Please wait

Care Home: Daisy Bank Nursing Home

  • 17-19 Leek Road c/o Jackson Dyson & Blundell Cheadle Staffordshire ST10 1JE
  • Tel: 01538750439
  • Fax: 01538750439
  • Planned feature Advertise here!

Daisy Bank is a care home providing personal care including nursing care for up to 32 elderly people. This includes care for up to six people over the age of 65 years with 0 022092009 physical disabilities, and dementia care for up to four people over the age of 65 years. The Nursing Home is owned by Classic Care Homes Limited and is located in the market town of Cheadle, Staffordshire. Cheadle town centre is closeby. It has a wide selection of amenities such as shops, leisure facilities, public houses, banks and churches. The home stands well off the road. Accommodation is provided on two floors. There is a passenger lift to provide easy access. There is ample on site car parking and the gardens are accessible around the home to people who use the service, including wheelchair users. The accommodation provides for twenty single bedrooms, with six shared (double) bedrooms. There is ample provision of toilet and bathing facilities including a wetroom/shower, communal lounges, dining room and seating areas. Upto date information regarding the weekly fees are not included in the Service User Guide, should people require more information they should contact the Care Manager direct.

Residents Needs:
Dementia, Old age, not falling within any other category, Physical disability

Latest Inspection

This is the latest available inspection report for this service, carried out on 20th May 2010. CQC found this care home to be providing an Good service.

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.

For extracts, read the latest CQC inspection for Daisy Bank Nursing Home.

What the care home does well We have recognised the achievements made since the last key inspection, in that requirements and recommendations made at that inspection have been satisfactorily addressed. We have found that Daisy Bank Nursing Home offers a satisfactory commitment to care with an open, professional and personable approach, which reflects the confident relationship between carers and those people using the service. Comments received from surveys and talking with people during the inspection included: "Make sure that all the medical care needs are met. Does this in a friendly, supportive way, and manages to retain a friendly `home from home` look and atmosphere, which is of real importance and value to mum". "What it does well is just exactly what is asked in this question. Being a home for all of us residents as soon as you come in from outside you feel it, a welcoming warmth, smiling atmosphere, happiness and caring. It`s sweet smelling, warm and comfortable, next to one`s own home I can think of none better. Also the food is wonderful". From our examination of care records we established that there are effective pre admission assessments, and care planning of individual needs, which are meaningful in formulating a good standard of nursing and personal care. When we discussed the quality of care with those people using the service and visitors, it was clear that they appreciated this professionalism, and personable approach to care. The housekeeping, administrative and support services have all contribute to the team approach, and are recognised by the management for their efforts. Comments we received from relatives during the inspection include: "The care from carers is very good despite being a very demanding role. The home mostly smells clean. Events are normally well thought out and designed to involve all the residents and families". "I think that Daisy Bank is a good nursing home, it isn`t just a house, its a home for people; its nice that the residents, relatives and staff appear to like it too". We considered that the overall management style demonstrated a solid approach in maintaining an environment conducive to the care of the elderly. What has improved since the last inspection? Our inspection has identified a clearer person centred approach to care, especially for people with dementia. The arrangements for activities and socialisation have shown some improvement, although there remains continued address to be accomplished to offer people an inclusive quality of life, and a sound foundation to provide a good standard of care. Various comments we received through surveying from people in the home: "Caring staff, comfortable rooms, good food, staff always available though often very busy. Could do to engage with residents more, but may need extra staff to allow time for this". "Would like to see more outside activities, maybe do a bit in the garden". "Daisy Bank is tremendous, all of its staff are so very committed to caring for their residents, although they could do with more organised activities on a daily basis". We recognise the improvements made in the administration of medicines, with improved storage, procedures and recordings of medicines given. We also note the improvements in staff training on medication made over the past year. We have acknowledged that there have been some improvements in the furnishings and decor throughout the home, continuing to present a comfortable, safe environment, and to assist people, especially those with a higher dependency of care or dementia needs. What the care home could do better: We considered that much could be achieved by a more structured activities programme, to facilitate and promote stimulation and diversion for people living in the Home. More variety in both indoor and outdoor activities would be beneficial, especially for people with dementia and other cognitive impairments. Consideration be given for the Statement of Purpose and Service User Guide be updated to reflect change, and that consideration be given to producing the documents in larger print and audio versions, to assist people with poor eyesight to make an informed decision. Much improvement has been noted in the management of medicines, which would be complemented with the procedure for `Homely Remedies` to clearly identify those medicines approved by the General Practitioner (GP), ensuring written authorisation on the same document. Whilst