Inspection on 06/08/08 for Nower Care

This is the latest available inspection report for this service, carried out on 6th August 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Nower Care 24/11/05

Nower Care 23/06/05

Nower Care 10/11/04

Nower Care 20/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Nower Care Nower House Coldharbour Lane Dorking Surrey RH4 3BL Lead Inspector Mary Williamson Unannounced Inspection 6th August 2008 10:00 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 Nower Care DS0000013730.V369268.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. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nower Care Address Nower House Coldharbour Lane Dorking Surrey RH4 3BL 01306 882844 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) nowerhouse@tiscali.co.uk Dorking Residential Care Homes Limited Ms Wendy Anne Sharples Care Home 50 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (50), of places Physical disability over 65 years of age (3), Sensory Impairment over 65 years of age (2) Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Of the 50 (fifty) service users accommodated under the category of OP, up to 7 (seven) may fall within the category DE(E): Dementia (older persons). Of the 50 (fifty) service users accommodated under the category OP, 3 (three) may fall within the category PD(E): Physical disability (older persons). The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE. Of the 50 (fifty) service users accommodated under the category of OP, 2 (two) may fall within the category SI(E): Sensory Impairment (older persons). 14th August 2006 Date of last inspection Brief Description of the Service: Nower Care is a care home for fifty service users located on the outskirts of Dorking Town. The home provides personal care in a homely and comfortable atmosphere. Service users accommodation is offered in single bedrooms some of which have en-suite facilities. There is ample communal space available which includes six lounge areas. The home has been undergoing extensive refurbishment in recent years to enhance service users accommodation. This building project is ongoing and has now restored some of the garden area and courtyard. Leisure activities are provided, and trips out to the local amenities and places of interest also take place. The fees charged in this service range from £500 for a standard room to £560 for a premier room. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is a three star rating. This means that people living in the home experience excellent quality outcomes. This was the first site visit of a key inspection and was unannounced. The inspection was undertaken by Mary Williamson Regulation Inspector. The Registered Manager Ms Wendy Sharpels represented the home during this visit. The General Manager Chris Harwood also participated in the inspection. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were examined. The inspector had the opportunity to speak with some of the residents and listen to their views about the home. Positive comments were received about the care staff and the care they provide. Residents were sitting in various lounges located on both units of the home, and were having morning coffee, talking in groups, reading their paper, or preparing to go out with the activities coordinator for a trip to the local garden centre. Staff were seen to undertake their duties in a caring and professional manner. It was also possible to talk to staff and gain heir views about working in the home and confirm some training they had undertaken. It was also possible to talk with the deputy managers on units, the training coordinator, and the activities coordinator and learn about their roles and responsibilities within the home. The home’s business plan and further development was presented by the General Manager. The home completed an Annual Quality Assurance Assessment (AQAA), which was detailed provided with all the information that we required. The CSCI would like to thank the residents, staff, and management team for their help and hospitality during this inspection process. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There have been no requirements as an outcome of this inspection and residents receive an excellent standard of care. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, and 6. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents have access to detailed information to help them choose the home. Needs assessments and contracts of occupancy are in place. The home does not offer intermediate care. EVIDENCE: The home has an information pack which included a statement of purpose, service user guide, a list of fees, and facilities available that provides prospective residents and their relatives with the information needed in order for them to make an informed decision about living in the home. A relative accompanying a new resident said she found the information “most helpful”. All residents have a needs assessment in place. This is undertaken by the manager prior to admission to determine if the home will be able to meet the prospective resident’s specific needs. A selection of needs assessments were Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 10 sampled and these are detailed, and reviewed regularly. During the inspection the home manager was arranging to undertake a review of needs of a resident who was in hospital in order to establish if the home could meet the changing needs of that resident. Contracts of occupancy are in place. The contracts seen are clear and outline the type of accommodation offered, the support provided, the amount, method and frequency of fees payable. These are signed by the resident or designated representative. The home does not provide intermediate care. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans outline how personal, social and health care needs are met. The medication procedure protects residents living in the home and privacy and dignity was seen to be observed. EVIDENCE: Individual care plans were sampled on both units of the home. These are well written based on the needs assessments, input from residents whenever possible, and information obtained from relatives. The care plans are maintained on computer and updated daily by senior staff and reviewed on a regular basis. A printed copy is also available in individual files. Residents are registered with local GP’s who visit the home on a regular basis. As most of the residents are fairly local to the area it is possible for them to retain their own GP with mutual agreement. Residents are also supported by the district nurses who undertake dressings, take blood samples, administer flu vaccines, and monitor pain control. Chiropody treatment is provided by the Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 12 NHS every three to four months, or more frequently by private chiropodist. A mobile optician service visits the home and residents may see a local dentist by appointment. Specialist input is on referral by the GP. The home has a procedure in place for the administration of medication. All staff that administer medication have full training and assessment prior to undertaking this procedure. The medication practice was observed on Woodcote unit. The medication recording charts (MAR) were seen and these are well maintained. Residents are encouraged to be as independent as possible in controlling their own medication and a risk assessment is in place for residents that self medicate. Privacy and dignity is respected and staff were observed to interact with residents in a polite and professional manner. Residents are addressed by their preferred title, and staff were observed to explain procedures to residents prior to undertaking these. All rooms are single occupancy and keys are provided on request. Facilities are available for residents to see visitors or visiting professionals in private. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15. People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are offered a full and varied programme of social and recreational activities. Family and spiritual links are maintained. The nutritional needs of the residents are met. EVIDENCE: Activities are well organised by the activities coordinator, and meet both the individual and collective needs of residents. An activity programme is displayed in the home and residents know on a weekly basis what is taking place. Three residents were going to the local garden centre during the morning for a walk about and a coffee. Trips out to local beauty spots and to the coast are organised and the activities coordinator stated that she intends to increase these trips during the next year. Entertainment is provided regularly and special occasions are celebrated for example birthdays and holidays. In house activities include board games, card games, music and movement, mobile library, quiz, videos, and craft. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 14 During individual and group discussions with residents they stated that there is “plenty to do here”, “I like to get out and about”, and “I am given the choice to join in or not”. Several residents receive a daily newspaper. Spiritual needs are supported and various clergy visit the home on request. A regular service takes place for residents who wish to attend. Family links are maintained and relatives are encouraged to visit the home at any reasonable time. Relatives are encouraged to attend reviews of care and take part in relatives meetings. The general manager stated that the home plans to include a relative’s apartment in the final stage of the redevelopment programme to enable relatives to stay in the home if necessary. The catering arrangements in the home are excellent. Residents are consulted on admission regarding their dietary needs. Menus are planned over a six week period with input from the residents, and knowledge of needs and preference. Residents were seen enjoying lunch in a relaxed and comfortable atmosphere. The menu included lamb casserole, or gammon, a selection of seasonal vegetables, and potatoes, followed by rice pudding. The kitchen is well organised by a chef (recruited since the last inspection) and a cook both of whom have considerable knowledge of the dietary needs of the elderly. The appropriate records relating to food hygiene and environmental health are in place. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The complaints procedure and the abuse awareness procedure in place protect the residents living in the home. EVIDENCE: The home has a complaints procedure in place, which is also included in the service user guide. There is also a form included within the service user guide titled “Praise, Comments, and Complaints”, for residents and relatives to complete if they wish. There have been no formal complaints received in the home or by the CSCI since the last inspection. A complaints log is maintained which includes any minor concerns or issues. Residents are aware of this procedure and one resident stated that if she had cause for concern then she would talk to the manager regarding this. The home has a safeguarding vulnerable adults procedure in place and all staff undertake training in this procedure during their induction training. The training coordinator confirmed this. There is also a whistle blowing policy in place. A copy of Surrey’s Multi Agency Policies and Procedures on Safeguarding Vulnerable Adults is also in place, and the manager and senior staff team have attended training in these procedures. The Skills for Care Manual also includes these procedures. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 16 Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, and 26. People who use the service experience good quality outcomes in this are. This judgement has been made using available evidence including a visit to this service. The home is suitable for its stated purpose. Residents live in a safe, comfortable, clean, and well-maintained environment that meets their individual and collective needs. EVIDENCE: The home has been undergoing major refurbishing and development over recent years. This has enhanced the standard of accommodation providing more en-suite facilities and superior communal space. The new reception and seating area provides a warm and welcoming atmosphere in the home. A conservatory overlooks newly laid gardens and a courtyard. Currently the Dyson wing is closed for refurbishment and the home has made every effort to ensure minimum disruption as possible is caused to the residents. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 18 Resident’s bedrooms are comfortably furnished and residents are encouraged to bring their personal belongings with them when they choose to live in the home. The laundry has been relocated to the basement and is well designed and equipped to serve the needs of the home. The home is clean, hygienic, and maintained to a good standard by a team of five housekeepers. There is a control of infection policy in place and all staff undertake this training which is mandatory and updated annually. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, and 30. People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by a well-established and skilled staff team providing continuity and stability. The recruitment practice in place protects residents living in the home. EVIDENCE: The staff duty rota was seen and indicates that sufficient care staff are on duty throughout the day to meet the assessed needs of the residents. Staff were observed to undertake their duties in a professional and confident manner with mutual respect. The staff team is well established with no new care staff been employed in the home since the last inspection. Residents spoke highly of the staff and the care provided. The home also employs a large team of ancillary staff who are highly motivated ensuring that the standards relating to food, cleanliness, maintenance, and administration are fully met. All staff have an individual training and development profile in place. This outlines all the training undertaken and highlights the training required. The training coordinator employed oversees staff development and undertakes the induction programme for staff. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 20 The general manager spoke about the recruitment practices in the home. All staff have a face to face interview, and all employment documentation is in place prior to commencement of employment. Staff employment records are well maintained. It was possible to talk to staff throughout the visit who all had a good understanding of resident’s needs. They confirmed the training provided including manual handling, first aid, food hygiene, health and safety, fire safety, infection control, and risk assessment. NVQ training is ongoing at various levels, and this is also overseen by the training coordinator. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. People who use this service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed I the best interests of the residents. The health, safety and welfare of the residents and staff are observed and promoted. EVIDENCE: The management structure within the home is satisfactory and supports the residents and staff. The registered manager has been in post for several years and has considerable experience in the provision of care for older people. She has an NVQ level four award in management. The service also has a general manager in post with an office located on the top floor of the home. He oversees the administrative responsibilities and is currently managing the building and refurbishment project. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 22 The registered manager operates an open and inclusive style of management and the new location of her work station in the reception area encourages this. There is also provision for interviews and conversations with residents and relatives to be conducted in private. Systems are in place to monitor quality assurance. Quality audit questionnaires are sent to residents and relatives annually and the feedback acted upon and retained on file for information. The home also is regulated by regulation 26 visits and reports are also retained for information. Regular audits of care plans, medication audits, and health and safety audits are also undertaken. Residents meetings take place and the chef also meets with residents to monitor catering arrangements. Formal staff supervision is undertaken and recorded at two monthly intervals. Financial records were not examined during this visit. Information supplied to the CSCI by the manager indicates that resident’s financial interests are safeguarded by the financial systems and procedures in place. The home has a wide range of health and safety policies and procedures in place and some of these were sampled throughout the inspection. The Annual Quality Assurance Assessment (AQAA) that was completed by the general manager outlined the procedures in place and the dates which these have been reviewed. Fire safety is observed and all staff undertake fire safety training annually. Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 23 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 4 4 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 4 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? 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. Refer to Standard Good Practice Recommendations Nower Care DS0000013730.V369268.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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