Inspection on 15/08/07 for Austhorpe Nursing Home

This inspection was carried out on 15th August 2007.

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

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Austhorpe Nursing Home Norwich Road Forncett St Peter Norwich Norfolk NR16 1LG Lead Inspector Mrs Marilyn Fellingham Unannounced Inspection 15th August 2007 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 Austhorpe Nursing Home DS0000070202.V352173.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. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Austhorpe Nursing Home Address Norwich Road Forncett St Peter Norwich Norfolk NR16 1LG 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) Austhorpe Care Home Ltd Miss Sandra Anne Watson Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Austhorpe House is a large detached building situated in the village of Forncett St Peter. It is registered to provide nursing care to up to 28 older people. Bedrooms are on the ground and first floors and consist of three double and twenty-two single rooms; twelve bedrooms have en suite facilities. The home has a limited variety of communal rooms for service users to use and a shaft lift is provided to assist service users from the ground to the first floor. Austhorpe House is set in approximately two acres of gardens with seating areas for the residents and wheelchair friendly pathways. Fess range from £460 to £550 per week. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived unannounced and spent over six and a half hours at the home. The views of the management, staff and a selection of service users and relatives were obtained. A tour of the home was made and records were examined and have helped inform the judgements made. A selection of comment cards were received from service users, relatives and professional agencies, these were used in the inspection process. The home has addressed issues highlighted in the last inspection report. The focus of the inspection was to assess all the key standards for homes for the elderly. What the service does well: The home has a core of very loyal and caring staff who have very positive relationships with the service users, relatives and other professional agencies. Service users are given many opportunities to take part in activities and outings. The home provides a very homely and comfortable environment that is clean and tidy. Meals are managed very well with all likes and dislikes being catered for. The service users are listened to. The acting manager is keen to address all issues raised in the inspection report. A thorough assessment of needs is carried out before entry to the home. The service users are treated with respect and dignity. The staff are very approachable and always make visitors very welcome. The home has a robust system in place for recruitment. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Austhorpe Nursing Home DS0000070202.V352173.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 Austhorpe Nursing Home DS0000070202.V352173.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personalised needs assessment means that people’s diverse needs are identified and planned for before admission to the home. EVIDENCE: Case tracking confirmed good practice. The admission process guides the manager and other senior staff who are responsible for the assessment of prospective service users to the home to ascertain if the individual’s needs can be met. Evidence was seen for this in the files of new persons admitted to the home. This included a full assessment of need in relation to the health, social and physical care needs. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements have been made in relation to the previous variable practice regarding care planning. This means that overall the delivery of care matches that of the assessed and changing needs of the residents. The handling and administration of medicines has improved but could be improved further by ensuring better recording of PRN medication. EVIDENCE: Service user plans of care showed improvement and were generally complete and catered for the assessed needs of the individuals; however there were some areas where the plans could be improved. Two care plans had evidence of evaluation of care; however the plans themselves had not been changed to correspond with the latest changes in needs. This could lead to the service users not being totally confident that their change in needs could be met. We also noted that although one care plan prescribed care in relation to the Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 10 prevention of pressure sores for one service user, there was no care plan in place for the actual pressure sores that they had on their heels. This lack of detail could result in failure to give the required care for specific needs. Those staff spoken with have a good understanding of the needs of the service users and were seen to be respectful and kind when dealing with them. Comments in the surveys were positive and complimentary about the care given. One resident commented that the staff were wonderful and most conscientious. One relative said that their resident was always well cared for and another said that they felt the staff were an extension of their family and so caring. The administration and handling of medication has improved greatly. A random check of medication tallied with that recorded on the medication record charts and related to the care plans, daily notes and GP visits. It was noted that that PRN (as required) medication was given to service users with little or no documentation in their care plans to indicate when this medicine was to be administered and therefore that its use was clinically justified. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities are offered within the home which means that the residents have the opportunity to participate in stimulating, motivating and social activities. Meals are managed well and appear to be quite social with relatives present and other visitors popping in and out. EVIDENCE: Those service users and relatives that we spoke to were very positive about lifestyles and felt that it matched their expectations; one relative commented that although their relative appeared to not be able to take part in any activities they were always included in any communal function. Discussion with the manager revealed that she is very aware as is the activity coordinator of the varied service users abilities and the activity programme is planned around those abilities and what individuals like doing. The residents had recently enjoyed a garden party where relatives, staff and friends were very involved, all those spoken to said that it had been a most enjoyable day. Good records are kept and many are in photographic form. The activity coAusthorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 12 ordinator has recently completed a course in Reminiscence and her input has been increased to twenty hours a week. The visitors spoken to said that they were always made welcome and offered beverages; two relatives, who are always present at lunchtime, have lunch with their relatives and are involved with assisting to feed them. The menus are varied and appear nutritionally balanced. Part of the kitchen floor has been replaced and this activity did not seem to have impinged on the quality of food offered. The mealtime witnessed by us was most relaxed with the residents being assisted in an empathetic way; residents choose where they wish to eat and there are always choices on the menu, this was confirmed by those we spoke to. One relative commented that the carers were very patient when feeding the residents and that all residents were encouraged to eat and drink. The manager is aware of the importance of nutrition in the elderly and is arranging for staff to have M.U.S.T. training. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel safe and listened to. The service users are protected from abuse and their monies are handled in an appropriate way. EVIDENCE: A complaints procedure is in place and those service users and relatives spoken to said that they understood the procedure for making complaint and that they always felt confident that the manager would listen to them if they had any concerns. We noticed that a copy of the complaints procedure was sited in the front lobby. Staff were also familiar with the complaints procedure and knew who to go to in the event of a complaint being made to them. Safeguarding adults training has taken place and those staff spoken to have an understanding of their roles in relation to protecting vulnerable adults. Arrangements are in place for a safer system for dealing with resident’s monies and a clear audit trail confirmed this. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The attention to maintenance and safety means that the service users live in a safe and well-maintained environment. EVIDENCE: The home was found to be extremely clean and tidy. Those visitors and residents spoken with stated that they always found the home very clean and the residents themselves felt that their rooms were kept clean. All cleaning agents were correctly stored. Residents agreed that the environment was homely and comfortable. Risk assessments were in place for maintaining a safe environment, these were informative. Minutes were seen for health and safety meetings that take place concerning the safety of the home. The home has a better system for controlling infection although it is recommended that the use of pedal bins be considered for best practice. All window frames are in the process of being re fitted. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s needs are not entirely being met by the numbers of staff. Service users are in safe hands, although additional training is necessary to underpin safe practice. There is a robust system in place for recruitment and thereby protecting the service users. EVIDENCE: Comments in surveys suggest that although the general consensus was that the staff were excellent and very caring but they were always ‘pushed for time’. The duty rosters showed that the manager often worked a shift, which reduced her capacity for discharging her other duties related to management of the home. The manager acknowledges that the many demands on the staff time affect the quality of care the staff team deliver, despite their admirable commitment and hard work. The duty rosters also indicated that there were shortfalls of staff on duty in relation to meeting the assessed needs of the residents and not entirely associated with dependency levels. The staff themselves felt that they were very busy particularly at meal times when thirteen residents needed assistance with feeding; they also felt that they could not spend as much time with the residents as they would wish to. This means that the resident’s basic needs are mostly met but that there are areas Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 16 that could be improved upon to ensure that the staff can respond fully to the emotional as well as the physical needs of the service users. Staff have a good idea of their roles and a training plan is being devised; however this has taken longer to put into fruition because of a change of provider. Induction is carried out for all new employees and examples of this were seen; those new staff spoken with confirmed that they had received an induction, which was based on the common induction standards. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management arrangements are meeting the needs of the service. EVIDENCE: Service users, staff and relatives were aware of the management structure of the home, they felt that the acting manager was excellent and responded to any of their concerns and communicated well with them. Service users and relatives said that the acting manager was trying to improve the quality of the service; the acting manager said she had tried to arrange meetings with relatives but so far had been unsuccessful. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 18 Staff appreciated the management style of the acting manager and felt that she was very approachable. They confirmed that they were receiving formal supervision and records were seen for this. The quality assurance system is still managed well and views are sought from all people who use the service. The acting manager promotes diversity and equality and is aware that more could be done in relation to this and the staff understanding of issues surrounding this. It is important that the providers ensure that the acting manager is registered with the Commission. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 x 3 3 x x x x 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 3 Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 20 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. 1 Standard OP27 Regulation 12, 18 Requirement Staffing levels must be reviewed to ensure that they are adequate to meet the needs of the increasingly dependent residents. Levels must be adequate to allow the manager to fulfil the full range of her responsibilities. People who use the service must have medicines prescribed on a PRN basis given to them by staff only when clinically justified and this can be demonstrated by record keeping practices. An application for the registration of the manager with the Commission must be submitted. (see Care Standards Act 2000 section 11 (1)) Additional training is necessary to ensure safe practice. Timescale for action 12/11/07 2 OP9 13 (2) 12/11/07 3 OP27 18,11 12/11/07 4 OP27 18 12/11/07 Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 21 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 OP19 Good Practice Recommendations It is considered good practice to use pedal bins for disposing of all waste; thus reducing the potential for the spread of infection. Austhorpe Nursing Home DS0000070202.V352173.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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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