acknowledging the progress made to ensure that the general fabric and furnishings and decor standards are maintained, efforts are to be made to provide people with a comfortable and safe living environment. The long standing issue to review the storing of wheelchairs to allow more room for people in the lounge area is to be addressed, that bathrooms are upgraded to meet standards of lifting equipment, bath, decor; and to desist from using bathrooms as storage areas. To consider the environmental arrangements for people with dementia, including provision of easy recognition, dignified identification of bedrooms and facilities to enhance their well being. The Registered Provider is to ensure that the Home meets the minimum expected standard of staff trained to the National Vocational Qualification (NVQ) at level II or III by April 2011, and that address is given to staff training in dementia awareness, and more training offered on the Mental Capacity Act, including Deprivation of Liberties, to meet the needs of people living in the Home. It is recommended that a training matrix is reorganised to facilitate effective management of training needs and accomplishments This will promote health and safety in the home and enable the manager to monitor and demonstrate that all mandatory and specialist training has taken place and is up to date. Nursing and care staff are to be offered regular formal staff supervision, and should be consistent in order to support and guide staff, and enhance outcomes for people. The Care Manager will ensure that all accidents are reported in the appropriate record, a quarterly analysis taken, and record retained in people`s care files. The managers will also ensure that all records are dated and signed, to clearly identify ownership and responsibility of actions taken. Key inspection report Care homes for older people Name: Address: Daisy Bank Nursing Home c/o Jackson, Dyson & Blundell 17-19 Leek Road Cheadle Staffordshire ST10 1JE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Jones     Date: 2 0 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Daisy Bank Nursing Home c/o Jackson, Dyson & Blundell 17-19 Leek Road Cheadle Staffordshire ST10 1JE 01538750439 01538750439 daisybankcheadle@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Classic Care Homes Limited Name of registered manager (if applicable) Mrs Ruth Addison Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 32 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 categories: Old age, not falling within any other category (OP) 32 Physical disability - over 65 years of age (PD(E)) 6 Dementia - over 65 years of age (DE(E)) 4 Date of last inspection Brief description of the care home Daisy Bank is a care home providing personal care including nursing care for up to 32 elderly people. This includes care for up to six people over the age of 65 years with Care Homes for Older People Page 4 of 33 Over 65 4 32 6 0 0 0 2 2 0 9 2 0 0 9 Brief description of the care home physical disabilities, and dementia care for up to four people over the age of 65 years. The Nursing Home is owned by Classic Care Homes Limited and is located in the market town of Cheadle, Staffordshire. Cheadle town centre is closeby. It has a wide selection of amenities such as shops, leisure facilities, public houses, banks and churches. The home stands well off the road. Accommodation is provided on two floors. There is a passenger lift to provide easy access. There is ample on site car parking and the gardens are accessible around the home to people who use the service, including wheelchair users. The accommodation provides for twenty single bedrooms, with six shared (double) bedrooms. There is ample provision of toilet and bathing facilities including a wetroom/shower, communal lounges, dining room and seating areas. Upto date information regarding the weekly fees are not included in the Service User Guide, should people require more information they should contact the Care Manager direct. Care Homes for Older People Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We conducted this unannounced inspection with the Care Manager, Deputy Manager, and senior care staff on duty, whose input contributed to this report. The Chief Executive Officer for Classic Care Homes Limited joined the inspection later in the morning, and remained for most of the day. Our inspection of the Home allowed us free access to all areas and open discussion with people who use the service, relatives and staff. There were 31 people in residence on the day of our inspection. We looked at how care is being arranged and supported for a range of people with personal care needs. To do this we looked at (case tracked) three peoples files from admission referral to the present time, and four staff files were examined. We also looked at other information such as complaints, incidents, events and other professional reports. We took the opportunity to speak with a number of people who are using this service, Care Homes for Older People Page 6 of 33 relatives and members of staff, who took an active role in our inspection process; their input contributed to the subsequent report. We acknowledged receipt of the Annual Quality Assurance Assessment (AQAA), nine returned survey forms that we sent out to people who use the service some weeks before the inspection, and three staff responses were received. We inspected a sample review of administrative procedures, practices and records, confirming satisfactory practice and management. There followed an inspection report feedback, involving the Chief Executive, Care Manager and Deputy Manager, in which we offered an evaluation of the inspection, indicating those requirements and recommendations resulting from the inspection. Care Homes for Older People Page 7 of 33 What the care home does well: What has improved since the last inspection? Our inspection has identified a clearer person centred approach to care, especially for people with dementia. The arrangements for activities and socialisation have shown some improvement, although there remains continued address to be accomplished to offer people an inclusive quality of life, and a sound foundation to provide a good standard of