Inspection on 14/03/06 for Austenwood Nursing Home

This inspection was carried out on 14th March 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Austenwood Nursing Home 29/10/08

Austenwood Nursing Home 12/11/07

Austenwood Nursing Home 22/11/06

Austenwood Nursing Home 03/01/06

Austenwood Nursing Home 25/05/04

Austenwood Nursing Home 17/03/04

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 Austenwood Nursing Home 29 North Park Gerrards Cross Bucks SL9 8JA Lead Inspector Mr Guy Horwood Unannounced Inspection 14th March 2006 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 Austenwood Nursing Home DS0000019177.V285906.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. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Austenwood Nursing Home Address 29 North Park Gerrards Cross Bucks SL9 8JA 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) 01753 890134 01/01/1901 Westview Limited Mrs Jeanette Gittens Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Elderly Physically Frail Elderly Mentally Impaired (organic) Date of last inspection 3rd January 2006 Brief Description of the Service: Austenwood Nursing Home is situated a short distance from the town centre of Gerrards Cross, which provides a variety of shops and local amenities. The town is served by public transport networks, and possesses a main line train station. The home has parking for several cars. The premises consist of an older two-storey building, and a more recent ground floor extension. The home has extensive grounds to the rear, and a large enclosed patio. The home is registered to provide care with nursing for up to 29 elderly people, who can be accommodated in one of 19 single or 5 shared rooms. Of these rooms, 11 possess en-suite facilities. The home has 4 bathrooms for communal use, all of which enable disabled bathing. In addition to the en-suite facilities there are a further 4 toilets, situated at convenient positions around the home. Toilets and bathrooms contain grab rails. The home’s communal areas comprise of a large lounge, which opens out onto the attractive patio, and a well-presented dining room, which can seat all Service Users at one time. Both levels of the home’s main house are accessible by a through floor lift. A registered nurse is to be found on the premises 24 hours a day, and is supported by a team of carers, housekeeping, administrative and catering staff. All Service Users are registered with a General Practitioner, and access to other healthcare professionals is either by direct contact or through G.P. referral. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the unannounced inspection carried out at Austenwood Nursing Care Home on the 14th March 2006, between the hours of 10.00am and 11.30am. The lead inspector was Mr Guy Horwood who was accompanied by Mrs Caroline Roberts, Regulatory Inspector. The inspection consisted of touring the premises, meeting with residents and staff and viewing records and documents pertaining to the provision of care and the running of the home. At the time of the inspection there were 28 residents accommodated at the home, 1 of whom was in hospital. At the last unannounced inspection the manager, Mrs Jeanette Gittens, was not on duty, therefore Mrs Gittens was contacted 1 hour prior to the inspection to ensure that she would be present at the time of the visit. Mrs Gittens met the inspectors upon their arrival, was present within the home throughout the inspection, and received feedback at the conclusion of the visit as to the inspector’s findings. At the time of the visit numbers of staff on duty, in addition to Mrs Gittens, numbered 1 trained nurse and 6 care staff. Housekeeping staff were also seen to be on duty. Several residents were spoken with during the visit, the majority of which expressed that they felt well cared for by a team of kind staff. Comments included that staff were “nice” and that they felt “well cared for”. One resident commented that the food was “very good”, although they also felt that some of the more confused residents disturbed those who were more compus mentis. One comment was also made that night staff sometimes appear annoyed when called repeatedly by residents using their call bells. The inspectors found staff friendly and would like to thank them for their cooperation and assistance during the inspection. The inspectors would especially like to thank the residents for their time and for allowing the inspectors into their home. What the service does well: Residents appeared happy and content, and those spoken with expressed that they felt well cared for. Residents appeared to be dressed in comfortable and co-ordinating clothing. A programme of meaningful activities and entertainments is provided for residents. Residents may receive visitors at any reasonable time. Residents are assisted to follow religious observance. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 6 No complaints have been received by or about the home since the last inspection. The procedures for raising concerns and /or complaints within the home are readily available. The home is clean, tidy and free from unpleasant odours. An on-going process of maintenance and decoration takes place within the home. Residents live in a home, which is run in a manner beneficial to them, and by a person competent to do so. The health and safety of residents and staff is protected through staff training and the regular servicing of equipment and fire detection systems. What has improved since the last 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. Austenwood Nursing Home DS0000019177.V285906.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 Austenwood Nursing Home DS0000019177.V285906.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): EVIDENCE: These standards were not assessed at this visit. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 9 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. Resident’s health care needs are monitored and recorded appropriately, and suitable equipment is utilised to promote their welfare. Resident’s benefit from systems used to monitor their health. EVIDENCE: The manager, Mrs Gittens, informed the inspectors that resident’s vital signs and weights were being recorded on a regular basis. Mrs Gittens stated that where it is perceived that there is a risk to residents skin integrity, a record is kept detailing the turning of these residents when in bed. In order that staff are clear as to the settings of individual residents air flow mattresses, (pressure relieving mattresses), Mrs Gittens has introduced the practice of attaching labels holding this information to these mattresses. Pressure relief mattresses and cushions were noted in use throughout the home. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 10 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. Residents are provided with a choice of meaningful activities, are able to practice religious observance. This provides stimulation and enjoyment. The home enables open visiting, which enables Residents to maintain contact with family and friends as they wish. EVIDENCE: The home employs an activities organiser for 10 hours a week, and in addition to these hours, 1 member of care staff undertakes an activities role between 2pm and 4pm on 2 days each week. The manager stated that some group activities take place, including escorted trips to local shops, garden centres and pubs. These trips are conducted either through the use of a local wheelchair taxi or by staff taking residents out in wheelchairs. Entertainers visit the home on a monthly basis, which seems to be popular with residents. Parties are held within the home with relatives invited, (for example Barbeques, VE Day Celebrations, Birthday Parties,) and a photographic record of such events held by the home was viewed. A recent “Makeover” event took place in the home and was apparently enjoyed. The manager realises the importance of one-to-one activities for those residents cared for in bed or choosing to stay in their bedrooms, and such activities include reading books and newspapers, manicures and conversation. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 11 Residents are able to follow religious observance through the monthly visit of a vicar and regular visits by a priest. The home operates a policy of unrestricted visiting to the home, and this was confirmed through discussion with residents. Visitors may be received in the lounge, although if privacy is required residents may meet with their relative in their bedroom, the nursing office or the dining room. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 12 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 No complaints have been received since the last inspection. Satisfactory policies and procedures are in place for dealing with concerns and complaints where received. EVIDENCE: No complaints have been received at the home since the last announced inspection. The homes complaints procedure has not altered significantly since the last inspection. All residents receive a copy of the complaints procedure, and copies are displayed within the home. A complaints record log is maintained, and the last entry in this dates back to 2002. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 13 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 & 26. Residents live in a clean, comfortable and well-maintained environment, thus presenting them with a homely and attractive residence. Staff may place residents at risk due to leaving external doors unlocked. EVIDENCE: The home appeared satisfactorily clean and tidy throughout, with no offensive odours noted. Room 24 was in the process of being redecorated, which included being wallpapered, having tiling around the sink replaced, and the entire room being painted. At the last inspection room 12b had been damaged following a water leak, which resulted in the carpet being damaged and an unpleasant smell permeating the room. It was pleasing to note that this room had been refurbished with new carpeting and was free from any malodour. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 14 Height adjustable beds were present in bedrooms with numerous alternating pressure mattresses in use. Since the last inspection, trellis has been fitted to the top of the fence separating the home from a public footpath. The manager stated that she has also spoken with staff in regards to leaving a rear door open. It was disappointing to find that this same door was unlocked at the time of the visit. The re-enforced glass in one of the main lounges doors was noted as cracked. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: These standards were not assessed at this inspection. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 16 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, 32, 33, 35 & 38. Residents live in a home, which is run in a manner beneficial to them, and by a person competent to do so. No recorded quality assurance processes are undertaken at the home. No personal money is handled by staff for, or on the behalf of, residents. The health and safety of residents and staff is protected through staff training and the regular servicing of equipment and fire detection systems. Residents and visitors may be placed at risk through the use of electric heaters. EVIDENCE: The manager, Mrs Gittens, is a registered nurse and has been registered as the homes manager as required under the Care Standards Act 2000. Mrs Gittens Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 17 and staff members spoken with, did not appear unduly concerned at the presence of the inspectors, and were co-operative and friendly throughout the visit. The manager and staff appeared caring and kind in their dealings with residents, which residents commented on - “We are well looked after”, “Nice staff”. Residents throughout the home appeared well cared for. Photo albums were noted showing residents birthday parties and other events within the home. At the time of this inspection the manager stated that there was not a formal quality assurance process being undertaken. Mrs Gittens commented that she did undertake informal auditing of care records and medication, but did not document this action. The home possesses quality assurance tools provided by an external agency, and it is recommended that this be employed to conduct formal, recorded auditing of the homes running, with the development of action plans from this process. A survey has not been undertaken since April 2006 as to resident’s views as to the running of the home. The manager has planned to undertake such a survey in the coming months. Mrs Gittens informed the inspectors that no personal money is handled by employees of Austenwood Nursing Home on the behalf of residents. A record of bath temperatures was seen as being maintained prior to residents entering a bath. Chemicals appeared to be stored appropriately throughout the home. Radiators are fitted with low surface temperature covers throughout the home. Two plug-in electric heaters were found on the floor in the dining room. These were extremely hot to the touch, and as such presented a significant risk. The manager stated that these heaters were on a timer and were to warm the dining room prior to meal times. It was stated that wall mounted heaters were on order to replace these temporary heaters. The reason given for these additional heaters was that the dining room had recently been a little bit cold due to the large windows and recent cold weather, but was usually adequately heated by the existing central heating system. The manager provides staff training with regards to safe moving and handling. New staff receive moving and handling training before being allowed to provide personal care unsupervised. Records pertaining to the testing of fire detection, extinguishing and alarm systems were well maintained and up to date. Records were viewed pertaining to staff receiving fire safety training and undertaking practice drills. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 18 Servicing and maintenance records were viewed for a number of items including hoists, boilers and portable electrical appliances. These records appeared in order and up to date. Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 19 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 2 Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. 1. Standard OP38 Regulation 13(4) Requirement Staff are to take every reasonable precaution through the locking of external doors, in order to ensure the safety of residents and persons within the home. 01/02/06 The cracked glass in the lounge door is to be replaced. The manager is to establish and maintain a system for reviewing and, where required, improving the quality of care provided at the home. Timescale for action 01/04/06 2 3 OP19 OP33 23(2)(b) 24 01/05/06 01/07/06 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 OP38 Good Practice Recommendations It is strongly recommended that the manager review the use of freestanding heaters within the home, being as they are extremely hot to the touch and present a risk to the health and safety of residents and visitors. DS0000019177.V285906.R01.S.doc Version 5.1 Page 21 Austenwood Nursing Home Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Austenwood Nursing Home DS0000019177.V285906.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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