENCE: The home has a detailed complaints policy, which is displayed in the reception area. There have been five complaints since the last inspection, and documentary evidence seen confirmed that these had been dealt with appropriately. Staff receive training in adult protection as part of their induction training, records seen confirmed this. A number of staff were questioned on this subject and all gave good responses to questioned asked. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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) 19.21.23.24.25,26 The home requires attention both internal and external to ensure it is comfortable and safe for service users. Systems are not in place to prevent cross infection this could place the service users at risk EVIDENCE: Following a requirement made on the last inspection the home has redecorated the lounge on the Willows unit. New armchairs and a new carpet have also been purchased. Many of the bedrooms on the Willows have been personalised with the service users own belongings. During a tour of the unit a number of areas were identified as requiring attention these included minor redecoration to service users bedrooms, new flooring to a toilet on the willows and minor decoration to the dining room on the Cedars unit. The corridors on the Willows unit especially the bedroom doors were in need of cleaning and some minor decorating to paintwork. There was a strong odour of urine on the Willows unit, Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 16 which was noted throughout the day, other parts of the home smelt clean and fresh. There are communal bathrooms and toilets in close proximity to service users’ bedrooms and communal areas. It was noted that there were bottles of shampoo, bubble bath and other toiletries in most of the bathrooms. These items could be ingested by service users and should be locked away. To prevent cross infection the home should have a policy informing staff on what cleaning product must be used to clean the bath following each use. The use of communal soap should also be stopped. Following a requirement from the last inspection the home has fitted some thermostatic valves to hand basins, however there are still some outstanding a further requirement is to be made. Carlinghow is a large building and is now in need of some major repair work to the outside. Some of the window frames are in need of replacement and others require repainting. Guttering and down pipes should also be renewed or repaired. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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) 27,29 There are adequate numbers of competent staff on duty to attend to the needs of the service users living in the home. The recruitment practices have improved but the manager must ensure that the documents in respect of people working in the home are obtained as outlined in schedule 2 of the Care Standards Act. EVIDENCE: The staff duty rota was checked for the months of July and August. These confirmed that the home is working within the staffing notice set by the previous registering authority. The homes staff covers holidays and sickness and agency staff are rarely used. Over 50 of care staff have an N.V.Q level 2 qualification and two staff are completing level 3. Six staff details were checked and the homes recruitment practices have improved since the last inspection. However one file checked only contained one reference and although it was stated that a POVA first check had been made there was no evidence of this. Service users spoken to said that the staff were helpful and friendly and that there appeared to be adequate numbers of staff on duty. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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) 31,33,35,36,38 EVIDENCE: The manager of the home has recently been promoted within the company and the deputy manager is currently the acting manager until he has undertaken the fit person process with the C.S.C.I. The acting manager stated that he operates an open door policy for both service users and staff to enable them to bring any issues or problems they may have to his attention. Resident and relative meetings are held every three months the last one being 1/4/05. Staff and service users spoken to said that the manager was approachable. Service users are able to deposit small amounts of monies in the homes bank account to enable them to purchase small items such as sweets and newspapers. Three service users’ monies were checked and the balances tallied with the records held by the home. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 19 Following a recommendation from the last inspection the manager has commenced formal staff supervision. Staff receive six supervisory sessions per year and during these sessions they discuss, amongst other things, their training needs and the aims and objectives of the home. Completed supervision records were seen for four staff. The home has introduced a quality assurance system, which is completed monthly by the area manager. An annual questionnaire is sent to all service users and their families to seek their views of the home and the care that they receive. The results of this questionnaire are going to be made available through the homes newsletter. Staff have received training in fire prevention and moving and handling. The fire alarm systems are checked weekly and certification in relation to gas, electricity and water are in place and up to date. There are concerns surrounding preventing cross infection particularly when dealing with service users hygiene needs. The manager stated that following a service user taking a bath the bath is rinsed with water prior to the next service user taking a bath. The home must ensure that the bath is disinfected after each use and the use of communal soap should be avoided. It was also noted that the shower head on one of the baths was thick with mould. Shower heads must be cleaned regularly to prevent the incidence of legionnela occurring. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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 x 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 x 2 x 2 2 2 1 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 1 x 3 x 3 3 x 2 Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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 7 Regulation 12 (1) a Requirement Risk assessments must be reviewed and if they identify a service user as being at risk then steps must be taken to reduce those risks. The registered person must ensure the safe recording and administration of medication. The building must be kept in good state of repair.Attention should be given to the windows, guttering and down pipes. The home must be kept free from offensive odours The home must obtain the documents as specified in Schedule 2. Staff must disinfect the bath after each use, Communal soap must be removed. Shower heads must be cleaned at regular intervals.Staff should further training in the prevention of cross infection. Thermostatic valves must be fitted to hand basins in all areas used by service users. Timescale for action on reciept of this report. 30/9/05 31/12/05 2. 3. 9 19 13 (2) 23 (2) b 4. 5. 6. 26 29 38 16(2) k 19 (1) b 13 (3) 31/10/05 30/9/05 31/10/05 7. 25 13(3)(4)c 31/12/05 Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.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. 2. 3. 4. 5. 6. Refer to Standard 7 12 21 20 23 26 Good Practice Recommendations Daily entries in service users care files should be reflective of the service users psychological and social well being. If a service user joins in social activities then this should be recorded in the care file. Replace the flooring in the toilet identified during the inspection. The areas identified in this report should be decorated. The service users bedrooms identified during the inspection should be decorated. Toiletries should not be left in the bathrooms. Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 Page 23 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 Carlinghow Nursing Home J51J01_s59693_CarlinghowNH_v232047_110805.doc Version 1.40 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. 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