Care Home: Falstone Court Nursing Home

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What the care home does well The home continues to meet the remaining national minimum standards. What the care home could do better: If all of the care plans and risk assessments had sufficient detail and all parts of the plan were regularly reviewed, staff would know that the information in them was up to date and correct. This would mean that they would be sure they were providing the people at the home with the support and care they need. Robust recruitment procedures and records would show that all of the staff have been properly vetted and this would demonstrate that the organisation have made sure that they only employ suitable people to work at the home and therefore safeguard the people who use the service. If the light cords throughout the building which are dirty, were replaced with something that was easy to keep clean this would reduce the risk of cross infection. The small kitchens would make the home more pleasant for the people who live there and their relatives if they were repaired and improved. Random inspection report Care homes for older people Name: Address: Falstone Court Nursing Home Rocklodge Road Roker Sunderland SR6 9NQ three star excellent service 20/07/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Hilary Stewart Date: 2 9 0 6 2 0 1 0 Information about the care home Name of care home: Address: Falstone Court Nursing Home Rocklodge Road Roker Sunderland SR6 9NQ 01915496699 01915497799 Telephone number: Fax number: Email address: Provider web address: www.southerncrosshealthcare.co.uk Name of registered provider(s): Name of registered manager (if applicable) Jill Mullea Type of registration: Number of places registered: Conditions of registration: Category(ies) : Apta Healthcare (UK) Ltd care home 41 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 41 The maximum number of service users who can be accommodated is: 41 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: Dementia Code DE, maximum number of places: 41 Date of last inspection Brief description of the care home Falstone Court Nursing Home provides accommodation and nursing care for 41 older people with a dementia type illness. Falstone Court opened as a purpose built home in 1995 and is next door to a sister home Falstone Manor. A General Manager oversees both homes and is based at Falstone Manor, as are personnel records and financial Care Homes for Older People Page 2 of 11 2 0 0 7 2 0 0 9 Brief description of the care home information. The Home has two floors with communal rooms available on both floors. All areas within the Home are accessible to people with mobility difficulties. En-suite toilet facilities are available in the bedrooms and toilets and bathrooms are available throughout the Home. The home is on the sea front and can easily be seen when driving along the sea front main road towards the city centre. A car park is provided and the home is accessible to wheelchair users. The scale of charges for the home starts at £490.00 to £621.30 Pounds per week. Other charges relating to continuing healthcare and self-funding are available in the home. Care Homes for Older People Page 3 of 11 What we found: The reason for this inspection was to check the following. 1. That there are sufficient staff employed at the home who are trained and supported to provide the people who live there with good care. Also that all of the staff are thoroughly vetted before they start to work there. 2. That the home has arrangements in place to safeguard the people who live there. 3. That the care plans are clear, accurate and contain enough detail to inform staff about how they must meet the needs of the residents and provide them with good care. 4.The home has adequate arrangements in place to protect the health and safety of the people who live there. 5. To check that any requirements made at the last inspection have been met. The outcome was as follows: 1. The manager said that all staff receive the training and support they need, they have regular staff meetings and individual supervision. Staff said and records showed that they all have mandatory training such as first aid, food hygiene and safeguarding adults training. Some staff are completing a twelve week course in infection control and safeguarding adults. The manager said that there is always a qualified first aider on duty at the home. Nursing staff receive refresher first aid training and they are all up to date with this. Sufficient staff were on duty at the time of the visit. The manager said that the home has sufficient staff to meet the needs of the people who live there. Records showed that enough staff had been on duty at the home the previous week. All staff go through a recruitment process and they cannot start to work at the home until this is completed. The manager said that all staff have been (CRB) Criminal Records Bureau checked at an enhanced level to make sure they are suitable people to work at the home. However CRB details could not be found for all of the staff. The manager said that they are kept centrally at the organisations head office. Applicants are interviewed and are only successful when they have two satisfactory references. Some of staff records were looked at and they showed that most of the checks had been carried out. However in some records evidence was not available to show that any gaps in a persons work history has been looked at during the recruitment process. Most did not have a recent photograph on their file for identification purposes. 2. Copies of the homes complaints procedure are in the information about the home. The manager and staff said that the people who live there and their relatives know how to make a complaint. Records showed that there had not been any complaints made to the home since January 2010. The manager said that they had not received any complaints. The manager said that all of the staff have had training in how to safeguard the people they care for. Staff have access to a copy of the Local Authoritys procedures and the home has copies of their own adult protection procedures. The manager said that the Care Homes for Older People Page 4 of 11 safeguarding procedures are always followed if there are any issues. All staff have had training on the homes whistle blowing policy and procedure. 