care. Various comments we received through surveying from people in the home: Caring staff, comfortable rooms, good food, staff always available though often very busy. Could do to engage with residents more, but may need extra staff to allow time for this. Care Homes for Older People Page 8 of 33 Would like to see more outside activities, maybe do a bit in the garden. Daisy Bank is tremendous, all of its staff are so very committed to caring for their residents, although they could do with more organised activities on a daily basis. We recognise the improvements made in the administration of medicines, with improved storage, procedures and recordings of medicines given. We also note the improvements in staff training on medication made over the past year. We have acknowledged that there have been some improvements in the furnishings and decor throughout the home, continuing to present a comfortable, safe environment, and to assist people, especially those with a higher dependency of care or dementia needs. What they could do better: We considered that much could be achieved by a more structured activities programme, to facilitate and promote stimulation and diversion for people living in the Home. More variety in both indoor and outdoor activities would be beneficial, especially for people with dementia and other cognitive impairments. Consideration be given for the Statement of Purpose and Service User Guide be updated to reflect change, and that consideration be given to producing the documents in larger print and audio versions, to assist people with poor eyesight to make an informed decision. Much improvement has been noted in the management of medicines, which would be complemented with the procedure for Homely Remedies to clearly identify those medicines approved by the General Practitioner (GP), ensuring written authorisation on the same document. Whilst acknowledging the progress made to ensure that the general fabric and furnishings and decor standards are maintained, efforts are to be made to provide people with a comfortable and safe living environment. The long standing issue to review the storing of wheelchairs to allow more room for people in the lounge area is to be addressed, that bathrooms are upgraded to meet standards of lifting equipment, bath, decor; and to desist from using bathrooms as storage areas. To consider the environmental arrangements for people with dementia, including provision of easy recognition, dignified identification of bedrooms and facilities to enhance their well being. The Registered Provider is to ensure that the Home meets the minimum expected standard of staff trained to the National Vocational Qualification (NVQ) at level II or III by April 2011, and that address is given to staff training in dementia awareness, and more training offered on the Mental Capacity Act, including Deprivation of Liberties, to meet the needs of people living in the Home. It is recommended that a training matrix is reorganised to facilitate effective management of training needs and accomplishments This will promote health and safety in the home and enable the manager to monitor and demonstrate that all mandatory and specialist training has taken place and is up to date. Nursing and care staff are to be offered regular formal staff supervision, and should be consistent in order to support and guide staff, and Care Homes for Older People Page 9 of 33 enhance outcomes for people. The Care Manager will ensure that all accidents are reported in the appropriate record, a quarterly analysis taken, and record retained in peoples care files. The managers will also ensure that all records are dated and signed, to clearly identify ownership and responsibility of actions taken. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 10 of 33 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people are appropriately assessed before they are offered a place. They and their relatives can be confident that the service will be able to meet their needs. Evidence: We examined the services Statement of Purpose and Service User Guide, and found them to generally meet the required standard in offering a description the Homes aims, objectives, and the way it operated. It was noted that there was a need to review the documents to provide up to date information accurately, including information about contacts, CQC and staff working in the Home. The presentation and format of the documents do not lend themselves to be available to current and prospective residents. The arrangements are impractical to offer a copy to those people who may request them, and should be made available in large print versions, suitable for people to make an informed choice about where to live. Our examination of three peoples care records and plans, indicated that each person Care Homes for Older People Page 12 of 33 Evidence: had an individualised pre admission assessment, the amount of information recorded was sufficient in forming an appraisal of that persons needs and capabilities, assessing the social background, consistent with dating and ownership of the assessor. Through our case tracking of three peoples care records we clearly identified that the Care Manager, or her Deputy, at the point of reference, conducted the pre-admission assessment. We found that the documentation identified a clear dependency assessment, forming a comprehensive foundation for care planning to meet needs, which included a copy of the care plan from social services, prior to admission. The objective is for this assessment to be produced with the full involvement of people who may use the service and their family, allowing them to influence the direction of care. We found this to be true, with each individual having a plan of care, which included a detailed care plan, daily care programme, risk assessments with goals and outcomes. Any special needs of the individual were discussed fully and documented, ensuring their personal needs would be met. During the course of our inspection we had opportunities to sit and talk with people who use the service, staff and a number of visitors. We found evidence that much care had been taken in involving people, and their families in the admission process. Comments