Inspection on 16/05/06 for Argyles Nursing Home

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Argyles Nursing Home 06/06/07

Argyles Nursing Home 05/01/06

Argyles Nursing Home 26/07/05

Argyles Nursing Home 08/03/05

Argyles Nursing Home 23/11/04

Argyles Nursing Home 03/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Argyles Nursing Home Pound Street Newbury Berkshire RG14 6AE Lead Inspector Susan Cledwyn-Davies Unannounced Inspection 16th and 17th May 2006 10:50 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 Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Argyles Nursing Home Address Pound Street Newbury Berkshire RG14 6AE 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) 01635 551166 smithsu@bupa.com www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Miss Susan Jayne Smith Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: The Argyles is a care home with nursing run by BUPA care homes. The home can accommodate 57 residents over the age of 65 years of age. It is not registered to provide care for people who were suffering from dementia as the primary diagnosis. The accommodation in the home is provided over two floors. Each floor has access to two lounge areas. There is a passenger lift between the two floors of the home. The home is very close to the centre of Newbury and is easily accessible by road and rail, as well as pedestrian access. The current scale of charges as at 13.4.06 is £750-850 per week. Additional charges are made as required for hairdressing, chiropody, toiletries and newspapers. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been prepared using a pre-inspection questionnaire from the manager, 28 confidential questionnaires completed by service users and relatives, inspection records and a site visit that took place on 16th and 17th May for a total of 10.5 inspector hours. Included in the site visit was discussion with the manager and senior staff, conversation with service users and discussion with care and household staff. Some records were seen and the inspector had lunch with service users. Records included case tracking of four service users records and four recruitment and training files. What the service does well: What has improved since the last inspection? What they could do better: Encouraging and supporting choice is improving, the manager and deputy manager both spoke of improving choice for all service users. Improvements have already taken place. Providing more activities for physically frailer service users and in service user’s own rooms is part of this. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 6 Staff training needs to continue to ensure that more than 50 of care staff have achieved NVQ 2. Locking facilities are needed in each service users bedroom for medication or valued objects. 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. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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 Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Assessments of care needs took place before admission Intermediate care is not offered in the home. EVIDENCE: The statement of purpose and service user guide remains the same. These are given to relatives and prospective service users when visiting. All new service users admitted to the home have an assessment of needs before admission. One service user spoke of staff being very helpful and changing the bed especially for them. Visits to the home before admission are encouraged. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 9 An interim care plan is prepared for service users shortly after entering the home. The individual care plans are kept in each service users room for easy access by staff. The care plan is discussed with the service users. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care is assessed individually. Care plans are up to date and easily available. Medication practice is safe. EVIDENCE: The care plans are now regularly updated and risk assessments reviewed. The general manager and deputy manager check a number of care plans monthly. There was a previous requirement that was met. There was discussion about increasing the record of social activities and individual time. The deputy manager would be ordering the specific sheets for the Kardex recoding system. Health care is provided by local GP’s. Records of care provided are well maintained. Feedback from relatives and service users was positive. Qualified staff administer the medication and records are well maintained. Staff receive training updates annually. There is no check that qualified staff are administering medication according to the homes policy and procedure either when newly employed or occasionally after to ensure safe Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 11 administration. This was discussed with the general manager and deputy manager. Following the inspection an assessment format was sent to CSCI with advice that this assessment format will be used for all new qualified staff and subsequently annually. Safe medication storage is used and is well organised. The locked room is internal with no outside window or fan. It was advised that a thermometer be used to make sure that the temperature in this room did not exceed 24°c for safe storage of medication. Following the visit it was confirmed that a room thermometer had been purchased and checked regularly. The container for disposed of medication has now been moved from this medication store to a cupboard only accessed by the manager and deputy manager. During the visit staff were observed to be considerate and friendly towards service users. Service users spoke of staff respecting their views. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. A lot of work has been completed to improve the quality of service users life and increase choice. This work is continuing. EVIDENCE: Activities are provided by 1 part-time co-ordinator and 2 further staff. There are a variety of activities provided, largely in groups including trips out, which are very popular. There was feedback from questionnaires that individual activities were less seen. This was confirmed by observation and discussion with staff. The deputy manager is working towards more flexible service. Activities staff tend to work together and this is changing to provide more time for individual activities. Relatives confirmed in questionnaires and in conversation that they are advised of any problems and encouraged to visit. The service users on the first floor tend to be more physically frail and wheelchairs are used. There was discussion about the length of time service Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 13 users spend in wheelchairs and not in armchairs. A balance is aimed for to bring service users down for lunch. This balance needs to be assessed and checked regularly. The meals provided are varied and include fresh fruit and vegetable. A bowl of fresh fruit is now taken round each