Inspection on 19/10/06 for The Charlton Centre for Alzheimer`s and Dementia Care

This inspection was carried out on 19th October 2006.

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

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... 29/11/05

The Charlton Centre for... 11/08/05

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 0AE Lead Inspector Helen Battle Key Unannounced Inspection 19th October 2006 09:15 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 Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 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. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carlinghow Nursing Home Address Carlinghow Hill Batley West Yorkshire WF17 0AE 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) 01924 473333 01924 444344 ivor@charltoncare.com Charlton Care Homes Ltd Mr Ivor Charles Foster Care Home 83 Category(ies) of Dementia - over 65 years of age (83) registration, with number of places Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Carlinghow Nursing Home is registered to provide a service for up to eighty three elderly people with dementia who require nursing care. 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 amenities are within ten minutes’ walking distance. The home is well served by public transport. There is ample parking space at the home. The provider informed the Commission for Social Care Inspection on 11 August 2006 that the fees range from £360.84 to £505.00 per week. There are additional charges for hairdressing, newspapers, and magazines. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit carried out by two inspectors. The inspectors arrived at the home at 9.00am. One inspector left at 1.30pm and the other left at 4.00pm. During this visit the inspectors spoke to some of the service users, visiting relatives, some of the staff and the home’s management. The inspectors read care records, audited a sample of medications, reviewed staff recruitment and training records, and carried out a tour of the building. Prior to the inspection, ten service user questionnaires were sent to Carlinghow Nursing Home to obtain the views of service users living at the home. Due to the mental health problems of this service user group, no one was able to complete a questionnaire. There were forty-nine service users living at the home on the day of this inspection. Surveys were sent to ten relatives and friends of service users, GPs and social workers. At the time of writing this report, the inspector had received six responses from relatives and two from GPs. There were no responses from social workers. Other information used as part of the inspection process included notifications from the home to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the provider, and a pre inspection questionnaire completed by the manager. The inspector would like to thank everyone for their assistance during the inspection process. What the service does well: Service users are fully assessed to ensure the home can meet their needs prior to admission. Care plans and assessments are of a good quality and daily records give a satisfactory account of how service users spend their day. Activities are provided to meet the needs of the service users. Meals are of a good quality. Work is underway to improve the environment at the home. To accommodate the building work, the number of service users living at the home has been reduced. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 6 Staffing levels are provided that meet the needs of the service users. Staff receive induction and ongoing training. Dementia care training is taking place in the home and has already had a positive impact on the quality of the standard of care provided. The home is well run and managed by a nurse who has a good knowledge and experience of caring for this service user group. The home is very clean and odour free. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 8 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 Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their needs assessed prior to admission into the care home. EVIDENCE: Copies of Community Care assessments and pre-admission visit records were seen in the records held for two service users. The pre-admission assessment visits are carried out by the registered manager or an experienced registered nurse. These assessments are detailed and care is taken to ensure that service users are correctly placed. Service users’ families generally visit the home prior to admission. This home does not provide intermediate care. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users’ health, personal and social care needs are set out in the individual plan of care. Risk assessments are carried out and reviewed monthly. Generally, the service users are protected by the home’s medication policy and procedure. Service users are treated with dignity, respect and privacy. EVIDENCE: The care records of three service users were examined. All were of a good standard and clearly set out the needs of the service users based on assessments carried out in relation to falls, tissue viability, moving and handling, nutrition and social needs. All these assessments and related care plans were reviewed monthly. Specific detail was also included regarding how to deal with challenging behaviour of individuals. Daily records give a good account of what care and support is delivered on a daily basis. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 11 The medication of three service users was checked at random and all but one amount of medication was found to tally with the records held. The manager and line manager of the home immediately carried out an investigation and the issue was resolved. An administration error had occurred when the medication was received at the home. A recommendation is made regarding this. Eye drops were labelled with the date of opening and controlled drugs were stored correctly. Oxygen cylinders were not chained to a wall or on a stand in the medication room; a recommendation is made regarding this. Clear detail is recorded regarding the healthcare support from other agencies. These include optician, dentist and Continuing Care Team from the NHS Trust mental health services. The responses in the surveys received were positive about the staff. They stated that staff are pleasant, patient, friendly and always treat service users with respect. Staff were observed to treat service users with respect and maintain their privacy and dignity throughout this visit. One survey respondent said that they were pleased with the care and that their wife’s condition had improved since moving in. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally, the service users’ cultural, religious, social and recreational needs are being met, and they are supported to maintain contact with their family and friends. The service users are able to exercise choice and control over their lives. The home provides the service users with a varied and nutritious diet. EVIDENCE: An activities co-ordinator is employed at the home and has held this post for some time. She evidently knows the service users well and what their likes, dislikes and abilities are regarding how they like to spend their time. A record of previous hobbies and interests are documented after speaking with families and friends. Records are also in the process of being completed which give a picture of service users’ lives. Family and friends are being involved and this gives staff a person centred approach to care and activities. This is a positive move by the home and staff spoken to said they felt that this approach had improved the standard of care provided. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 13 Activities provided for service users are recorded on a board in reception and for the week beginning 16th October 2006 included one to one, nails and table games, reminiscence, bingo, baking and afternoon tea. Within the new Cedar unit there will be an area where service users and their families will be able to sit quietly (faith room) and also receive Holy Communion in a private area. It was reported that members of multi cultural denominations visit the home occasionally. Three service users regularly attend the Salvation Army and are escorted by staff from the home. Trips out for service users have taken place over the summer and have included visits to Ponderosa, White Rose Centre and a shopping trip. Lunch was seen being served during this visit and service users appeared to be enjoying a meal of lamb hotpot served with boiled potatoes, carrots and cauliflower, followed by lemon sponge and custard. This was nicely presented and service users were being assisted to eat their meal, where required, in an appropriate manner. The atmosphere was relaxed and unhurried. One of the inspectors sampled the meal and it was tasty and hot. Contact is maintained with families and friends. Relatives were seen to visit the home during this visit and were seen to be made welcome by the staff. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users, their relatives and friends are confident in raising any concerns and complaints. The service users are protected from abuse. EVIDENCE: The complaints policy is displayed on the wall in the reception area of the home. This directs visitors to the Service User Guide and Statement of Purpose, both of which are available in the reception area. Records of complaints received at the home were seen and contained copies of investigations and letters of response to complainants. Staff receive adult protection training as part of the “Skills for Care” induction. Refresher training regarding adult protection is given periodically by the area manager. Thirty-six staff have already had an annual refresher and further training dates are scheduled. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users live in a safe and, overall, a well-maintained environment that is clean and hygienic. EVIDENCE: There is major building and refurbishment work underway at Carlinghow Nursing Home to improve the facilities and environment for service users. At the time of this visit, one unit was closed and the work is ongoing with a view to open this newly refurbished unit early next year. The work already undertaken has been carried out to a high standard, with the best interests of this particular client group underpinning all the decisions made. The home is to be commended on this. The rest of the home was particularly clean and hygienic, the domestic staff should be commended on the high standard in such a large building. There were no unpleasant odours noted. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 16 Two issues were raised during the visit regarding a missing window restrictor and a loose radiator cover top. These were rectified immediately. The rest of the accommodation was maintained to a satisfactory standard. Plans to continue the refurbishment throughout the home on a phased basis are in place. Work has also commenced on a garden area in the grounds to make it safe and accessible for service users. This is a positive move which will improve the quality of life for many service users. The requirement made in the last report regarding the condition of the external window frames remains in this report. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient numbers and receive induction and ongoing training. The recruitment process ensures that service users are sufficiently protected by the home’s recruitment policy. EVIDENCE: Rotas were examined and reflected that staffing levels are in place to meet the needs of the service users. These levels are reviewed regularly by the manager and are increased where the assessed needs of service users dictate this. Almost all staff have had training in the following areas in the last 4 months: manual handling, fire procedure, adult protection and Control Of Substances Hazardous to Health. Other training has included care planning, dementia care mapping, improving dementia care and “yesterday, tomorrow, today” – Alzheimers training. Staff spoken to said that they had found the dementia care training of particular benefit and that it had helped them to improve the standard of care given to the people living at Carlinghow Nursing Home. Records of induction training were also seen. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 18 The recruitment records for three members of staff were examined and all were found to have the correct information in place. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run and managed by a manager who is fit to be in charge. The home is run in the best interests of the service users. The financial interests of the service users are safeguarded. The health and welfare of service users and staff is promoted and protected. EVIDENCE: The registered manager of the home is a nurse who has an excellent knowledge and understanding of this service user group. His enthusiasm for Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 20 improving the quality of life for the service users has evidently been passed to the staff working at the home. The home is run in the best interests of the service users, with the manager constantly reviewing practice to ensure the best possible care is provided for service users. A quality auditing system has been introduced and monthly audits are carried out on nutrition, medication, privacy and dignity, pre admission procedures, monies, cleanliness and housekeeping, internal environment, external environment and accidents. Two care plans each week are currently being audited. Other audits include maintenance and servicing, staff files, staff training and complaints. Monthly management visits have been commenced and a report forwarded to the Commission. Annual questionnaires are sent out and these have been done recently. At the time of this visit 21 responses had been received. When all the results are in, these will be collated, published and displayed in the entrance to the home. The personal monies of three service users was checked and found to tally with the records held. The two identified hazards outlined in the “Environment” section of this report were rectified immediately at the time of the visit. Weekly checks of the fire alarm and emergency lighting system are recorded as being carried out weekly. Monthly checks of the hot water temperatures are recorded. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 21 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 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23 (2) b Requirement The building must be kept in good state of repair. Attention should be given to the windows, guttering and down pipes. Timescale of 31/12/05 not met. Timescale for action 31/12/06 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 OP9 Good Practice Recommendations All medication received at the home should be correctly recorded. Oxygen cylinders should be chained to a wall or on a stand in the medication room. Carlinghow Nursing Home DS0000059693.V303097.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000059693.V303097.R01.S.doc Version 5.2 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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