Inspection on 14/09/05 for Carisbrooke Nursing Home

This inspection was carried out on 14th September 2005.

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

Carisbrooke Nursing Home 07/03/07

Carisbrooke Nursing Home 21/03/06

Carisbrooke Nursing Home 03/03/05

Carisbrooke Nursing Home 05/05/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOMES FOR OLDER PEOPLE Carisbrooke Nursing Home 50 Teignmouth Road Torquay Devon TQ1 4ET Lead Inspector Mandy Norton Announced 14 September 2005 th 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 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. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Carisbrooke Nursing Home Address 50 Teignmouth Road, Torquay, Devon, TQ1 4ET Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 326409 01803 313368 Mrs Betty Delicia Miller Betty Delicia Miller Care Home with nursing 25 Category(ies) of Physical disability (25), Terminally ill (25) registration, with number of places Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The Home is registered as a Care Home with Nursing for a maximum of 25 Service Users in the categories of PD 25, TI 25 Date of last inspection 03.03.05 Brief Description of the Service: Mrs Betty Miller, the proprietor and Matron, established Carisbrooke Nursing Home in 1971. It is located in the Torre area of Torquay, close to local amenities. The home is registered to provide general nursing care within 17 single rooms (14 of which have en-suite facilities), and 3 double rooms. It provides nursing care for long and short- term admissions for physically disabled, palliative care and post- operative care (convalescence).The home is arranged on3 floors with a access via a passenger lift and a small stair lift to 3 double rooms on the top floor. The garden is well kept and accessible to Service Users Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over 3 hours and 50 minutes and was conducted with the Matron. The focus of the inspection was to assess some of the key standards and to review the nearly completed refurbishment to various parts of the home. What the service does well: 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. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 7 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 standard(s) 3 and 6. Comprehensive pre admission assessments are made and therefore people are admitted to the home appropriately. Patients admitted for respite care are encouraged to maintain their independence and return home as soon as they are able. EVIDENCE: The matron said that pre admission assessments are carried out the herself or one of the Sisters to ensure the home can meet the assessed needs of the prospective patient. The home receives a care plan from the care manager for publicly funded patients. All patients are assessed for ‘funded nursing care’ contributions once they are admitted to the home. The home takes some respite patients, often post operatively, and is able to offer a specific room for their stay and the services of a physiotherapist employed by the home. Other specialist services are accessed as necessary as each person is assessed for their individual needs. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 8 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 standard(s) 7, 8,9 and 10. The health care needs of the residents are identified and met. Interactions between staff and residents promotes and protects patients privacy and dignity. EVIDENCE: The care plans examined were all well presented, had been regularly reviewed, contained appropriate risk assessments and sets out in sufficient detail the actions to be taken by staff to ensure the needs of the patients are met. The patients are all registered with a GP and have eye tests and dental checks as necessary. A tour of the home confirmed that equipment necessary for the promotion of tissue viability and prevention or treatment of pressure sores is available throughout the home and is in good condition. The matron has also recently purchased a new hoist. Feedback cards completed by the physiotherapist, complementary therapist and recreational therapist indicate that the matron and staff work as part of a multidisciplinary team in order to meet patients individual needs. There were no patients able to self medicate during the inspection. The procedures for receipt, recording, storage, handling, administration and Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 9 disposal (especially in light of the change to waste management regulations In April 2005) discussed during the inspection are all carried out in accordance with laid down legislation. Service User comment cards completed (5) indicated that patients feel well cared for and safe and have their privacy respected. A tour of the home confirmed that staff treat the patients and visitors with respect and dignity and interact with them appropriately. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 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 standard(s) 12, 13 and 15. The staff show a good understanding of the patients cultural, social and recreational needs and the importance of maintaining contact with family and friends and engage the patients in a variety of ways. The meals in the home are excellent offering both choice and variety and catering for special dietary needs. EVIDENCE: The matron described her efforts to ensure a range of activities are available to suit all patients preferences and abilities. This was confirmed by a tour of the home where some patients were engaged in a craft session (offered twice a week) and the activities programme was displayed on the notice board so all patients and relatives can see what the home offers. A complementary therapist and a recreational therapist provide regular sessions within the home, these are well attended. Outings and trips are arranged on an individual basis. There is a monthly holy communion session held in the home. Visitors were seen coming and going during the inspection and can see their relative/friend either in their own room or in the communal areas as they wish. The patients spend their time as they wish and the homes routines are flexible enough to meet individuals needs. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 11 Menus provided with the pre inspection questionnaire and comments on 4 of the completed ‘Service user comment cards’ indicate that the meals are enjoyed and are nutritious and suited to individuals needs. The cook is well known to the clients and will make sure all requests for meals /food likes are met. Drinks and snacks are available 24 hours a day. The home belongs to the local ‘falls collaborative’, part of any risk assessment carried room has recently been redecorated and has had a new carpet. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 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 standard(s) 16 and 18. The home has a satisfactory complaints system. Clients in the home are protected by staff having a knowledge and understanding of Adult protection issues. EVIDENCE: The complaints procedure is clearly displayed within the home and is in the homes brochure (statement of purpose) All of the completed relatives/visitors and service users comment cards indicated that they had never had to make a complaint but they would know who to approach should they need to. The policies and procedures around protection are clear and available to staff at all times. All staff attend the local PCT adult protection training. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23 and 26. The standard of the environment within the home and the grounds is excellent providing clients with attractive and homely place to live. The overall quality of the furniture and fittings is good providing a safe environment. The home is clean and hygienic. EVIDENCE: The location and layout of the home are suitable for its purpose. The home has been undergoing extensive redecoration and refurbishment recently (this was near to completion on the day of the inspection). Outside has seen renewal of the verandah and repainting of the house. Inside all corridors/hallways have been redecorated and re-carpeted, the dining room has been re-carpeted, decorated, has new curtains and has had the doors widened to make access easier. Sixteen rooms and the office have also been Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 14 re-carpeted and some have had new curtains. There is a polite notice in the home informing patients and relatives about the refurbishment. The communal space includes and lounge (conservatory) in which a variety of activities take place and a dining room. There are areas where patients can meet their visitors in private if they wish to. The outdoor space is well maintained, attractive and accessible to all patients. There are sufficient toilets and bathrooms throughout the home and most rooms benefit from en-suite facilities. A tour of the home confirmed that suitable adaptations are in place such as grab rails and other aids in toilets and bathrooms and individual rooms as necessary. Individual rooms seen during a tour of the home were comfortable, clean and contained many of the patients own possessions. Domestic staff were seen cleaning the home during the inspection and the home presented as clean, hygienic and odour free. The laundry has the appropriate equipment to deal with the laundry the home produces. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30. Clients needs are met by a satisfactory mix of nurses, carers and ancillary staff who are trained and competent to do their job. EVIDENCE: The duty rota provided with the pre inspection questionnaire details the number of staff on duty and during the inspection people looked well cared for. The pre inspection questionnaire indicates that staff turnover is low. All 5 of the completed relatives/visitors comment cards returned prior to the inspection indicated that they feel that there are ‘sufficient staff on duty at all times’, and all 5 of the completed Service users comments cards returned prior to the inspection indicated they felt ‘well cared for’. Domestic, catering and administrative staff are employed to support the care staff in meeting the needs of the patients. Training records examined were up to date and covered a variety of subjects including PEG management, falls collaborative, food hygiene, values in care and safe handling of medicines. Future planned training includes dementia care, tissue viability and swallowing assessments. Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed duirng this inspection. EVIDENCE: Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 4 3 3 3 3 x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 18 NA 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. 1. 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 Good Practice Recommendations Carisbrooke Nursing Home D54-D07 S28649 Carisbrooke V237354 140905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business PPark Ashburton TQ13 7UP 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. 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