evening and each service users is offered a piece. This has been popular. Use of the dining room has increased. The inspector had a lunch with service users. The dining room was attractive and the tables well presented. Service users enjoyed the meal and often stayed behind to chat. The dining room is now used for 2 sittings, the first for people needing support and the second providing a more social time. There were comments from service users about eating positions because they remained in their wheelchairs. Written confirmation was received that all service users have been assessed for their choice of seat and position at the dining table and consequently more service users are being transferred to dining chairs for their meals. During the meal the dessert was served with cream and no choice was given. This was discussed with the cook who was working towards more choice e.g. individual vegetable dishes on each table. Additional sauces will in future be served separately to enable service user choice. The approach of staff to choice by service users is being actively encouraged. There have been improvements and the deputy manager aims to continue this. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a known complaints procedure. POVA issues are taken seriously. EVIDENCE: Service users questionnaires and feedback from relatives and service users confirmed that how to make a complaint is known. There is a comprehensive complaints procedure. There has been one complaint in the last 12 months. POVA issues are taken seriously. There has been one POVA referral to the Local Authority that was investigated thoroughly. POVA training takes place for all staff plus 2 staff have also completed the POVA training for trainers. POVA update training is planned. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is clean and fresh. Individual bedrooms contain personal property. The house has had some recent decoration; the upstairs carpet has just been renewed. Individual service users rooms should contain a locking drawer etc. so that individuals can store medication, private property safely. EVIDENCE: The home is modern and has had some redecorating recently. Bedrooms are individual in design and each service user is able to bring in their own personal items. During the visit the main first floor corridor and stair carpet was changed. The home is well maintained. Some service user’s bedrooms do not contain a locking facility. For two service users this is necessary because of keeping their own medication in their room. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 16 This room does not have a locking cupboard so the deputy manager is making sure that they have a key to lock their door. It is important to have a secure place so service users can keep private objects safe. The inspector was advised that locking facilities are being provided gradually. A recommendation is made to provide locking facilities in each room as soon as possible. The home is clean and fresh smelling. The household staff work very hard to maintain a pleasant environment. The laundry is adequate but small. There was a previous requirement to make sure that fire doors closed properly. Doors have been checked and a number adjusted. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is sufficient skilled staff with basic training. NVQ training is now being actively encouraged. Staff recruitment is greatly improved. EVIDENCE: There is a staff team of sufficient skills and numbers. This was confirmed by service users questionnaires, contact with relatives and by observation. There was a comment from a service user that at busy times the staff could be slower but that was understandable and not much more time. Staff training included NVQ training. At present 20 of care staff have NVQ 2,a further 7 are completing at the end of June and percentage will then be 43 . The standard asks for 50 as a minimum. The manager advised that a further 11 staff are due to start the training after this. If all this training is completed then 88 of staff will have NVQ training. A recommendation is made to reinforce the importance of achieving this training. Recruitment practice has greatly improved. There has been an audit by human resources of all files and the report showed that practice was greatly improved. The recruitment files seen were complete and showed safe practice. Staff training is organised by the training coordinator. There is a good record kept of training attended. Some staff have come from abroad and English is Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 18 not their own language. All staff with limited English have lessons in the home. The standard of English spoken is improving. The coordinator also keeps a record of supervision; this is generally conducted in groups plus an annual appraisal for all staff. The deputy manager confirmed that supervision is being reviewed so that all qualified staff will complete individual supervision regularly. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager is qualified and experienced. Quality assurance takes place involving service users and relatives. Service users monies are held safely. Health and safety issues are well maintained. EVIDENCE: The manager is qualified and experienced. Following poor practice in management of recruitment with further training and Human Resources input practice is greatly improved. Quality assurance within the home is researched by a few methods. Firstly including 6 monthly confidential questionnaires for service users and relatives organised by BUPA and the general results returned to the home. The Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 20 manager has a relatives meeting twice a year to hear their views. These meetings are well attended and relatives have a number of suggestions. The manager will be making sure that her response is noted and publicised to all residents and relatives. The administrator holds Service users monies if requested, records are shared monthly with relatives and all records are audited annually by BUPA. The house equipment and services are serviced regularly. Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard OP15 Good Practice Recommendations That care staff continue to promote resident choice. This aspect of care delivery should be promoted at every opportunity. That care staff continue to promote resident choice. This aspect of care delivery should be promoted at every opportunity. That a locking facility is available in each service users room. The Registered Manager should continue to promote NVQ training to the care staff who work in the home to ensure the minimum ratio of 50 of the care staff team achieve an NVQ qualification. 2. OP14 3. 4. OP19 OP28 Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 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 Argyles Nursing Home DS0000010969.V291055.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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