received from surveys we sent out before the inspection to people who use the service : When I approached the home we were told that they looks for the positive way forward. We have seen this for ourselves over the past months. They help people live their lives, respects everyone. We wanted to make sure so when a neighbour told me of the care given, and said it was a good place with good people, we decided, and have not regretted it. We received plenty of comments and descriptions from friends. The information I received was very informative and helpful. From our discussions it was clear that people are able to visit and assess the facilities and suitability of the Home at any reasonable time, and to meet with staff and management. Staff are aware of the special period of personal anxiety that people have under those conditions, a point well illustrated when talking to people, and examining records on case tracking. No intermediate care took place in the home. Care Homes for Older People Page 13 of 33 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care, which people receive, is based on meeting personal needs, with clear principles of respect, dignity and privacy put into practice. Medicine administration systems are safe and secure. Evidence: Care records and case tracking we examined provided clear evidence to show that the pre admission assessment represented the foundation for a well considered, and detailed care planning process, in association with Social Services reports. We found that the profile of each persons social, physical and psychological status offered an individual plan of care, based upon a Person Centred Support Care process of dependency assessment and activities of daily living, frequently reviewed in an individual plan of care that is reviewed monthly, to reflect their changing needs and adapting care profiles, supported with a substantial and very informative daily progress report. Established monitoring systems following a process of goals, care and evaluation of high quality care plans, appreciated by those people and relatives alike. Risk assessments are carried out on an individual basis and reviewed as required, these include tissue viability, continence and nutrition. The strength of purposeful Care Homes for Older People Page 14 of 33 Evidence: planned care lies within the frequency of the review process in monitoring and adapting care profiles. The AQAA stated, and we confirmed that those people who use the service, families and friends are invited to participate in the care planning process, and established monitoring systems following a process of goals, care, and evaluation of quality care plans. Case tracking confirmed to us that specialist support and advice are sought as needed, with each person having access to a local Doctor, Dentist, Optician, Chiropodist, and Occupational Therapist as required. Through case tracking, our discussions and inspection of records, it was recognised that the home arranges for health professionals should special health care needs be recognised. Our observations showed that generally people using the service appeared to be content, comfortable and happy with their lifestyle, complimentary regarding the quality of their lives and the care they were receiving. Comments we received during the course of inspection from people using the service, visitors and professionals: They make sure that all the medical care needs are met. Does this in a friendly, supportive way, and manages to retain a friendly home from home look and atmosphere, which is of real importance and value to mum. There could be slightly better communications between the staff of different shifts (but this is only in connection with relatively minor matters, and does not refer to medical care needs). My mothers health has improved since she has been in Daisy Bank and she is content there, although there is a need to stimulate and motivate a bit more. On presenting new people for assessment, and reviewing their care, I have always found the quality of care and standards to be excellent We confirmed that the administration of medicines adhered to procedures to maximise protection for people who use the service. We found that the care manager is responsible for overseeing all matters relating to medicines. We found sufficient evidence of compliance to the requirements and recommendations made following from the last inspection; effecting a well developed, and smooth process of ordering, receiving, storing, administering and disposing of medicines. Records were seen to be complete and easy to follow through, with no observed breaches in the system. Controlled Drug management was comprehensive. We examined the policy for Homely Remedies, that is medicines approved by the GP that nursing staff can administer as appropriate to needs. We advised that the Care Homes for Older People Page 15 of 33 Evidence: procedure clearly identifies those medicines approved by the GP, and authorised on the same document. In our examination of care records, we established that a policy and procedure on care of the dying and death had been introduced to meet individual needs, and were in place with the full knowledge of those who use the service and relatives. We noticed that there were Do Not Resuscitate forms on file; the Manager was aware that these must be reviewed regularly within a multi-agency framework that includes the persons general practitioner and social worker. Individual spiritual persuasions were seen to be documented and respected. It is stated in the services Statement of Purpose and the AQAA, that independence, privacy and dignity are encouraged, with the full involvement of family in all matters concerning the well being of people. This was confirmed in our discussions with people who use the service, visitors and staff, although the records need review to offer consistency. Relatives and friends have freedom of visiting, which emphasised the importance of maintaining social contact. We were impressed with the confidence and closeness within the Home and the mutual respect that prevailed. We looked at bedrooms presented to facilitate privacy for the individual, which included medical examinations and personal care procedures