3. The manager said and records showed that each person who lives at the home has an individual care plan. We looked at a sample of care plans from both Falston Court and Falstone Manor to see if they reflected the care they receive, they were up to date and that they were accurate. They care plans showed that risk assessments were in place for pressure prevention, nutrition and hydration, falls, moving and assisting, dependency and dealing with challenging behaviours. Generally the care plans were detailed and daily progress records and visits from other professionals were well recorded. There were examples of personal history, which gave staff insight into who the individual was before they came to the home and highlighted the things that are important to them. Peoples nutritional needs were assessed and and written into their individual care plan for example if they had difficulty swallowing or poor appetite. There were good examples in plans around pain management, specialist positioning and communication. Records showed that advice had been sought from health care professionals including dietitians, Speech and Language Therapists (SALT), tissue viability nurses (TVN ) general, practitioners, physiotherapists, and wheelchair services. Care plan reviews were being carried out with the service user when possible and their relative or representative. However, there were some care plans that had not changed since 2008 despite changes in individuals health care. For example, one said Nil by mouth in March 2008 but was reviewed by Speech and Language Therapists (SALT) and was now on stage 3 thickened fluids. The recommendation had been followed by staff although the care plan had not been changed. There was also contradictory information regarding catheter care where it was not clear when the catheter needed to be changed. For example in one care plan it said change every 8 to 10 weeks and then later in February 2010 the catheter was to be changed every six weeks. The risk assessments and care plans for moving and handling did not identify the type of hoist, sling, number of staff or the methods staff were to use to transfer service users safely. Evaluations of the care plans were bland and repetitive with comments of prefers to stay in bed and daily visits from family, which doesnt provide a full and proper evaluation of a service users care, progress or deterioration. Service users looked well cared for and the home had a calm and relaxed atmosphere. Staff were observed talking to the residents and involving them in activities. 4. Safety checks have been carried out on the equipment in the home such as testing electrical equipment and servicing the central heating boiler. The manager said that they have frequent fire drills and staff receive training so they know how to keep people safe if there is a fire. This training is repeated regularly. The manager said that the medical equipment in the home is serviced regularly and they can buy new equipment through a supplier whenever it is needed. They have recently purchased new suction equipment and blood pressure monitoring machines. Suction equipment is not being used in the home at present. The manager said that the organisation has risk assessments and procedures for the use of medical equipment. The list of staff authorised to administer medicines was up to date which would make it easier to identify who was involved in administration of medicines if an error or Care Homes for Older People Page 5 of 11 discrepancy arose. A random check of Medicine Administration Records(MAR) did not highlight any discrepancies. Staff carry out daily audits of medication. Falstone Court is purpose built and shares the site with Falstone Manor.The two services share car parking space to the front and rear of the building, kitchen and laundry facilities. The home has two floors with communal rooms available on both floors. All areas within the home were accessible to people with mobility difficulties. One lounge was being redecorated and the dining room had new furniture and tables were nicely set for meals.Service users could access a sensory garden from the dining room. There are small kitchens on both floors and the fitting are badly damaged with the drawers broken, cupboards split and broken tiles. Bedrooms had been personalised and all had an en suite toilet and hand washbasin.There were accessible bathrooms showers and toilets close to all communal areas. Light cords throughout the home were dirty and needed to be replaced with cords that could be easily cleaned to reduce the risk of cross infection. There was damage to doors and walls from trolleys and wheelchairs. Throughout the home and although there is a good cleaning programme in place one lounge had an odour and corridor carpets were looking worn. The manager said that they always notify the Commission of anything that adversely affects the well being of the service users at the home. They keep a copy of all notifications in the office. 5. The manager is experienced and well trained they are obviously present in the home and make sure that it is service user focused. They said that staff have received training in the deprivation of liberty safeguards so staff are now aware of their duty to safeguard the rights of the residents. What the care home does well: What they could do better: 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 set out on page 2. Care Homes for Older People Page 6 of 11 Care Homes for Older People Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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, 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 1 7 15 Ensure that all service users 31/08/2010 plans clearly identify how changes in each individual service users health and welfare needs are to be met. They must contain detailed evaluations to make sure that they are accurate and up to date. This will make sure that staff are provided with accurate, detailed and up to date information so they can provide residents with consistent good care. 2 8 13 Make sure that each persons 31/08/2010 risk assessments are reviewed and update to show their changing health needs. Moving and handling equipment must be detailed to show the type of hoist and sling and the action that staff need to take to make safe transfers. This will make sure that the residents are provided with good care and kept safe. Care Homes for Older People Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 3 19 13 The Small kitchens must be repaired and improved. This will improve the environment and make it more safe for the people who live at the home and their relatives. 30/09/2010 4 26 13 Make sure that dirty light pulls are replaced. This will reduce the risk of cross infection. 31/08/2010 5 29 19 All staff must be thoroughly vetted before they start to work at the home. This will demonstrate that the organsiation take seriously their responsibilities to only employ suitable people at the home therefore safeguard the people who live there. 31/08/2010 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 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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