Inspection on 13/12/05 for Catherine House General Nursing Home

This inspection was carried out on 13th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Catherine House General Nursing... 30/07/07

Catherine House General Nursing... 02/11/06

Catherine House General Nursing... 21/06/05

Catherine House General Nursing... 18/01/05

Catherine House General Nursing... 05/05/04

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

CARE HOMES FOR OLDER PEOPLE Catherine House General Nursing Home Cork Street Frome Somerset BA11 1BR Lead Inspector Justine Button Unannounced Inspection 13th December 2005 09:30 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 House General Nursing Home DS0000003248.V273242.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 House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Catherine House General Nursing Home Address Cork Street Frome Somerset BA11 1BR 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) 01373 451455 01373 455177 catherinehouse@schealthcare.co.uk Southern Cross Healthcare Services Limited Mrs Ann Rhoda Mary Dawes Care Home 67 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (43) of places Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A named RMN shall be employed to manage the dementia care floor. The first floor shall accommodate exclusively people with dementia care needs. The top floor shall provide accommodation for eleven service users with personal care needs, up to five of whom may have nursing needs. No ground floor bedroom shall be used for service users whilst any of them are being used to accommodate nurses working for the company. There will be no less than two trained nurses covering the second and third floors throughout the day and evening shifts and further nurse on the dementia care floor. There will be no less than two trained nurses on the night shifts, one on the dementia care floor and one on floors two/three. 21st June 2005 Date of last inspection Brief Description of the Service: Catherine House is a purpose built service located in the centre of the town of Frome. The service supports three groups of service users; those needing personal care, general nursing and those with dementia care nursing needs. Those people with dementia care needs are accommodated on a separate unit. All rooms are single occupancy with en-suite facilities. Each floor has it’s own communal space including sitting, dining and adapted bathrooms. In addition to this there is a large room on the ground floor which is used for social events, meetings and staff training. The reception and office are also found on this floor. The service provides in house laundry. The lower floor of the service is currently used as staff accommodation. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out as part of the annual inspection programme for the home. This inspection was conducted by two inspectors between 09:30 and 16:00 hrs. The inspectors’ aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff. Service users and relatives spoken to all gave excellent testimony about the care and support they received. People spoken to confirmed that staff are kind and respectful and inspectors observed staff interacting in a kindly manner with all service users. The manager Mrs Ann Dawes was available on the day of inspection. The inspectors concluded that the home is providing a good service for older people. Lunch was observed and looked plentiful and appetising having been freshly prepared by the cook. A tour of the premises was made, care in the home observed and a range of records was inspected, including care records. The home is generally well maintained. What the service does well: What has improved since the last inspection? Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 6 Since the last inspection some of the dining room flooring has been replaced. This has improved this area and as the flooring is laminate is easily cleaned. 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 House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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 House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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, 2, 3, 4 & 5. People who move into the home receive adequate information and have contact with the service to discuss their needs prior to admission. EVIDENCE: The home has both a service user guide and a statement of purpose. These were seen on the day of inspection and contained all the necessary information. Discussion took place with a person who had recently moved into the home. This person confirmed that they had received information about the home prior to moving in. They confirmed that they found this information useful and it was used to reduce their anxiety. They also confirmed that they had been able to visit the home prior to moving in and that an assessment of the individuals needs had been completed. A copy of the homes “terms and conditions of residence” was seen at the inspection. These are issued to those people who are able to pay privately for their fees or for those people who “top up” the fees paid by Social Services. People whose fees are paid by Social Services in full do not receive a copy of Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 9 terms and conditions from the home. There is a contract between the home and the Social Services, which are paying the fees. Following recent guidance from the Office of Fair Trading it is advised that people who fall in to this category are made aware of the services to be provided by the home and that they receive a clear and transparent contract. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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 & 10. All people who live at the service have a plan of care. These plans detail the care to be given. All health needs are met. The privacy and dignity of people who live at the service is maintained. EVIDENCE: A sample of seven service user plans was inspected. These showed an adequate range of care plan pages, which were written briefly, but gave clear information for staff to follow. Service users questioned were not all aware of their service user plans. People who live at the home or their representatives should be involved in the development and review of their plan. This would ensure that care and support is delivered in the manner in which the person would like. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 11 The home conducts written risk assessments to protect individual abilities and needs of service users. The service user plans confirmed that health professionals visited the home on a regular basis including GP, podiatry and optical care. It could not be confirmed if people had access to a dentist. A good range of assessment tools with regard to pressure risk, moving and handling and ‘slip, trip or fall’ and nutritional risk are used. At least one incident was observed during the inspection with regard to moving and handling. This incident did not conform to good practise guidelines. This incident was discussed with home manager at the end of the inspection. Consideration should be given to use of handling belts for some people. The moving and handling assessment will help to identify these people. On the day of inspection the people who reside on the upper floor did not have water jugs. Adequate fluid intake is important for those who are elderly and frail. Staff need to ensure that fluid intake is maintained at all times. People spoken to stated that staff were very kind and that they always “knocked on your door before coming in”. During the inspection, the inspector observed staff interacting with service users in a professional, kindly and respectful manner. Staff are friendly, but professional in their approach. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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. There are some activities on offer although this area needs to continue to be developed. People living at the service are able to meet and welcome visitors. Meals are varied and nutritious EVIDENCE: Activity provision has improved recently. The documentation with regard to the activities undertaken was viewed on the day of inspection. Activities on offer included bingo, flexercise, flower arranging, art & craft activities. Outside entertainers often visit the home. From the documentation seen it appeared that the same people attended the majority of activities. Staff need to ensure therefore that the range of activities is increased (including those seen for 1 to 1 time) to include those who are less able. Limited activities were seen on the dementia care floor. A number of people at the home stated that they would like to see the choice and range of activities increased. Visitors were seen and all said that they felt welcomed. Excellent testimony from relatives was received on the day of inspection. Comments included “ Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 13 Mum is so well looked after”, “this is the happiest my sister has been in ten years. I do not have to worry about anything”. Lunch was observed during the inspection. People who live at the service stated that the meals were of good quality and enjoyable. A choice of menu is routinely offered. Hot drinks are served between meals with biscuits and or cakes. On the day of the inspection a number of people had a choc ice mid afternoon. These appeared to be enjoyed by those who had them. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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. The home has a complaints procedure which is made available to service users. People living at the service are protected from abuse with the homes policies and procedures and practice. EVIDENCE: The home has adult protection and Whistle blowing policies. The home has a complaints policy and procedure. A copy of the complaints procedure is available in the entrance hall. All complaints are investigated and a record is kept. All people spoken to during the inspection stated that they would be happy to raise any concerns they had with the home manager. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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, 20, 21, 22, 23, 24, 25 & 26. The service is well maintained. The environment is clean, tidy and odour free in most areas. The service is appropriate for it’s purpose with the majority of specialist equipment available. All of rooms are single occupancy. There are adequate bathing and toilet facilities. EVIDENCE: A tour of the building was conducted. The majority of areas were clean, tidy and smelt fresh. The bedrooms are for single occupancy all having en-suite facilities. People spoken to during the inspection stated that they were happy with their rooms and that they were able to bring in personal possessions if they wished. Specialist equipment is available with the exception of adjustable beds. This may compromise the flexibility for the service user and the safety for staff in terms of moving & handling practices. Following requirements from previous inspection an action plan was developed to replace the existing beds with Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 16 those, which are more suitable. This agreement has not been adhered to. Southern Cross intended to replace the beds at a frequency of one per month. Given the number of service users accommodated at Catherine house this will take a period of approximately four years. It is recommended that the frequency that the beds are purchased be reviewed. There are adequate numbers of bathrooms all of which are adapted for the needs of the people who live at the service. There is are lounge/dining area on each floor and also a large room on the ground floor which is used for social events, meetings and staff training. These rooms are appropriately furnished and decorated. They were well lit. People who live at the service are able to bring in small pieces of their own furniture. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 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. The service provides staff who are suitably trained and in adequate numbers. The recruitment practises protect the people who live at the service. EVIDENCE: The staffing rotas were viewed on the day of inspection. The occupancy within the home is currently reduced due to the building work. The rotas demonstrated that there are adequate staff on duty. People spoken to during the inspection stated that there were enough staff on duty and that they did not have to wait if they required assistance. The staff training records were viewed these demonstrated that the staff had received mandatory training. Staff spoken to during the inspection stated that they felt that they had received enough training to fulfil their roles. A number spoken to had undertaken NVQ qualifications. Staff recruitment files were viewed these demonstrated that the home’s recruitment procedures were in line with good practise guidelines and included CRB and POVA checks. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 18 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, 32, 34, 35, 36, 37 & 38. This home generally has good occupancy rates. Service users speak well of the care and service they receive. Records are well managed and are stored securely. The home is well managed. EVIDENCE: Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 19 The registered manager has been in post for a number of years. She is therefore well experienced and professionally competent to run the home. She has kept her professional development updated. All feedback from service users, staff and a visiting professional was that there is an open management approach in the home. All those who were asked said that they could approach either the manager or the deputy with any concerns. The manager was observed to demonstrate a clear sense of leadership by their interactions with staff. There are regular staff meetings and further impromptu meetings when necessary to discuss issues of concern. There are also regular service user/ relatives meetings. All meetings are minuted. Staff stated that they receive regular supervision. There is a calm and professional approach to management in the home, helping to give a sense of security and comfort for service users and staff. Small amounts of money are kept for safe-keeping for those service users who request this. Receipts are kept for all purchases and receipts are given when money is paid into the account. There are two signatures for all transactions. The fire safety log was viewed this showed that the fire alarm had not been tested weekly. A weekly fire alarm check is in line with good practise. The manager stated that she would ensure that this was completed in future. The accident book, wheelchair, lift and hoist servicing records were viewed. These were in satisfactory order. Some chemicals were observed to be stored in the sluice. This area is not locked. This is recommended. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 20 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 1 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 3 3 3 3 3 3 1 Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes. 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 OP8 Regulation 13 (5) Requirement It is required that moving and handling techniques are reviewed. Consideration should be given to the use of handling belts for assessed individuals. It is required that the Registered Person must undertake a risk assessment for the provision of adjustable beds and devise an action plan as to how these are to be provided. Timescale for action 28/02/06 2 OP24 16(2)(c) 30/03/06 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 3 Refer to Standard OP38 OP38 OP8 Good Practice Recommendations It is recommended that the fire alarm is tested weekly. It is recommended that consideration be given to locking all areas where chemicals are stored. It is recommended that all service users have access to regular fluids. DS0000003248.V273242.R01.S.doc Version 5.0 Page 22 Catherine House General Nursing Home 4 OP2 It is recommended that the contract (terms and conditions) are reviewed in line with the recently publicised guidelines issued by the Office of Fair Trading. Catherine House General Nursing Home DS0000003248.V273242.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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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