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Inspection on 07/04/05 for Carr Green Nursing Home

Also see our care home review for Carr Green Nursing Home for more information

This inspection was carried out on 7th April 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a group of staff who have worked at the home for a long time. Staff enjoy working at the home and have a good relationship with residents. Residents said that staff were kind and caring and that the food was alright.

What has improved since the last inspection?

The home now has a fax machine (staff have purchased this from their own fundraising activities). This has been a requirement for 3 years. The registered manager is making improvements that are within her control and do not require any money.

What the care home could do better:

The home needs a lot of redecoration and general refurbishment to bring it up to a good standard. The manager depends on the company who own the home to look after all the repairs, redecoration and to generally keep the building in good order. Often there is a slow response to her requests and sometimes no response. The owners need to make a significant improvements at the home to make it a safe and comfortable place to live. Staff must be recruited properly, so that residents are cared for by suitable people.

CARE HOMES FOR OLDER PEOPLE Carr Green Nursing Home Carr Green Lane Rastrick Brighouse HD6 3LT Lead Inspector Paula McCloy Unannounced 7 April 2005 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. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Carr Green Nursing Home Address Carr Green Lane Rastrick Brighouse HD6 3LT 01484 710626 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) Flowertouch Limited Mrs Sandra Speight Care home with nursing 31 Category(ies) of 31 x Old age - over 65 years registration, with number 3 x Dementia - over 65 years of places 2 x Terminally ill - over 65 years Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Can provide accommodation and care for seven named service users - category DE(E) Date of last inspection 17 November 2004 Brief Description of the Service: Carr Green provides both personal and nusing care for 31 older people in what once was a school. The home is located in Rastrick close to local amenities. There is a small garden area and car parking is available. All of the residents accommodation is on one level. There are single and double bedrooms available. None of bedrooms have ensuite toilet s. There is one large lounge and a dining room. There are four bathrooms and six seperate toilets. the kitchen and laundry are in the basement. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 71/2 hours and concentrated on the environment and staffing A full tour of the premises took place and staff records were inspected. Four of staff on duty during the day and five of the 21 residents were spoken to. Not all of the requirements and recommendations made in the last report were followed up at this inspection. These will be checked on future visits. What the service does well: What has improved since the last inspection? What they could do better: The home needs a lot of redecoration and general refurbishment to bring it up to a good standard. The manager depends on the company who own the home to look after all the repairs, redecoration and to generally keep the building in good order. Often there is a slow response to her requests and sometimes no response. The owners need to make a significant improvements at the home to make it a safe and comfortable place to live. Staff must be recruited properly, so that residents are cared for by suitable people. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 6 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. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 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 standard(s) Not inspected. EVIDENCE: Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 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 standard(s) Not inspected. EVIDENCE: Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.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) Not inspected. EVIDENCE: Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 11 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) Not inspected. EVIDENCE: Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 12 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) The home is not well maintained and is not providing the people living there with safe, comfortable surroundings. EVIDENCE: There is no redecoration or refurbishment plan for the home. There are a number of areas that require attention, in particular: The fire officers’ recommendations have not been met. Five dining room tables are very ‘wobbly’ and need repair or replacement. The lounge carpet needs replacing, staff have identified this as being a potential hazard to residents. The hot water to one of the baths has been turned off. Bathrooms and toilets need to have suitable locks fitted. Hot water temperatures have not been risk assessed, are not regulated and the water leaving the taps in some bedrooms and bathrooms is too hot to keep your hand under. Two bedrooms and one of the staff toilets do not have any water coming out of the hot tap. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 13 Only one of the four bathrooms is used. There is another bath that has a hoist, which needs to be brought back into use. Bedroom doors are being wedged open. The radiator covers that are in place have been fixed to the wall. This means that residents are unable to have any control over the temperature of their bedroom. The radiator covers also need painting. Because the radiators are fixed, dirt and dust has accumulated behind them. These areas need a thorough clean. Some emergency call pull cords have bandages attached to them so that residents can reach them. This is unsightly and potentially unsafe. These pull cords need to be replaced. Some toilets and bathrooms need mirrors. One of the bedroom carpets is in urgent need of replacement. The bed linen is in a very poor condition. Bed sheets are thin, the foam backing on bedspreads has disintegrated and draw sheets in holes. The carpet in the main entrance has ‘rippled’ and is a trip hazard. Windows in bedrooms are not opening and/or closing properly. The floor in one of the staff toilets is very ‘spongy’ and unsafe. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 14 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) 27,28,29 & 30 The procedures for recruiting staff are not thorough and residents are at risk from being cared for by unsuitable people. There are a core group of staff who have worked at the home for a long time. EVIDENCE: The staff files for all of the staff working at the home indicated that out of a total of 42 staff, 9 staff had not had Criminal Records Bureau checks carried out. It was noted that two written references were not being taken up consistently. One member of staff only had one reference that had been taken by telephone and a reference had been taken up from the care home that they had worked in before. For another member of staff neither reference had been taken up from the cares homes they had worked in before. Requirements have been made regarding the recruitment procedures at the home since 2002. Because of the continued failure to comply enforcement action by the Commission for Social Care Inspection will now be taken. There were plenty of staff on duty and they attended to residents requests for help quickly. Residents spoken to said staff were kind and caring. The manager is looking at the training each staff member needs. All staff need moving and handling training and this needs to be arranged quickly. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 15 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) 31 & 38 The manager is identifying problems at the home. The owners of the home are not resolving these problems and are leaving residents at risk. EVIDENCE: The Registered Manager is an experienced general nurse, who is in the process of completing her NVQ 4 in management. There is a communication problem between the staff at the home and the company that own Carr Green. Staff at the home are identifying equipment that they require, areas of the home that need general refurbishment or improvement. However, there is often no response to these requests. Staff have recently bought a fax machine from their own fundraising activity, as the company have failed to supply this essential piece of equipment. One staff member said they felt embarrassed when they show people around because of the state of the building. There were a number of health and safety issues identified that must be addressed: Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 16 Staff need moving and handling training. The fire alarms must be tested on a weekly basis. The last electrical installation inspection was completed in October 2003, there is no evidence that the recommendations made have been completed. The last page of the Landlords gas safety report was missing, therefore it was not possible to establish if recommendations were made. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 1 1 1 1 3 1 1 1 STAFFING Standard No Score 27 3 28 2 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 1 x x x x x x 1 Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 18 Yes 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 19 Regulation 23 Requirement The improvements to fire precautions in the home must be improved in line with the fire officers recommendations. A site visit has been arranged with the fire officer on 28.4.05 when timescales will be agreed. The ‘wobbly’ dining room tables must be repaired or replaced. The lounge carpet must be replaced. The assisted bathroom identified must be brought back into use, and the hot water supply to this bath reconnected. Bathrooms and toilets must have suitable locks fitted to ensure residents privacy. The emergency call bells must be accessible to residents. Cords of an appropriate length must be installed New bed linen and towels must be provided. When residents wish to have their bedrooms doors open suitable automatic self-closing devices should be installed, following discussions with the fire officer. Lockable space must be provided J52J01_s1046_Carr Green_v220293_070405.doc 2. 3. 4. 20 20 21 16 16 23 Timescale for action 28 April 2005 meeting with fire officer and agree action plan 14 May 2005 31 May 2005 31 May 2005 31 May 2005 7 May 2005 7 May 2005 31 May 2005 5. 6. 21 22 12 16 7. 8. 24 24 16 13 9. 24 16 31 August Page 19 Carr Green Nursing Home Version 1.40 for residents in their bedrooms. 10. 24 16 The carpet, or part of the carpet, in the identified bedroom must be replaced with a suitable, safe floorcovering. Suitable doorlocks must be fitted on bedroom doors. These must meet the requirements of the fire service. Windows in residents bedrooms must be maintained to ensure that they open and close effectively. The radiator controls must be accessible so that the temperature of individual rooms can be varied to suit the resident. The hot water temperatures must be regulated so that hot water is delivered at 43 deg C 2005 14 May 2005 30 September 2005 7 May 2005 31 August 2005 11. 24 12 12. 25 23 13. 25 23 14. 25 13 15. 16. 25 26 13 16 17. 29 19 18. 30 18 All of the bedrooms, bathrooms and toilets must have a hot water supply. Radiator covers must be removed at regular intervals and the area behind them thorougly cleaned All new staff must have all of the necessary checks completed before they start work at the home. At the very least two written references must be obtained, one of which must be from the last employer and the protection of vulnerable adult liist checked to ensure the peson is suitable to work with very vulnerable people. Following the appraisals of staff that are currently being undertaken a training plan for J52J01_s1046_Carr Green_v220293_070405.doc 31 May 2005 (bathrooms ) and 30 June 2005 for wash hand basins 7 May 2005 21 May 2005 An enforceme nt notice will be served in respect of this requiremen t 31 May 2005 Carr Green Nursing Home Version 1.40 Page 20 19. 31 12 20. 21. 22. 23. 38 38 38 38 13 13 23 13 24. 38 13 2005/06 must be developed and staffs identified training needs met. The company must respond to the manager’s requests for equipment, replacement items etc. with appropriate timescales being agreed The carpet in the main entrace must be re fitted so it lays flat. The floor in the staff toilet must be repaired. The fire alarms must be tested on a weekly basis, and a record of these tests maintained. The following test certificates must be available: Landlords Gas Safety certificate Small electrical appliance test certificate Electrical Wiring Certificate Copies of these certificates must be sent to the Commission for Social Care inspection together with details of works that have been completed to meet any recommendations made All staff must receive moving and handling training. 7 May 2005 and thereafter. 7 May 2005 14 May 2005 7 April 2005 and thereafter 14 May 2005 7 June 2005 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. 2. Refer to Standard 25 21 Good Practice Recommendations The radiator guards should be painted. Mirrors should be available in all of the bathrooms and toilets. Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Carr Green Nursing Home J52J01_s1046_Carr Green_v220293_070405.doc Version 1.40 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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