Inspection on 11/10/05 for Catherine Court Nursing Home

This inspection was carried out on 11th October 2005.

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

Catherine Court Nursing Home 22/06/06

Catherine Court Nursing Home 27/04/05

Catherine Court Nursing Home 07/12/04

Catherine Court Nursing Home 14/06/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech 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 Catherine Court Nursing Home Cressex Road Booker High Wycombe Bucks HP12 4QF Lead Inspector Mr Guy Horwood Announced Inspection 11th October 2005 09:45 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 Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 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. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Catherine Court Nursing Home Address Cressex Road Booker High Wycombe Bucks HP12 4QF 01494 524850 01494 524914 manager.catherinecourt@careuk.com 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) Community Health Services Limited Care Home 60 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (30) of places Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly Mentally Impaired Including Respite Elderly Physically Frail Including Respite Admission of a specific Service User This variation applies to a specific Service User, who`s admission the home advised the Commission of. This variation will cease when the Service User leaves or is discharged and the home will notify the Commission accordingly. That from the 19th of May 2004 the home`s registration is varied to enable the admission of a 64-year-old Service user. 27th April 2005 4. Date of last inspection Brief Description of the Service: Catherine Court Nursing Home is situated a short distance from the town centre of High Wycombe, in a residential area. The town possesses a variety of shops and local amenities, and provides access to local and national transport networks. The home is owned by Care UK Ltd, and was purpose built for the provision of care. The home provides care with nursing, and can accommodate up to 60 residents, 30 of whom may be provided with care suitable for those with mental health or dementia type illnesses. 52 Service Users can be accommodated in single bedrooms, and 8 in 4 shared rooms. All rooms have en-suite facilities, and a further 4 bathrooms and 4 shower rooms are provided. A qualified nurse is present within the home 24 hours a day, and is supported by a team of carers, housekeeping, catering and maintenance staff. Access to healthcare professionals is through direct contact, or by referral through the Service Users General Practitioner. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the announced inspection carried out at Catherine Court Nursing Care Home on the 11th October 2005, which commenced at 9.45am. The lead inspector was Mr Guy Horwood, who was accompanied by Mrs Caroline Roberts, (Inspector). Upon arrival Mrs Ann Hill, the home’s recently appointed manager, met the inspectors. At the conclusion of the visit the inspector’s discussed the inspection findings with Mrs Hill. At the time of the inspection the home was accommodating 60 residents. The inspection consisted of meeting with resident’s and staff and viewing records and documents pertaining to the provision of care and the running of the home. The inspector’s toured the building and viewed resident’s bedrooms and communal areas. Prior to the inspection comment cards were issued to residents, their representatives and external healthcare staff connected to the home. Comment cards were returned to the Commission at the time of the inspection and following the visit. Returned cards consisted of 2 from General Practitioner’s, 16 by residents and 18 by residents relatives and friends. • Of the 16 residents comment cards received, no written comments were made, but from “tick box” responses: - All said that they felt safe at the home. - 15 said they felt well cared for, (1 said sometimes). - 14 said staff treated them well, (2 said sometimes). - 14 said their privacy was respected, 1 said it wasn’t and 1 said sometimes. - 10 said they liked the food, 5 said sometimes and 1 said they didn’t. - 13 said the home provided suitable activities, 1 said it didn’t, 1 said sometimes and 1 didn’t answer. Of the 18 Relatives/Visitors comment cards, from “tick box” responses: - 15 stated that they were “Satisfied with the overall care provided”, although 2 were not. - 17 felt able to visit a relative in private, although 1 commented that other residents entering their relative’s bedroom often interrupted them. - 16 said that the staff kept them informed of important matters affecting their relative, 1 said that staff did not communicate effectively, and 1 said staff were inconsistent in contacting them. - 12 (67 ) felt that staffing levels were not always sufficient. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 6 • - 7 had had to make a complaint to the home. These included issues of missing personal items, poorly laundered clothing, unpleasant odours in rooms and corridors, and the poor condition of carpets within bedrooms. Several comments were received from relatives pertaining to the new manager, Mrs Ann Hill. These include: - “Since the new Home Manager Ann Hill has taken over, things have improved considerably due to her own high standards…and by listening to ideas and complaints…”; - “I can see an improvement in the EMI wing since the new manager took over.”; - “The new manager is making a big difference – all to the good!” These sentiments were echoed through conversations with residents, relatives and staff spoken with during the inspection, and the manager is to be commended in this. A number of