Inspection on 16/05/07 for Church Farm Nursing Home

This inspection was carried out on 16th May 2007.

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

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

Other inspections for this house

Church Farm Nursing Home 22/01/07

Church Farm Nursing Home 24/01/06

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

CARE HOMES FOR OLDER PEOPLE Church Farm Nursing Home Church Lane Cotgrave Nottingham NG12 3HR Lead Inspector Rob Cooper Key Unannounced Inspection 16th May 2007 10:00 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 Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Church Farm Nursing Home Address Church Lane Cotgrave Nottingham NG12 3HR 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) 0115 989 4595 0115 989 4345 Church Farm Nursing Home Ltd Mr John Spollin Care Home 34 Category(ies) of Dementia (34), Dementia - over 65 years of age registration, with number (34) of places Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories Dementia - Over 65 years of age ( DE(E) ) (34) Dementia - 55 years and over (DE) ( 34) 22nd January 2007 Date of last inspection Brief Description of the Service: Church Farm nursing home cares for thirty-four residents in an extended and converted period building in the heart of Cotgrave. It is close to the village centre shops and bus routes to Nottingham city centre. The home is registered to provide nursing and non-nursing care. A maximum of three people who require palliative care can also be accommodated. There are both single and shared bedrooms. Two of the three bathrooms have adaptations. The home has an attractive garden to the front and an enclosed courtyard to the side, which is level and is freely used by residents. All areas of the home are accessible through ramps and a passenger lift. Fees: The range of fees for the service is £437 - £575.50 fully inclusive, including hairdressing and chiropody. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of the key inspection process – so that no one at Church Farm knew that the inspection was going to take place. The visit took approximately six hours through the middle of the day, with one inspector present. The method used to carry out this key inspection was to send out a preinspection questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. We also sent out a number of surveys to residents and relatives, however none had been returned by the date of this inspection. This was followed with a visit to Church Farm, where a method called case tracking was used; this involved identifying three residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of Church Farm, looking at the activities on offer, and talking to residents and staff about the quality of the service, and their experiences of living and working at Church Farm. The registered manager John Spollin supplied much of the information during the visit. On the day of this inspection there were thirty-one residents in residence. Prospective residents can also obtain information about Church Farm from their web site at: www.churchfarmnursinghome.co.uk This web site is currently still under construction, and a link is to be installed to the Commission for Social Care inspection’s web site where the inspection reports for Church Farm can be viewed. What the service does well: Church Farm has very good information available for prospective and current residents; this is in the form of both printed material, and a web site. There are good links between Church Farm and relatives, and occasional relatives meetings. Relatives are able to visit at any reasonable time. The staffing is flexible, and thought has been given into how to meet resident’s needs and help people to make personal choices. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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 Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 13&6 Quality in this outcome area is excellent; this judgement has been made using available evidence including a visit to this service. Prospective residents at Church Farm had sufficient information before they moved in to make an informed choice about where to live. Currently residents are well informed about the services Church Farm offers Church Farm does not offer intermediate care. EVIDENCE: Both the statement of purpose and service user guide for Church Farm were seen. Both documents contained all of the information, which Care Homes Regulations say that they should. Both documents were written in an easy to understand style, and contained photographs to illustrate them further. The Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 9 web site for the home is still under construction, but does already contain important information about the services on offer at Church Farm. As part of the case tracking process three resident’s files were seen. Each file contained an assessment of need, which had been completed in-house, or had a ‘life review’ assessment or transfer information depending on where the resident had been prior to moving in to Church Farm. There was clear evidence that the assessments had been completed prior to residents moving in to Church Farm, and that the resident’s care needs had been based upon the assessments. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. 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 using available evidence including a visit to this service. The residents have their health and personal care well managed, supported and recorded by the staff at Church Farm. EVIDENCE: The resident’s files contained a good selection of care plans aimed at meeting their needs. However in some care plans a little more information would ensure that resident’s strengths are encouraged and not overlooked. For example: In the dressing care plans – it would be better to identify that an individual can manage zips but needs help with buttons, rather than saying some help required. All of the files that were seen contained care plans related to resident’s health care needs, and these were clear and detailed. Residents are able to access an optician (Vision Call) who will visit the home to test resident’s eyes and arrange spectacles if necessary. Three residents were asked about seeing their doctor, and all said that they had a local doctor who either came to see Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 11 them at the home (arranged through the staff) or they visited the surgery – depending on their particular need, although a doctor does routinely visit Church Farm every Wednesday from the local surgery. Boots (The Chemist) provide Church Farm with their medication. An inspection of the storage, and booking in and out procedures showed that medication is handled safely and there is a clear audit trail for medication from the point of ordering to administration and/or disposal. Administration records were inspected and found to be complete. The lunchtime medication round was observed, and there were no concerns seen in the administration procedures. No resident at Church Farm currently self-medicates, although one resident is being encouraged to consider this, and is being supported in the process. During the course of the inspection a number of staff to resident interactions were observed. These were seen to be polite and respectful, and staff were observed knocking on resident’s doors before entering. Three residents were spoken with during the inspection, and each one said that they thought the staff treated them well. One saying: “The staff are very nice” while a second when asked if the staff were kind said: “Yes – I’ve never thought otherwise.” Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. 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 using available evidence including a visit to this service. Residents at Church Farm have a lifestyle that reflects their cultural, social and religious interests, and needs. EVIDENCE: A programme of activities was seen, and evidence that a different activity is organised on a Monday together with a trip out on a weekly basis was also seen. Two residents were asked about activities: One said “There’s always something happening”, while the other said: “I’m quite satisfied, although often we just want to sit and chat.” One relative was spoken to during the inspection, and she said that she was “Thrilled” with the service being offered to her mother. She said that she could visit when she like, and was always made to feel welcome. A carer had been made available when mother had a hospital appointment, to help me take her. There had been relatives meetings in the past, and while recently they had focussed on the plans for the new extension, there was generally a positive mood among relatives, and good communication with Church Farm. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 13 Each of the residents spoken with said they thought there was a great deal of choice at Church Farm, and gave examples. The choices ranged from the food on offer in the menu, activities, trips out, and daily living (particularly in relation to what time they got up) as breakfast was a staggered affair through the morning, so there was no pressure to be in the dining room by a set time. Observation of the lunchtime meal showed that the quantities and quality of the food were very good. Three residents when asked said that the food was: “Very good, we’ve just had a very good meal”, “it’s very good indeed” and “I’m very fussy about food, but I do enjoy it here.” The menu showed a good variety and selection of food available, and all of the records relating to food storage and preparation evidenced that there was good and safe practice within the kitchen. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Church Farm are safe, and their complaints are taken seriously and dealt with. EVIDENCE: Church Farm has received two complaints since the last key inspection in January 2007. A review of these complaints showed that they had been dealt with in line with Church Farm’s complaints procedure. Three residents were asked about making complaints; all three said they had not felt the need, but knew how to, and who to complain to. Twelve of the staff team were attending a safeguarding adults training course during the inspection, and a review of the training records showed that there is a planned programme for all staff to receive this training. This training is aimed at raising staff awareness of abuse, and through raising the issues, offering residents greater protection against abusive practice. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Church Farm live in a safe, clean and comfortable home, with their personal possessions around them. EVIDENCE: A partial tour of Church Farm showed it to be comfortable and well maintained. Plans for a new extension, which will improve the communal areas and provide some better bedrooms, were seen, and it is anticipated that work will be completed before the end of the year. Three residents were asked about the building, each resident said they had a comfortable bedroom, and that they liked living there. Staff were seen cleaning in various areas of Church Farm during the inspection, and the building was found to be clean. Two residents were asked Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 16 about the cleanliness, and both said that they were quite happy, and that they thought the staff worked hard to keep the home clean and tidy. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Staff at Church Farm have been recruited professionally, and are competent and trained to do their jobs. EVIDENCE: A review of the staffing rota and staffing levels at Church Farm showed that there were enough staff currently employed to meet the resident’s needs. Two residents were asked about staffing levels, and both said that they thought there were enough staff. In addition Church Farm employ breakfast staff, who are employed to help residents get up and have a staggered breakfast – rather than everyone being up to fit in with a rigid breakfast time of 8.00-9:30 for example. This promotes independence, and personal choice. The care industry considers National Vocational Qualifications (NVQ) to level II in care to be the basic qualification for staff working in residential care. A review of the training records showed that currently there are four staff with NVQ qualifications, a further eight are currently studying for their NVQ level II, and three more for their NVQ level III, with South Notts College. It is recommended that a minimum 50 of the care team are NVQ qualified, and the staff team at Church Farm are currently working towards this figure. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 18 Four staff files were seen, and these contained all of the information that would show that staff had been recruited in a safe manner – in that applicants had to fill out an application form, provide two written references and undergo a Criminal Records Bureau check. A review of the documentation showed that there were no issues raised in the recruitment process, and that it was possible to prove the process had worked to protect residents. Discussions with two staff members about their recruitment evidenced that they had undergone preemployment checks, and had not started working until those checks had been completed. A review of the staff training records showed that Church Farm does have a training plan for its staff, and that there are staff training courses planned for the coming months. The records showed that staff were receiving the skills training to be able to do their jobs, and discussions with three members of staff supported this view, and provided evidence of the different training courses staff had attended, including training in the mandatory areas – fire, food hygiene etc. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 & 38 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Church Farm is a safe, well-managed care home with good systems for ensuring it’s quality in place. EVIDENCE: The registered manager has been through the Commission for Social Care Inspection’s ‘fit person’ process, and has been judged to be fit to manage a residential care home. Evidence was seen that the manager is suitably experienced and qualified, having been in post for twelve years. Church Farm has a quality assurance system, which relies on questionnaires being filled in by residents and visitors. Copies of the questionnaire were seen together with evidence that the questionnaires had been evaluated, and an Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 20 action plan produced. However no resident’s meetings are currently taking place, and therefore there is no formal method of residents to raise issues or have a voice. The fees at Church Farm are inclusive, so that the majority of the resident’s needs are covered. If residents do have any small cash needs they are either handled by them on an individual basis (with no input from the staff) or by their families. Church Farm operates a supervision system, with staff having formal supervision approximately six times a year. Records relating to the staff’s formal supervision were seen and these indicated that staff members were properly supervised. Three staff members were spoken with about formal supervision and said that they were having a formal supervision session approximately every eight weeks. All of the staff spoken with said they felt they were very well supported by the management team at Church Farm. Many different health & safety records were seen, including the fire safety records – weekly tests, emergency lighting tests and extinguisher maintenance records, and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up-to-date, which evidenced that the residents and the staff are living and working in a safe environment. Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Care plans should be more specific about resident’s individual strengths and needs, and be aimed at a member of staff who has no prior knowledge of the resident, rather than assuming that they will know them well. Formal residents meetings should be introduced to give residents the opportunity to comment on the service they are receiving, and have a voice at Church Farm. 2. OP33 Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Church Farm Nursing Home DS0000065731.V339213.R01.S.doc Version 5.2 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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