being performed in private. Our discussions with people confirmed that individual spiritual persuasions and individual diversity was seen to be respected. Care Homes for Older People Page 16 of 33 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples rights to live a meaningful life are promoted, and people are offered opportunities to exercise choice and control over their lives. People are offered a healthy, well balanced diet. Evidence: We found daily life to be flexible to accommodate peoples needs and capabilities, offering choices at meal times, and during personal and social activities, including recognition of varied religious needs. Our discussions with people who use the service and staff, identified a relaxed atmosphere in which peoples needs were respected, with the security that there are familiar events to the day they could relate to. We acknowledge that Daisy Bank encourages social activities, offer of 1:1 and group activities, recognised as an important part of the care process, as evidenced in examination of records, and discussion with staff, with a varied programme of activities and social events, which included themes, garden parties and entertainment organised by the Home. We recognised strong links with the local community, who engage at special events, especially at Christmas and Easter, and a recent, successful 1940s day. There is a monthly Newsletter and a very active Friends and Relatives committee, of which we were able to speak to a member visiting her mother on the Care Homes for Older People Page 17 of 33 Evidence: day. We were informed that the Home is planning extended activities to add to those already in place, including more involvement with people confined to bed, and those with dementia needs. On the day of inspection staff were seen to be reading and talking to people, and generally engaged in individual and group activities throughout the course of inspection. Our discussion with visitors and people living in the Home identified a clear vision of care for people with dementia, and the need to continue the furtherance of a social care process. Comments from surveys returned indicated: Provides a nice, homely atmosphere, staff are approachable and friendly. Residents are treated with respect and as individuals. A freshly cooked hot meal is available daily. Entertainment is provided on a regular basis, the latest event being a 1940s day which both residents and staff enjoyed. Would like to see more outside activities, maybe do a bit in the garden. They keep the place very clean, produce good food and serve it on time by friendly and patient staff. Made special effort to decorate extensively at Christmas. Have staggered breakfast for staff to make sure there is at least one member of staff in each communal room at all times. They encourage clients towards activities, rather than sit doing nothing for long periods at times between meals. Daisy Bank is tremendous, all of its staff are so very committed to caring for their residents, although they could do with more organised activities on a daily basis. Families and friends are actively encouraged to participate in the daily life of the home, with no restriction being placed on visiting times. During the course of the inspection we saw staff and visitors interact with people in a positive and polite manner. It is stated in the Statement of Purpose and AQAA, that personal choice, dignity and self determination are respected in policy and action, which we found to be true. Those individuals rooms we inspected showed a very positive influence of personalisation in the inclusion of belongings, some furniture and general decor, demonstrated a degree of expressed individuality. We found that the good standards of catering at Daisy Bank continues, to which all those people we spoke with being complimentary of all aspects of quality. A menu on an eight weekly cycle offered a wholesome, varied and excellent choice. The Environmental Health Officer has continued to allocate a five star rating for the quality and standards of catering. We confirmed that the cook knew each person using the service, and some of the relatives. We discussed diversity with the cook, who Care Homes for Older People Page 18 of 33 Evidence: indicated an awareness in meeting individual needs; there were no special cultural needs at the time. Individual preferences were conveyed to the catering staff, who met with, and discussed their requirements. A very pleasant lunch with a choice was served during inspection, in pleasantly furnished and clean dining rooms. Staff were seen to offer discreet assistance to those who required it. The choice of dining room, lounge or bedroom was at the discretion of people in the home. Care Homes for Older People Page 19 of 33 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given opportunities to freely express any concerns, and these are quickly responded to. People are protected from abuse, and their human rights are promoted. Evidence: Through the course of inspection we confirmed that peoples legal rights are protected by the systems in place in the home to safeguard them, including the continual review and assessment of care planning, and policies in place, including the complaints procedure. The complaints policy and records of complaints dealt with were examined, which evidenced handling of peoples and families concerns in a meaningful and effective manner. From our discussions with people who used the service it was evident that any small matters were handled immediately, discretely and to the satisfaction of all concerned. There were a few minor complaints, which we feel would be better dealt with through a record of concerns, complaints and safeguarding, to record peoples, and their families concerns in a meaningful and effective manner. Comments received from people we met in the course of inspection, and through surveys received: If Im not happy, in my way I know I can ask the manager of the home, or any Care Homes for Older People Page 20 of 33 Evidence: member of staff, and know it will be dealt with. I know who to speak to if Im not happy, the carer always listens, and is very good at sorting things out. I have lived here for three years and have