Care Home: Charlton Court

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What the care home does well Residents looked well cared for. They said they were well looked after. Staff support residents to maintain contact with their family and friends. Residents spoke highly of staff. They said: "the staff are canny, she (pointing to carer) is an absolute godsend""the staff work hard, they are very good" The care plans that we read clearly set out the needs of the residents. When we spoke to those residents or discussed their care with staff, the needs matched those written in the plans. The care is regularly reviewed, taking into account peoples changing needs and individual wishes. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of those spoken to were pleased with the quality and choice available. We tasted the food that was served to residents. It was well presented, hot enough and tasty. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect residents. We asked some visiting health professionals what they thought of the home. They said: "staff go that extra mile to meet resident`s needs and protect their privacy" "they provide an excellent level of care" "staff are always approachable and keen to meet their clients needs". Health professionals said the manager was particularly good and that care in the home had improved under her leadership. What has improved since the last inspection? Staff training has improved. They have achieved a high percentage in training for NVQ. 64% of staff are qualified to level 2 or above. This is above the required 50% target. Staff said: "it is better now, we have training left right and centre" The medication system has improved. There are no longer gaps in the recording of medicines. What the care home could do better: The social information in residents care notes could be better. There were no social histories in two of the files examined. These help to give a better background of resident`s interests and abilities. Some of the safety certificates were not in place. These are the one`s carried out externally on gas and electrical systems. CARE HOMES FOR OLDER PEOPLE Charlton Court Bristol Drive Battle Hill Wallsend Tyne & Wear NE28 9RH Lead Inspector Janet Thompson Key Unannounced Inspection 10:30 7th July 2008 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 Charlton Court DS0000071019.V362324.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. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Charlton Court Address Bristol Drive Battle Hill Wallsend Tyne & Wear NE28 9RH 0191 262 7503 0191 263 1552 charltoncourt@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross BC OpCo Ltd 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) Mrs Amanda Joan Sleightholme Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54) of places Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Old Age, not falling within any other category, maximum number of places 54 The maximum number of service users who can be accommodated is: 54 24th April 2007 2. Date of last inspection Brief Description of the Service: Charlton Court is a purpose built care home providing both personal and nursing care. It is situated within a residential area of Wallsend. The home can be accessed by public transport. The home is registered to provide care for up to 54 elderly persons. The home also provides NHS continuing care on behalf of Newcastle and North Tyneside Health Authority. Accommodation is provided over two floors. All bedrooms are single occupancy and have en-suite facilities. There are several lounges and dining rooms within the home. There is an enclosed garden to the rear of the home for the use of service users and their visitors. Further information about the home can be found in the home’s service user guide, statement of purpose and previous inspection reports. These are readily available in the home. The fees for the home range from between £361 to £555 per week. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use the service experience excellent quality outcomes. This was an unannounced inspection. How the inspection was carried out: Before the visit we looked at: Information we have received since the last inspection visit. How the service dealt with any complaints or concerns since the last visit. Any changes to how the home is run. The manager’s views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received three responses from questionnaires. During the unannounced visit we: Talked with people who use the service and some of the staff. Looked at the information about people who use the service and how well their needs are met. Looked at other records the home is required to keep. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, comfortable and safe. Checked what improvements had been made since the last inspection visit. The manager was at the inspection. Feedback was given to her at the end of the visit. What the service does well: Residents looked well cared for. They said they were well looked after. Staff support residents to maintain contact with their family and friends. Residents spoke highly of staff. They said: “the staff are canny, she (pointing to carer) is an absolute godsend” Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 6 “the staff work hard, they are very good” The care plans that we read clearly set out the needs of the residents. When we spoke to those residents or discussed their care with staff, the needs matched those written in the plans. The care is regularly reviewed, taking into account peoples changing needs and individual wishes. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of those spoken to were pleased with the quality and choice available. We tasted the food that was served to residents. It was well presented, hot enough and tasty. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect residents. We asked some visiting health professionals what they thought of the home. They said: “staff go that extra mile to meet resident’s needs and protect their privacy” “they provide an excellent level of care” “staff are always approachable and keen to meet their clients needs”. Health professionals said the manager was particularly good and that care in the home had improved under her leadership. What has improved since the last inspection? What they could do better: The social information in residents care notes could be better. There were no social histories in two of the files examined. These help to give a better background of resident’s interests and abilities. Some of the safety certificates were not in place. These are the one’s carried out externally on gas and electrical systems. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. Charlton Court DS0000071019.V362324.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 Charlton Court DS0000071019.V362324.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. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. EVIDENCE: Two pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessment. Health Professionals told us that each resident has an individual assessment carried out by a large team. The information could come from nurses, doctors, physiotherapists and carers. Charlton Court DS0000071019.V362324.