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Inspection on 22/06/06 for Catherine Court Nursing Home

Also see our care home review for Catherine Court Nursing Home for more information

This inspection was carried out on 22nd June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Those residents spoken with, who were able to express a view, said that they enjoyed living in the home and were happy with the care, they were receiving. During the inspection staff were seen to be providing good personal care and all residents appeared appropriately dressed. Relatives spoken with were also very positive about the care and commented that staff are very welcoming especially the manager. Residents receive a varied, wholesome and nutritious diet, ensuring that individual tastes and needs are catered for. The home employs 3 full time activity co-ordinators.

What has improved since the last inspection?

Care plans have been reviewed to ensure that identified needs are fully documented with action plans in place. On going refurbishment. Significant training has taken place for staff.

What the care home could do better:

Continued ongoing redecoration and furniture renewal. Any care plan relating to a specialist medical issue must fully identify that issue with actions required of staff.

CARE HOMES FOR OLDER PEOPLE Catherine Court Nursing Home Cressex Road Booker High Wycombe Bucks HP12 4QF Lead Inspector Mrs Caroline Roberts Unannounced Inspection 22nd June 2006 11:00 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 Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 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.V292813.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Elderly Physically Frail Including Respite Elderly Mentally Impaired 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. 11th October 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.V292813.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the un-announced inspection carried out at Catherine Court on the 22nd June 2006. The majority of all inspections conducted by The Commission for Social Care Inspection will be unannounced. The lead inspector was Mrs Caroline Roberts. The inspection consisted of meeting with residents, staff and visitors, viewing records and documents pertaining to the provision of care and the running of the home. Evidence gained from this has formed the judgements for this report. The inspector toured the building, gaining permission from a number of residents to enter their bedrooms and viewing a further number from the doorway. The inspector met and discussed the inspection findings with the manager prior to leaving. The inspector found staff polite, helpful and welcoming, and would like to thank them for their co-operation and assistance throughout the course of the inspection. The inspector would especially like to thank the residents for their time and for allowing the inspector into their home. What the service does well: What has improved since the last inspection? Care plans have been reviewed to ensure that identified needs are fully documented with action plans in place. On going refurbishment. Significant training has taken place for staff. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 6 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. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All of the assessments evidenced were completed fully and clearly and demonstrated that the home was able to meet the identified needs of the individual prior to admission to the home. Intermediate care is not provided at this service. EVIDENCE: The home has developed a service user guide as part of the welcome pack for new residents. Copies of this are available in the entrance area of the home. This document contains information about the Organisation and details about the home, to enable the resident to make an informed choice about moving into the home. Files belonging to two residents who were most recently admitted contained copies of assessments carried out by the home, prior to admission. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 9 The homes assessment process begins when enquiries are made by logging the basic details and needs of potential residents. The homes senior staff then conducts a broader assessment. The homes own assessment system covers all items specified in standard 3.3 National Minimum Standards. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 10 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 Quality in this outcome area is Good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. There is a clear care planning system in place to adequately provide staff with the information they need to satisfactorily identify and meet resident’s individual needs. There a clear medication policies and procedures for staff to follow to ensure that residents are safeguarded with regards to medication. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. EVIDENCE: Individual plans of care were available for each resident and the records of four residents were examined. The records for these residents were found to be generally detailed and comprehensive and followed on from a full assessment of the residents needs. There was evidence that the care plans are reviewed on a monthly basis and updated to reflect changing needs. The records indicated that residents are seen by other health care professionals such as dentists, chiropodists, GP’s and specialist nurses, for example diabetes nurses. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 11 The specific care plan of one resident suffering from diabetes needed further developing as did not provide adequate information about this particular condition and clear instructions for the homes staff, this was discussed with the manager and a requirement is served. The manager has in place a system for auditing a number of care plans in the home on a random basis, this also takes into account medication usage and specific health related issues. Care plans are well constructed and maintained. Risk assessments are routinely undertaken for all residents around risk of falls, nutritional needs, continence and development of pressure damage. The home has clear medication policies and procedures for staff to follow. Discussions with staff and a review of medication storage and records show that staff are following the policies and procedures. All staff responsible for administering medication undertake appropriate training. The medication administration procedures were found to be satisfactory, no unexplained gaps were noted on the medication administration sheets, medication is stored appropriately with systems in place for the receipt and disposal of medications. Staff talked about and were observed to treat residents’ in a respectful and sensitive manner. They understood the need to respect an individuals dignity through practices such as the way they addressed residents and when entering bedrooms and bathrooms. One resident who has lived at the home for about one year commented, “ I am well cared for”. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Residents interests and previous lifestyle are taken into consideration when developing care packages and contact with family and friends is encouraged. The food is well presented and appeared appetising and nutritious. EVIDENCE: The home employs 3 full time dedicated activities organisers. A structured programme of activites is in place, on the day of the inspection two of the activities organisers had taken out 3 residents for lunch. Meetings are arranged to include the views and wishes of the residents. Church services are aranged via the local church. Routines in the home are arranged around residents needs as much as possible. The home do not have restrictions on visiting hours, except visiting during the night would need to be pre-arranged and under exceptional circumstances. Family and friends can meet in residents own bedrooms or one of the lounges, family can stay for meals with prior arrangement. Residents and families are encouraged to manage their own finances, although the home do offer residents access to the resisdents saving scheme for small Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 13 amounts of personal finance, for which procedures are followed including clear documentation and receipts for all expenditure. Most of the bedrooms in the home show that residents are able to bring items of their own furniture to personalise their rooms. Residents are involved in the care planning process. The home has 1 dining area on each of the 2 groups both of which are pleasently decorated and offer ample room for the residents to ejoy the meal in a congenial setting. Meals can be taken in the residents own bedroom if wished. 3 cooked meals aday are offered with drinks readily made available. Menus are varied and reflective of the season. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 14 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 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home operates a transparent approach towards complaint investigations. POVA policies are available in the home and staff are trained in this area. EVIDENCE: The home has a complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence and the service user guide copies of which, are displayed in the entrance area. The home has received 8 complaints in the period under review, 6 of these were fully substantiated all had evidence of responses and a thorough investigation. The home has a written policy and procedure for dealing with allegations of abuse and whistle blowing. All staff have received POVA training this was evidenced through the training records and individual discussions with staff, which questioned the knowledge of staff around this area. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 15 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 Qulaity in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. 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. 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, this programme of refurbishment is ongoing as many of the bedrooms still need redecorating and new furniture provided the manager is asked to provide a copy of the projected further work to the commission for social care inspection. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 16 The home was found to be clean and fresh with no unpleasant odours detected during the inspection. The kitchens were inspected and all areas and equipment was found to be clean. 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. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 17 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): 27,28,29,30 Qulaity in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Residents benefit from a committed staff team who have the skills and training to meet their needs. Staffing levels are sufficient to meet the personal and nursing needs of the residents. EVIDENCE: Of the 18 relative comment cards received, 13 felt that there are always sufficient numbers of staff on duty, 5 felt that there wee not, one of these stated at weekends and one at night. On the day of the inspection there were 57 residents being accommodated in the home. Typically there are 2 nurses and 6 carers on each group throughout the waking day, assisted by a housekeeper on each group. The full time manager works weekdays. Her hours are not included in the care hours. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 18 Regular meetings are held for care staff and qualified nurses to discuss both clinical practice and care related issues. The information on the duty rota was consistent with the names and delegations of the staff on duty. An examination of the files of three staff employed in the home showed that the home is undertaking all the necessary checks to ensure the protection of residents. There is an in house training programme for carers and nurses. Mandatory training in essential areas such as, manual handling, food hygiene and fire safety is being undertaken at the required intervals. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 19 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. A very experienced and well qualified person manages the home. Residents best interests are safeguarded by the homes record keeping. Monitoring visits are undertaken by the organisation to monitor and report on the quality of the service, copies of these visits are forwarded to the Commission. EVIDENCE: The manager has substantial experience of working at a senior level (for example manager) in a care home setting and has already demonstrated competence in her present role. Residents and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 20 Of the 18 comment cards received five personally mentioned the manager with comments such as: “Significant improvement since Ann Hill became the manager” “Home much friendlier, informative and cheerful, well-done to the new manager” “Since Ann Hill has become the manager the home has improved tremendously, welcoming clean home”. “Great improvement in the home since the new manager, I feel I can talk to her easily if any problems arise”. “In the last few months the nursing home has improved vastly, this is due to the care of Ann Hill the manager. The manager has recently completed her registration process with The Commission for Social Care Inspection. The home hold small amounts of cash for residents, this is appropriately stored with receipts for all transactions. Care UK send out quality assurance questionnaires to all residents/relatives and health care professionals involved with the home, the outcome of this exercise is then fed back to the home, the manager then feeds this back to residents and relatives at quarterly meetings. The manager undertakes monthly environmental audits with records maintained; these include Health and Safety issues and fire procedures. The manager audits random care plans on a monthly basis. There are detailed Health and Safety policies in the home. These serve as a training manual and reference document for staff to use. These cover policy areas such as fire prevention and care of substances Hazardous to Health (COSHH). These policies ensure that the health and safety of the residents and staff are maintained at all times. Records made available for inspection purposes evidenced that regular service agreements are in place to further ensure safety: Lift service on 13.3.06 Fire alarm service including extinguishers 5.12.05 Hoist service 14.1.06 Health and Safety inspectorate visit 21.3.05 Health and safety inspection 9.9.05 Mattress service 30.3.06 Gas safety certificate 2.2.06 PEA 2.11.05 Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 21 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 22 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., Diabetes), are to provide adequate detail to allow the staff to meet this individuals need fully. Timescale for action 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Catherine Court Nursing Home DS0000019188.V292813.R01.S.doc Version 5.1 Page 24 - 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. 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