had no complaints to date. No complaints had been received by us since our last inspection. The manager reported through the AQAA that they had received three complaints, all dealt with to the satisfaction of all concerned, including an acceptance to review procedure in one case. The overall policy of openness and transparency was acknowledged. We were informed that all the people who used the service had received information on the procedure to complain, including reference to us. This process was evidenced on examination, and case tracking, as previously reported upon. Our discussion with the Care Manager confirmed that there is satisfactory evidence of a protocol, and response to anyone reporting any form of abuse, to ensure effective handling of such an incident. No allegations had been referred to CQC during the past 12 months. The policy and procedure for handling issues of abuse was examined, and found to be appropriate. We examined three staff records to confirm that staff were suitably checked through Criminal Records Bureau (CRB), and Protection of Vulnerable Adult (POVA) disclosure. We found staff received training on abuse at induction, this includes the right to Whistle blowing, consistent with the Public Disclosure Act, 1998. Care Homes for Older People Page 21 of 33 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Home provides an adequate, safe, clean and comfortable environment for the people who use the service, which requires a programme of upgrade. Evidence: External access is satisfactory for visitors, with adequate parking. The grounds were found to be generally well maintained, with an attractive patio and lawned area. The state of repair and maintenance is generally very good, offering a comfortable, homely yet secure environment. On admission the Care Manager or her deputy assesses each individual persons needs for equipment and necessary adaptations. A letter confirming those arrangements was seen in each case file. Internal access was facilitated with ample fittings of hand and grab rails in well lit and airy corridors, facilitating wheelchair access throughout all areas of the home. We have indicated the need to develop the decor of corridors to reflect a growing need to assist people with dementia, in pathway location signs, including corridors with themes and easily recognizable colour coordination, linked in with familiar and individualised bedroom doors. There are sufficient variable height nursing beds available. The Care Manager confirmed to us a willingness on the part of management to meet any reasonable demand for special needs. All communal areas were seen to be of a satisfactory standard, providing a main Care Homes for Older People Page 22 of 33 Evidence: lounge area, pleasantly decorated, providing good quality furnishings and items to provide comfortable areas where people were able to interact with their friends, or to entertain their guests. We found the area somewhat restrictive due to a large number of wheelchairs stored. We discussed several options to alleviate the storage problem that has been a problem for several years, requiring a positive response from the Provider. A pleasant, homely dining area was clean, and conducive to enjoy a good meal. We found that this area would benefit from a review of decor, having a menu displayed and fruit available. Bedrooms were generally well maintained to peoples personal preferences, with some displaying peoples own furniture, and most with personal belongings. It is the policy that on bedrooms becoming vacant that each room is reappraised for redecoration, as confirmed during the Inspection. We noted that there have been some progress made in enhancing personal space for people with dementia, in identifying bedroom doors, yet there is some need to continue the work in a more permanent style, fitting items of easy recognition and usage, and installing a personal ownership to their rooms. The nurse call alarm system was satisfactorily tested, with a good response from staff on duty. Personal electrical equipment (PAT), that is televisions, radios, etc, where seen to be tested. Generally we found the environment is traditional, presenting an homely and comfortable environment. Several people we spoke to expressed a sense of belonging and satisfaction in the quality and presentation of their living areas. They keep the place very clean, produce good food and serve it on time by friendly and patient staff. Made special effort to decorate extensively at Christmas. The televisions in the residents lounge would be better wall mounted so that visitors do not interfere with residents viewing. Wheelchairs would be better stored elsewhere and not in residents lounge. What it does well is just exactly what is asked in this question. Being a home for all of us residents as soon as you come in from outside you feel it, a welcoming warmth, smiling atmosphere, happiness and caring. Its sweet smelling, warm and comfortable, next to ones own home I can think of none better. Also the food is wonderful. Bathrooms and toilets are fitted with appropriate aids and adaptations, however we found that the quality of bath and lifting equipment is in need of replacement, and one bathroom continues to be used as a storage area, offering a limited facility. We acknowledged the popular use of the new shower room, which met satisfactory Care Homes for Older People Page 23 of 33 Evidence: standards. Toilets and bathrooms were located on both floors and were in close proximity to bedrooms and communal areas. Sluice facilities have suitable arrangements to assist in control of infection, although requiring securing when not in use. Notices regarding chemical handling in the areas that store chemicals need to be prominently displayed. The housekeeping services in the Home were seen by us to be of a good standard. The people spoken to generally remarked that they find the environment always very clean and fresh. Comments from a survey we sent out: Daisy Bank is always clean and smells nice, with bedrooms and bathrooms always clean and tidy. The home achieves a high standard of cleanliness. Heating and ventilation were found to be satisfactory, and lighting was domestic in style. Aids, adaptations