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 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. EVIDENCE: Three care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. Some of the action instructions for care were excellent. They were clear and personal. Care plans recorded personal preference as well as need. For example: X likes to have a cup of tea before bed. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 11 A relative spoken to on the day told us that the care was very good. He had witnessed staff spending time with people who were very ill, sitting holding their hand or talking to them. Health Professionals who visit the home very week said: ‘Staff are always approachable and keen to learn new skills to manager their clients needs’ ‘staff support dying patients and their relatives well’ Medication ordering, administration, storage and disposal were examined. All medicines are audited by the nurse every week and by the manager monthly. All medicines were accounted for and all those administered were signed for. Three amounts of controlled drug were checked and were correct. Staff were seen to treat residents politely and respectfully. Charlton Court DS0000071019.V362324.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. EVIDENCE: Residents are supported to use a range of services within the local community. Residents are encouraged to be in control of their own lives and enjoy their own interests and hobbies. Some residents had social care plans which indicated if they were at risk of social isolation and how this could be avoided. In two of the case files examined the pen picture/social profile was not filed in. This would have helped to give staff a better understanding of a resident’s past life, interests and skills. Having said that residents did say they had enough to do. They said: “yes there is enough to do if you want” Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 13 “we get asked to join in but never pushed” Visitors to the home told us that: ‘the individual resident counts’. Residents also said they liked the food. We ate the food at the home. It was well presented. The food was hot enough and very tasty. The choice that day was steak pie or spicy veggie burger. The standard of the cooking was very good. The home has started the NUTMEG system. This is an independent nutritional tool that devises balanced menus and promotes healthy living. Charlton Court DS0000071019.V362324.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. EVIDENCE: Staff follow the home’s policies and procedures relating to the management of complaints and allegations of abuse. Staff are kept up to date with information and training. Training on the protection of vulnerable adults is currently taking place. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. The complaints record was examined. There were three complaints recorded. They had been dealt with quickly to the satisfaction of the complainant. Charlton Court DS0000071019.V362324.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe comfortable home that is generally pleasant and clean. EVIDENCE: The home was generally clean and free from odours. The furniture and general décor provides residents with a comfortable homely environment. Residents said the home was warm enough. A relative said the home was always clean, they said: “there are always clean towels and liquid soap in the bathroom, it always looks clean. Health professionals who visit the home regularly also confirmed that the place was clean. They said: “it’s a clean home, they are good at containing infection”. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 16 The nursing unit could benefit from some updating. Some of this is already planned and will be reassessed at the next inspection. Charlton Court DS0000071019.V362324.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. EVIDENCE: The current staffing for the home is: Two RGN’s on the first floor and four care assistants all day. One senior carer and two care assistants downstairs all day. At night there is: One RGN and two care assistants upstairs. Two care assistants downstairs. Training records showed and staff confirmed that 64 of staff had achieved NVQ level 2. Some essential training was currently taking place. Infection control training is planned. There was a training overview chart, which helps to ensure that staff do not fall behind in statutory training. Five staff recruitment files were examined. These were for one new carer, one nurse and three long term employed carers. All contained good information. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 18 Thorough background checks had been carried out before employment. Residents were protected through checking of criminal records information for all employees. Interviews were conducted against a person specification list to ensure fair and equal employment. Several positive comments were received about staff. These have been reflected through other sections of this report. Charlton Court DS0000071019.V362324.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, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are protected through reflective management taking account of the diverse needs of the service. EVIDENCE: The home does have a registered manager. The manager is experienced in management and has been assessed by CSCI as ‘fit’ to manage. Several positive comments were received about the managers style and approach. All spoken to agreed that the care in the home had improved since she was appointed. Health professionals said: Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 20 ‘I visit the home on a weekly basis, since Amanda has become the manager care has improved greatly’. ‘the manager and team always respond quickly if an issue is raised’ ‘the manager is very approachable and willing to accept support’ Staff said: “we now have what we need to do our job and a good manager” “she (the manager) is very good, we work hard for her and she supports us” Residents and relatives said: “we have seen improvements since Amanda came” “you can talk to her anytime and she will sort out anything”. Staff spoken to were clear about their role and responsibilities. The home operates a quality assurance system. Residents, their relatives and professionals are consulted about the service provided. Servicing and maintenance agreements are in place for facilities and equipment. There was no gas safety certificate or electrical test certificate for the building. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks; tests and instructions to staff are conducted at the required frequency and recorded. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Residents personal monies were well accounted for. Charlton Court DS0000071019.V362324.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 4 8 4 9 3 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 3 X X X X X X 3 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 4 3 X 3 X X 2 Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP38 Regulation 13 Requirement Ensure that the gas safety certificate and electrical test certificate is available. Timescale for action 01/09/08 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 Social profiles should be completed for residents. Charlton Court DS0000071019.V362324.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Charlton Court DS0000071019.V362324.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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