further written comments were received from relatives, and these have been used to compile the body of this report within the relevant sections. • General Practitioners commented that “Standards have risen back up to the previous high with the introduction of new management” and “Generally caring – patient centred approach”, but also stated that the dementia care unit was “sometimes a bit smelly”, that communication with some care staff, “(not nursing)”, was difficult due to English being a second language, and that in one instance the advice as to a wound dressing was not followed by care staff. The inspector’s found staff polite and co-operative, and would like to thank them for their assistance throughout the course of the inspection. The inspector would especially like to thank the resident’s for their time, and for allowing the inspectors into their home. What the service does well: Provides information for potential residents to make an informed decision as to whether they wish to live at the home. Residents appeared cared for by a caring staff team. Residents feel safe at the home, and the majority said they are always treated well. The home provides a varied activities programme. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 7 The manager acts promptly and fairly to deal with accusations of poor staff conduct in order to safeguard residents welfare. The manager encourages comments from residents, their relatives and visitors and staff aimed at improving the service. The home is managed in an open and transparent manner promoting the involvement of residents, relatives, visitors and staff. Staff receive training suited to their role and in order to improve their skills and knowledge. What has improved since the last inspection? What they could do better: The healthcare needs of residents with diabetes could be better provided for, as could their healthcare records and medication charts. Continue to improve the environment with the on-going programme of repair, decoration and replacement. This must be followed by a structured programme of on-going maintenance in order to prevent the home returning to a state of disrepair and neglect. Improve staffing levels through the recruitment and retention of suitably qualified and experienced staff. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 8 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. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 9 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 Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 10 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): 1,3. Potential residents and their representatives can be provided with information as to the services provided at the home. This provides an informed choice as to whether this home is suited to the individuals needs. The pre-admission assessment process appears satisfactory. This allows the home to make an informed decision as to whether they can meet a residents needs, and as a consequence, residents appear to be placed appropriately. EVIDENCE: The homes recently updated Statement of Purpose and Service Users Guide were viewed and appeared satisfactory. These are provided to residents in the form of a “welcome pack”, which also holds the organisations fire and complaints procedures. These documents have been updated recently. A recent pre-admission assessment was viewed. This assessment held good details as to the potential resident, enabled the home to make an informed decision as to whether they should admit the person. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. A significant improvement has been made in the detail, maintenance and review of the residents care plans, therefore staff are provided with up to date details as to how residents needs are to be met. However, the manager and staff team need to ensure consistency in the level of detail held within the care plans throughout the home. Staff appear competent in the moving and handling of residents therefore ensuring the health and safety of staff and residents. Residents at risk of developing pressure ulcers are identified and provided with appropriate equipment in order to avoid deterioration of their skin integrity. The healthcare needs of diabetic residents are not managed adequately thus placing these residents at risk of ill health due to poor care in relation to their diabetes. Medication records are not adequately maintained, and medication administration is not always as prescribed, thus residents are placed at risk of receiving incorrect medication dosage. Staff appear to provide care with respect and regards to the individuals right to privacy, thus maintaining the resident’s dignity. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 12 EVIDENCE: The care plan for a recent admission was viewed. This care plan held a good amount of detail, included up to date tissue viability, nutritional and moving and handling assessments and outlined the care to be provided to meet the residents needs in a user friendly, relevant and comprehensive manner. Other care plans viewed held a similar level of information, including details as to social needs. All were up to date, well maintained and subject to a process of regular review. Pressure relief cushions were noted on some chairs, and airflow mattresses on beds. Up to date and reviewed tissue viability assessments were found in care plans, which included details as to the settings of pressure relief mattresses. A variety of recently purchased recliner and fixed armchairs of different sizes were noted. Staff were witnessed transferring a resident with a hoist in a communal area. This was done with care and competency, and staff took into account the