and equipment were available throughout the Home. Fire equipment was inspected and seen to be serviced and up to date. The kitchen presentation showed good standards of cleanliness and evidence of sound food hygiene practices. All fridges and freezers were seen to be used in the appropriate manner, and were checked daily by the kitchen staff. A cleaning schedule was in place, up to date and comprehensive. We spoke with the cook who confirmed to us that she actively engages with people who use the service to determine their needs and likes and dislikes. She was aware of the issues of culture, ethnicity and age diversity, having had experience in dealing with a diverse population. Care Homes for Older People Page 24 of 33 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further staff training, monitoring and supervision are required to ensure staff have the appropriate skills and knowledge to meet peoples needs. Recruitment processes are inconsistent and need review to ensure protection of the people who use the service from harm and abuse. Evidence: We confirmed that there were 31 people living in the home on the day of the inspection. Three weeks of staffing rotas showed to us a satisfactory balance between skills, experience and numbers to provide a good standard of care. The Registered Manager, who is supernumerary, is supported by a Deputy Manager and a satisfactory complement of Registered Nurses and care staff. Discussions with staff also confirmed their commitment to providing a quality service and their awareness of the principles of good practice. At the time of the inspection there were two Registered Nurses and four care staff on duty. Average care staff coverage: Morning shift 2 Registered Nurses 4 Carers Afternoon shift 1 Registered Nurse 4 Carers Night shift 1 Registered Nurse 2 Carers Care Homes for Older People Page 25 of 33 Evidence: There is also a satisfactory complement of housekeeping, laundry, maintenance, and catering staff. We sampled four staff files, and found that the Provider and Care Manager have established procedures for interview, selection and appointment of staff, although lacking consistency for all employees. The thoroughness of staff selection has a significant effect upon the provision of care to ensure protection of people. All new staff goes through a detailed induction process, that will ensure that they are going to be the right person for the home. We advised that the staff record be reviewed in the way information is organised and presented, and to establish the practice of recording interviews, and follow up letters of appointment. Discussions with the Registered Care Manager confirmed that just 50 per cent of care staff had receipt of the National Vocational Qualification (NVQ) at level II or III, with a further two staff members currently undertaking the training. There was evidence that a training schedule has been established, although poorly managed to ensure that an effective training programme is undertaken to maintain quality of standards. We advised a more detailed plan be organised and that a particular attention is addressed to achieving mandatory training for all staff, and in identifying a programme for dementia awareness. It was also identified that there needs to be more training offered on the Mental Capacity Act, including Deprivation of Liberties, to ensure that care staff are sensitive to meeting needs and protecting the dignity of people living in the Home. All the staff we interviewed advised us that they received a good induction programme on starting work at Daisy Bank, and confirmed that a substantial account of a meaningful schedule of training to meet mandatory and specific demand has been achieved. Staff employment and training records would be more secure with a review of the organisation of files to demonstrate more clearly the standards stated and observed. Discussion with staff demonstrated an inconsistent process of supervised practice, failing to meet the required six sessions a year. Care Homes for Older People Page 26 of 33 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the home is run in their best interests. The ethos of the service is based on openness and respect. The care team, through good working practices, promote the health, safety and welfare of people who use this service. Evidence: We acknowledge that the Care Manager Ruth Addison has continued to demonstrate clear competence in managing Daisy Bank, in establishing a solid professional management style that has been implemented, to achieve good standards of set aims, objectives and care. A Registered General Nurse who has actively promoted, and enhanced the Key worker and Named Nurse team concept, supporting a person centred support planning process. The Registered Provider has demonstrated a high profile and involvement in the smooth running of the home, and is prepared to delegate a wide range of management responsibility to good effect. We have identified in this report a number of issues to which the Care Manager has acknowledged and demonstrated a positive response and reinforced her commitment in promoting best Care Homes for Older People Page 27 of 33 Evidence: practice to improve the service delivery. We also discussed the management and direction issues with the Provider and established the foundation of those issues, linked to the need to evaluate a resource plan to meet our requirements and recommendations. We acknowledged the openness and confidence in the observed interactions of staff, relatives and people who live in the home. The relationships were seen to be of mutual trust and respect. Several comments made by people who live at Daisy Bank, and visitors we spoke with, reinforced the strong foundation of confidence they had in the management leadership. Comments we received from surveys and staff interviewed on the day: There is nothing I can think of that would make the home better. I have told the home to save me a place for when I need to go into a home. The manager is approachable and friendly to residents, staff and relatives. Staff training benefits the residents, but also the staff are more experienced and confident in their roles. The care from carers is very good despite being a