Care Home: Tarvin Court Nursing Home

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What the care home does well What has improved since the last inspection? A programme of refurbishment is being implemented. Records showed that new staff have a structured induction to the home.The manager has been registered with the Commission for Social Care Inspection. CARE HOMES FOR OLDER PEOPLE Tarvin Court Nursing Home 4 Tarvin Road Littleton Chester Cheshire CH3 7DG Lead Inspector Wendy Smith Unannounced Inspection 9:45 26 October 2007 th 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 Tarvin Court Nursing Home DS0000018817.V351686.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. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tarvin Court Nursing Home Address 4 Tarvin Road Littleton Chester Cheshire CH3 7DG 01244 332538 01244 336533 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) Ashbourne Homes Limited Linda May Coleman Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 28 service users to include:* Up to 28 service users in the category of OP (Old age, not falling within any other category). Date of last inspection 14th June 2006 Brief Description of the Service: Tarvin Court is a care home providing nursing and personal care for up to 28 older people. The home is in Littleton, approximately two miles from Chester city centre, and is on a main bus route. The home is set in its own grounds and combines the original Victorian building with a purpose built extension. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 26th October 2007 and took four hours. The home had 20 residents, all over 65 years of age. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with residents, staff and the manager from another Southern Cross home who was providing management cover during the illness of the registered manager. Some of the information contained in this report is taken from the Annual Quality Assurance Assessment that was completed by a project manager at the request of the Commission for Social Care Inspection. Prior to the visit, comment cards were provided for a number of residents, visitors, social workers and GPs to give their views of the home. What the service does well: What has improved since the last inspection? A programme of refurbishment is being implemented. Records showed that new staff have a structured induction to the home. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 6 The manager has been registered with the Commission for Social Care Inspection. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People interested in going to live at Tarvin Court are assessed by a qualified person to establish whether the home will be able to meet their needs. EVIDENCE: All of the residents living at the home are older people who are physically frail. A number of residents also have a degree of cognitive impairment, but the acting manager (who is covering the home due to the illness of the registered manager) said that the needs of these people could be met in full at Tarvin Court and there was evidence in the care plans of support being provided by community psychiatric nurses as needed. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 9 When an enquiry is received from a person interested in coming to live at the home, or having a short stay there, the manager or the deputy manager goes out to assess their needs. In the current absence of the registered manager, managers of other local Southern Cross homes are helping out with these assessments. A comprehensive assessment form is completed so that staff have information about the new resident. There is a four week trial period. Tarvin Court does not provide intermediate care but people can come for short stay if a room is available. Tarvin Court Nursing Home DS0000018817.V351686.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): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s have individualised care plans; these are well detailed and ensure care staff are meeting the personal and health needs of people living at the home. EVIDENCE: The care plans for three residents were looked at and all had been completed to a good standard. Full assessments were recorded and the plans for care related to the assessed needs. All had been reviewed monthly and amended as needed. Six monthly care reviews with the resident and a relative were recorded. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 11 The care plans recorded visits from doctors, social workers, physiotherapist, community psychiatric nurse and continence advisor. At the time of the visit no residents were terminally ill and none had a pressure sore. A small number of the more frail people are cared for in bed. Residents were seen to have the equipment they need to help prevent pressure sores. A small number of residents have been assessed as requiring bedrails. Where bedrails were in use they were fitted properly to the bed and protected with padded covers. Most residents are registered with the local GP surgery that has been identified by the PCT to provide medical cover for the home. A GP from this practice visits weekly and a practice nurse also visits weekly to provide advice and support for the home’s nurses. Comments were received from relatives included: I would just like to mention how caring and friendly all the staff are at Tarvin Court, and. The majority of staff seem friendly and cheerful and very helpful. Arrangements for the ordering, storage, administration and disposal of medicines were looked at. Company policies and procedures are in place. The medicines room was clean and tidy with all items stored in an orderly manner. Regular medicines are dispensed in a monitored dosage system. There were good records of medicines brought into the home and administration records had no missed signatures. A monthly audit of medicines is carried out and the last audit recorded a score of 98.7 compliance. Tarvin Court Nursing Home DS0000018817.V351686.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): Standards 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. Residents are able to exercise choices in daily living and maintain contact with friends and family. EVIDENCE: At present there are limited social activities available because the activities organiser has left. The post has been advertised and some applications have been received. An activities organiser from another Southern Cross home is helping out one day a week and care staff are also facilitating some social activities for residents. There had been a recent trip to Blackpool and a resident said that she had enjoyed this. A hairdresser visits weekly. The overall atmosphere of the home is quiet and peaceful and this suits many of the residents. Most residents spend most of their time in their own rooms and were occupied in reading and watching TV. One relative commented: Mum chooses to take her meals in her room and does not want to participate in any activities – this is respected. Three relatives commented that they are always kept informed about important issues. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 13 There were some complaints about catering earlier this year, and a new head cook was appointed in September 2007. She has considerable previous experience as head cook in another care home, and residents and staff spoken with agreed that the meals had improved. On the day of this visit nine residents were having lunch in the dining room and all appeared to enjoy their meal. Tarvin Court Nursing Home DS0000018817.V351686.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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and concerns raised by residents and/or their relatives are taken seriously and responded to appropriately. EVIDENCE: Corporate complaints policies and procedures are in place and survey forms received from residents and relatives confirmed that they aware of how to make a complaint. Any complaints received are recorded and kept on file. The records of two investigations carried out in August 2007 were not available in the file. A recent complaint made by the relative of new resident had been addressed by the area manager, who had held a meeting with the complainant. Policies and procedures are in place for reporting any allegations of abuse. All staff have either already received training about this or will be attending training on November 6th 2007. Tarvin Court Nursing Home DS0000018817.V351686.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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, environment for residents to live in. EVIDENCE: A tour of the building showed all areas to be clean, tidy and well maintained. Redecoration and refurbishment has been taking place and new corridor carpets have been fitted on the ground floor. There is new furniture and soft furnishings in some of the bedrooms. A senior carer who has worked at the home for several years said how pleased she was to see the home looking so nice. All bedrooms were singly occupied. There is a cleaner and a laundry assistant on duty every day. A bank domestic is usually able to help out during holidays or sickness. safe, clean and well-maintained Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 16 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): Standards 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. Enough qualified and experienced staff are provided to ensure that the needs of residents can be met in full. EVIDENCE: The staffing rota showed that there is a registered nurse and three care assistants on duty during the day, and a registered nurse and two care assistants at night. The home has some bank staff, but occasionally agency staff are used to cover shortfalls. The annual quality assurance assessment recorded a low staff turnover. Five of the home’s regular care staff and two bank staff have a national vocational qualification in care. None of the other care staff are working towards a qualification at present. Two of the senior care assistants are qualified as nurses in their own country. A training matrix was available but unfortunately not all training had been recorded on it and half of the staff had no date recorded for fire training or moving and handling training. The deputy manager, who is also a moving and handling trainer, was certain that all of the staff had received moving and handling training. This is now being addressed and fourteen staff attended fire training on 5th October 2007. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 17 Personnel records were looked at for three new members of staff. These showed that the appropriate checks had been carried out to ensure that they were safe to work with vulnerable people. There were also records to show that new staff had completed an induction programme. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a way that promotes the best interests of residents and ensures that the health and safety of staff and residents are protected. EVIDENCE: The manager was registered with the Commission for Social Care Inspection in October 2006 but unfortunately she has had a serious illness and has been off sick since August 2007. It is hoped that she will return to work early in the New Year. Management cover is being provided by other staff employed by Southern Cross. The manager of a nearby home is working two or three days a week at Tarvin Court. A project manager has been assigned to the home and the area manager is also involved in overseeing the service. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 19 A system of staff supervision is in place which gives all members of staff the opportunity to meet with a senior person six times a year. A senior manager visits the home at least once a month and makes a report as required by Regulation 26 of the Care Homes Regulations. A monthly home audit is carried out alternately by the home manager and a senior manager. This covers all aspects of the running of the home and the care of residents. The Commission for Social Care Inspection annual quality assurance assessment was completed very well by the project manager and identified plans for future development. An administrator is employed part-time to deal with day-to-day office work. The administrator has responsibility for looking after personal spending money in safekeeping for residents. Personal spending money deposited on behalf of residents is paid into a bank account and a small float is kept at the home for residents to use. Residents are helped to take responsibility for managing their own money if they wish. Information provided in the annual quality assurance assessment showed that all plant and equipment in the home are serviced and maintained in good order. Fire records are maintained including details of regular fire drills and the names of staff attending. Fire records also showed quarterly visits by a contractor to check and service the fire alarm system and emergency lighting. All of the required policies and procedures are provided by Southern Cross Healthcare and regularly reviewed. Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 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 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP16 OP28 OP30 Good Practice Recommendations Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Tarvin Court Nursing Home DS0000018817.V351686.R01.S.doc Version 5.2 Page 23 - 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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