residents dignity during the procedure. Care plans held details as to what equipment was to be used for individual residents, i.e., hoist type, sling size, as well as the number of staff required. Although a well completed and detailed care plan pertaining to catheter care was noted in one of the files viewed, the level of detail in this care plan was not consistent in other catheter care plans, with some considered unsatisfactory. Care plans held details as to visits by General Practitioner’s, specialist nurses and when specimens had been obtained and/or sent. Medication policies were viewed and found to be satisfactory. These had been reviewed recently and amended where necessary by the manager. Medication was stored securely and appropriately. Medication from the pharmacy is checked and recorded upon receipt. The medication charts and care records for 2 diabetic residents were viewed. These care records showed that instructions as to the monitoring of blood sugar levels were poor and / or were not being followed consistently by staff. In some instances, where blood sugars had been measured and recorded as higher than normal, there was no indication that staff had taken any action to monitor or address this issue of raised blood sugar – in some instances no repeat test was carried out until the next day. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 13 It was concerning to note that in one instance a resident was found to have a raised blood sugar (19.5), was described as drowsy in the corresponding care notes, had not eaten lunch, and was supposed to be “monitored frequently”. No record of the resident being monitored effectively was evident, and it appeared that insulin was then omitted, with no evidence that this was at the direction of a doctor or other healthcare professionals advice. An instance where staff had written instructions for the administration of insulin on the Medication Administration Record (MAR) was questioned, in that it stated that the insulin should be given “as directed” with no direction as to the dose. No evidence was available to confirm the current prescribed dose, and that it was as per the original prescribing doctors instructions, (e.g., copy of original prescription). On this same chart it was concerning to note an instance where the evening dose of insulin had not been administered as the home had run out of insulin. A nurse was witnessed administering medication to residents. This was done in an unhurried and careful manner, with the nurse organised for the task. A complaint was voiced by one resident that an agency staff member had recently failed to administer her regular medications. A medication chart listed details of a morphine-based medicine to be administered to a resident accommodated for 2 weeks respite. Instructions were insufficiently detailed and had been entered by a member of staff – again no evidence of the original prescription could be provided and no General Practitioner signature was present. Directions as to the medication for respite care residents was hand written in MAR charts, in several instances provided insufficient detail, and was unable to be evidenced as correct thorough the production of the original prescription (or copy of). Residents appeared comfortable and well cared for, and to be dressed in coordinated clothing appropriate for the temperature. Unlike at previous inspections, no residents were noted to be mobilising in a state of undress. Staff were witnessed interacting with residents in a caring, kind and respectful manner. One resident was overheard commenting that a staff member was “lovely” as she had warmed up the shower room before taking the resident in from her bedroom for her shower. Staff were witnessed to knock at doors prior to entering rooms, covered residents appropriately where transferring them from bathrooms to bedroom, and spoke in a pleasant and polite manner in the majority of cases. From the comment cards received from 16 residents, 14 felt their privacy and dignity was respected, one felt that this was not the case, and one that it was only respected “sometimes”. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 14 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. Residents are provided with suitable and varied activities, which provides stimulation and enjoyment. The home enables open visiting, which enables Residents to maintain contact with family and friends as they wish. In most instances residents are able to meet in private, although on the EMI unit there may be occasions where other residents interrupt private meetings. EVIDENCE: The home employs 2 activities organisers, who maintain files on residents as to their social history, any hobbies and interests, and a diary of any activities undertaken within the home. These records were very detailed, provided good information, were up to date and suggest a variety of activities are provided on both an individual and group basis. The activities organisers are to be commended on their work to maintain the activity records. A number of residents comment cards were returned to the Commission. 14 of these stated that the home provided suitable activities, 1 said it didn’t and 1 said sometimes they did. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 15 At the time of the visit one of the activities organisers was seen to be working with 2 residents on the EMI unit. The 2 residents appeared to be enjoying the activity, and interaction appeared friendly, relaxed and caring. From the 18 relatives comment cards received, 17 felt that they could meet with their relative in private. However, 1 said that this was not the case on the EMI unit as other residents frequently wandered in to the bedroom where they were visiting their relative. Relatives and residents confirmed that the home operates an open visiting policy. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 16 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): 16,18. The home has a satisfactory and visible means of raising concerns and complaints, and relatives feel that where they voice their concerns, that they are listened to by the homes manager. From relative’s comments, however, it would appear that staff have become complacent as to some causes of complaint – e.g., missing clothes / property. The home has comprehensive policies and procedures for the reporting of allegations of abuse, staff receive training in identifying and reporting abuse, and the manager is competent in following procedures to report allegations of abuse. The manager acts promptly and fairly to deal with accusations of abuse in order to ensure the safety of residents. EVIDENCE: Relatives meetings are held at the home, and comments received from relatives suggest that this presents the opportunity to raise concerns / complaints with the manager directly. Comments in relatives responses to the Commission also suggests that relatives feel the manager listens to their grievances where raised. Of the 18 relatives comment cards returned to the Commission, 7 said they had had to make a complaint to the home. Topics of complaint included poorly laundered personal clothing, the loss of personal property, the poor condition of carpets in some areas and unpleasant odours in some rooms and corridors. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 17 Where personal items have gone missing at the home it has been commented “this seems to be accepted by staff, so little is done”. The home has comprehensive policies for the identification and reporting of abuse. It is recommended that the above policies include the contact details of local adult protection teams and CSCI. The manager has been prompt and appropriate in dealing with recent allegations as to unsatisfactory staff conduct, and has followed the homes and local adult protection protocols in order to ensure the safety of residents. The manager has been prompt in contacting external agencies to report incidents affecting the safety of residents. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 18 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. The home is undergoing a period of extensive redecoration and refurbishment to improve the quality of the environment. It is anticipated that this will provide a pleasant and homely place to live in. The home has policies in place pertaining to issues of hygiene, and has been proactive in implementing measures to prevent issues of cross infection. However, visitors to the home have commented that unpleasant odours are frequently present within the home, which detracts from the pleasant and homely environment sought by the manager. EVIDENCE: It was evident that an extensive programme of repair and refurbishment has been taking place, with new carpets, furnishings and decoration noted in various areas throughout the home. It was pleasing to note that both kitchenette areas have finally been refurbished. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 19 Infection control measures were noted to include the provision of individual bottles of alcohol hand wash for staff members, and in reception for visitors. It was also noted that individual slings are provided for residents requiring hoisting. Relatives comment cards stated that unpleasant odours are frequently noted in rooms and corridors. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30. Insufficient numbers of permanent staff are available, therefore residents needs are not always met. The use of agency care staff detracts from the level of care provided by permanent staff. Staff are provided with a training programme in order that they can meet residents needs. EVIDENCE: Of the 18 relatives comment cards returned to the commission, 12 (67 ) were of the opinion that not enough permanent staff were employed at the home, references were made to problems with agency staff members, and comments were passed specifically to the poor staffing levels at weekends. One visitor commented that agency staff were problematic, and the same person commented that they had no concerns as to the care afforded by permanent staff members. Other indicators as to insufficient numbers of staff included: - Insufficient numbers of staff present to assist residents on a one-to-one basis with meals at lunchtime. - Residents were still being assisted to get up, washed and dressed shortly before lunch, (this was not through the residents choice). Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 21 - Residents mobilising throughout the EMI unit, wandering into other residents bedrooms, removing personal property and disturbing visitors meeting in private with their relatives. The inspectors received unsatisfactory reports from relatives as to the communication and management skills of a senior nurse within the home, and these concerns were confirmed through the inspectors dealings with the specified staff member. This issue was discussed with the manager who had received other comments as to this staff members ability. The home has continued to attempt to recruit staff for various posts within the home, but is finding this a lengthy process. At the time of writing this report a number of new care staff are reported to have commenced in post at the home. Where new staff are recruited an induction process is provided and mandatory training undertaken. Staff commented that due to the frailty of some residents and the high dependency levels within the home, the workload was heavy. The home currently has 12 staff undertaking their NVQ Level 3. A programme of staff training is on going within the home, with the manager responsible for identifying topics and subsequently arranging training dates. Through relevant training and supervision, staff appear more aware of residents with dementias care needs. Recent staff training has included fire safety training, and evidence was seen of future training dates with a diabetic specialist nurse and dietician. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 22 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): 31,32,38. The manager is suitably qualified and experienced to manage the home and direct staff as to how resident’s needs are to be met. The management of the home appears to promote resident focused care through the involvement of the staff team, residents and their relatives. This has improved staff morale, which in turn leads to resident’s health, personal and social needs being better catered for, and presents an open and transparent service. EVIDENCE: The manager, Mrs Ann Hill, has been in post as the manager of Catherine Court since April 2005, and is currently going through the fit person process as required under the Care Standards Act 2000. Prior to being the manager of Catherine Court, Mrs Hill was the registered manager for a similar size and category of care home for Care UK Ltd, but Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 23 within a different Commission for Social Care Inspection area. Inspectors from the relevant region have been consulted with, and inspection reports from the managers previous home have been viewed in line with the registration of Mrs Hill, and this information suggests that the manager is suitably experienced, qualified and competent to manage Catherine Court. In support of this, a number of positive comments, including as to her character and management ability, were received with regards to Mrs Hill from residents, their relatives, external healthcare professionals and the homes staff team. A number of staff members were spoken with during the visit. It was pleasing to be informed that staff morale had improved significantly since the arrival of the new manager, that staff found Mrs Hill approachable and supportive, and that staff felt that “things (are) much better” at the home. Comment cards received by the Commission from residents relatives state that relatives meetings are held with the home’s manager, and provide the opportunity for relatives to raise concerns / complaints. During a tour of the premises a rear secure fire door was noted as having been left open, thus presenting a security risk. This was brought to the attention of the manager who discussed the issue with the person responsible. The homes fire safety and maintenance records, including policies and procedures, are satisfactory, and have recently been reviewed by the homes manager. All staff have undergone fire safety training this year. The home has emergency policies and procedures to address the failure of the homes lifts, phones, lighting, and laundry. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 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 2 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X X X X 2 Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 25 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 OP7 Regulation 15 Requirement Care plans addressing specific healthcare needs, (e.g., supra pubic catheter care), are to be consistent in their level of detail throughout the home. Diabetic residents healthcare needs are to be identified, recorded and met. The manager is to ensure that staff adhere to the home policies and relevant guidelines as set out by professional bodies to ensure the safe handling, recording and administration of medicines within the home. Where staff enter hand written instructions as to the administration of medicines in a MAR sheet, a copy of the original prescription must be held with the MAR sheet as evidence of the transcribed instructions. As part of the pre-admission procedures for respite residents, the home is to obtain a copy of the person’s medicines prescription prior to their admission. A copy of this should be held with the residents MAR DS0000019188.V272264.R01.S.doc Timescale for action 01/03/06 2 3 OP8 OP9 12(1) 13(2) 01/02/06 01/02/06 4 OP9 13(2) 01/02/06 5 OP9 13(2) 01/02/06 Catherine Court Nursing Home Version 5.0 Page 26 6 OP27OP10 18(1) 7 OP27OP10 18(1) 8 OP16 22 9 OP26 23(2) sheet during their stay at the home. Sufficient numbers of staff are to be on duty to assist residents with meals in an unhurried and sensitive manner. Sufficient numbers of staff are to be on duty to monitor resident movements on the EMI Unit in order to ensure the privacy of residents in their own rooms and to prevent the removal of other residents property. The manager must ensure that complaints are dealt with promptly. Staff are to be made aware of the subject of complaints where appropriate, and of their role in addressing complaints. The home is to be free from unpleasant odours. 01/02/06 01/02/06 01/03/06 01/02/06 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 2 Refer to Standard OP9 OP18 Good Practice Recommendations It is strongly recommended that Oromorph is stored and handled as a controlled medicine within the home. It is recommended that the homes vulnerable adult protection policies include the contact details of local adult protection teams and CSCI. Catherine Court Nursing Home DS0000019188.V272264.R01.S.doc Version 5.0 Page 27 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. 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