very demanding role. The home mostly smells clean. Events are normally well thought out and designed to involve all the residents and families. I think that Daisy Bank is a good nursing home, it isnt just a house, its a home for people; its nice that the residents, relatives and staff appear to like it too. Our examination of records showed appropriate risk assessments are in place for people, through care planning and recording, staff selection and of the general environment, these are up to date and accurate. The services completed AQAA states that the home has quality monitoring systems in place, and they also consult the people who use the service and their relatives about the service. We acknowledged a Quality Review had been undertaken by the Provider this Spring, showing evidence of positive feedback to complement that received by CQC. We recognise that the Providers with the Care Manager have developed a formal approach to monitoring quality across a wide range of activities. An examination of administrative, monitoring, planning and care records showed a general responsible attitude to effective record keeping. They were found to be well maintained, accurate and up to date, although there are instances where dating and ownership of records were not consistent. We identified that individuals are encouraged to be independent with regard to financial Care Homes for Older People Page 28 of 33 Evidence: affairs with the assistance of their relatives. Small amounts of cash were efficiently handled by the Care Manager through the Providers office. We made a random sample examination of the procedures manual, and found it to offer a comprehensive reference. Policies on Confidentiality, Safeguarding and complaints were examined, and found to be accurate and informative, although several years old and needing a review. Reference has been drawn to the Mental Capacity Act and Deprivation of Liberties clause, with a need in addressing training requirements. Equality and diversity issues were also discussed covering a wide range of issues, including food, religion and staffing. We found that the health and safety of people who use the service and staff, are promoted with safe storage of hazardous substances, regular utility servicing The accident book was seen and found to be in order for staff and people using the service, although the record shows no recent entries. The Care Manager was advised to ensure that completed records are held in peoples care plans to facilitate audit of accidents and effectiveness of action taken. We found the administration and management of the home is efficient, uncomplicated and sensitive to the needs of people living in the home. Care Homes for Older People Page 29 of 33 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 30 of 33 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 That the Statement of Purpose and Service User Guide be updated to reflect change, and that consideration be given to producing the documents in larger print and audio versions, to assist people with poor eyesight to make an informed decision. That the procedure for Homely Remedies clearly identifies those medicines approved by the GP, and authorised on the same document. Much could be achieved by a more structured activities programme, to facilitate and promote stimulation and diversion for people living in the Home. More variety in indoor activities would be beneficial, especially for people with dementia and other cognitive impairments. A Concerns, Complaints and Allegation book be established to more effectively monitor incidents. To ensure that the general fabric and furnishings and decor standards are maintained, to provide people with a comfortable and safe living environment. To review the storing of wheelchairs to allow more room for people in the lounge area. Page 31 of 33 2 9 3 12 4 5 16 19 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 6 21 That bathrooms are upgraded to meet standards of lifting equipment, bath, decor; and to desist from using bathrooms as storage areas. To consider the environmental arrangements for people with dementia, including provision of easy recognition, dignified identification of bedrooms and facilities to enhance their well being. That the service ensure that the Home meets the minimum expected standard of staff trained to the National Vocational Qualification (NVQ) at level II or III by April 2011. That address is given to staff training in dementia awareness, and more training offered on the Mental Capacity Act, including Deprivation of Liberties, to meet the needs of people living in the Home. It is recommended that a Training Matrix is introduced so that all staff training (together with dates) is visible at a glance. This will promote health and safety in the home and enable the manager to monitor and demonstrate that all mandatory and specialist training has taken place and is up to date. That the Provider ensures a regular review of policies and procedures in light of changing legislation and of good practice. Regular formal staff supervision, should be consistent in order to support and guide staff and enhance outcomes for residents. That all accidents are reported in the appropriate record, a quartly analysis taken and record retained in peoples care files. That the Care Manager ensures that all records are dated and signed to clearly identify ownership and responsibility of actions taken. 7 24 8 28 9 29 10 30 11 33 12 36 13 37 14 37 Care Homes for Older People Page 32 of 33 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 33 of 33 - 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!

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

The Provider has not yet updated their profile and added details of the services and facilities they offer. If you are the provider and would like to do this, please click the "Do you run this home" button under the Description tab.

Promote this care home

Click here for links and widgets to increase enquiries and referrals for this care home.

  • Widgets to embed inspection reports into your website
  • Formated links to this care home profile
  • Links to the latest inspection report
  • Widget to add iPaper version of SoP to your website