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Inspection on 19/07/05 for Churchill House Nursing and Residential Home

Also see our care home review for Churchill House Nursing and Residential Home for more information

This inspection was carried out on 19th July 2005.

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

The home has group of staff who are keen to maintain the high standard of care given in the home. The residents spoken to felt that the staff work hard to improve their quality of life in the home. Meals are varied, well balanced and nicely presented offering choice and variety. The staff team manage the daily activities and entertainment well providing opportunities for residents to join in with activities both inside and outside the home.

What has improved since the last inspection?

Some refurbishment had taken place in the home since the last inspection with the purchase of new carpets in hallways on the ground and second floors. The central heating system has been adjusted to ensure that room temperatures are at a constant temperature at all times and that residents can control this in their own individual room. Staff Files across the Company are now maintained to the same standard which is complient with the statutory requirements of the Care Standards Act.

What the care home could do better:

At the time of the inspection the home was being well managed which was reflected in the comments made to the inspector by the residents he spoke to. The home continues to provide a good standard of care and no requirements were made at this inspection.

CARE HOMES FOR OLDER PEOPLE Churchill House Nursing & Residential Home Bromfield Road Ludlow Shropshire SY8 1DW Lead Inspector Mike Highfield Unannounced 19 July 2005 10:00 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Churchill House Nursing and Residential Home Address Bromfield Road, Ludlow, Shropshire, SY8 1DW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01584 877500 01584 877500 Jubilee Care Limited Care Home with Nursing 55 Category(ies) of Old Age (33) registration, with number of places Dementia (13) Physical Disability (3) Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Home should comply with the Staffing Notice issued by Shropshire Area Health Authority dated 7 October 1999. 2. The home may accommodate a maximum of 55 service users. 3. The home may accommodate a maximum of 3 persons with a Physical Disability and 13 Older People with Dementia. 4. The remainder being Elderly Persons, not fallling into any other category. Date of last inspection 20th January 2005 Brief Description of the Service: Churchill House is a care home with Nursing beds registered to provide care and accommodation for up to 55 elderly people. 13 beds provide care for the elderly mentally infirm and 3 beds for physically disabled people. Churchill House is owned by a limited company, Jubilee Care Ltd. The General Manager is Mrs Heather Stanford RGN, who has many years experience in management and the care of the elderly. The home is now jointly managed on a day to day basis by Mrs Susan Brown, RGN, and Mrs Rachael Ruscoe, RGN, their registration is currently being processed. The home is situated on the fringe of Ludlow, in Shropshire, adjacent to the main A49 in a residential development. It was purpose built in 1995, the accommodation is on two floors (access via stairs or a shaft lift), and it is set in attractive gardens. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of four hours. A partial tour of the premises took place and staff and care records were perused. Four residents were spoken to at length concerning the services they were being offered all made very positive comments about the home and the support they were receiving from the staff team. The care staff stated that they were given the full support from the management team in any training they undertook. What the service does well: What has improved since the last inspection? What they could do better: At the time of the inspection the home was being well managed which was reflected in the comments made to the inspector by the residents he spoke to. The home continues to provide a good standard of care and no requirements were made at this inspection. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1-6 The home has a very good admission policy, residents are fully assessed before admission following a clearly defined procedure which involves other professionals and the residents family in the process. EVIDENCE: A statement of purpose and service user guide was available, together with a copy of the last inspection report on display in the entrance foyer. Each resident is provided with a contract on admission to the home. The terms and conditions include all required components. Residents continue to be admitted following a comprehensive assessment of their needs that is usually undertaken by one of the managers. Both are qualified to under take this role and have many years of experience in the care of elderly people. All the residents and one visitor spoken to were generally complimentary regarding the care they receive and that their individual needs and interests were being met. Prospective residents may visit the home prior to admission, spend some time there and talk to staff and residents about their experiences in the home. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-11 There is a clear and consistent care planning system in place which provides staff with the information they require to meet the residents needs. EVIDENCE: Care plans, seen as part of the inspection process were well documented and contained information about health and personal care needs. The records are reviewed every month, and the staff spoken to were knowledgeable about the residents and their care. Staff at the home are pro-active in the prevention of pressure sores there are many pressure relieving beds, mattresses and cushions in use. Residents being nursed in bed appeared to be very comfortable, well cared for and pain free. At the time of the inspection all matters pertaining to the recording, administration and storage of medication were safe. There is a lockable facility in each bedroom should anyone wish to self medicate. Controlled drugs are stored and recorded correctly. Four staff have achieved accredited training in administration of medicines since the last inspection. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 10 Training manuals are supplied to all staff incorporating the basic principles of care. Discussions and observations made during the inspection indicated that the residents are treated with respect and dignity. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-15 Residents maintain contact where they wish with family, friends and the local community and they are offered a varied, well balanced diet, which takes into account individual likes and dislikes along with seasonal changes. EVIDENCE: It was evident throughout the visit that the routines of daily living at Churchill House were flexible and each resident could find the lifestyle experienced in the home matched their expectations and preferences. Residents who are able, are fully encouraged and enabled to go out for trips, visit relatives and attend social functions. An activity programme is also distributed and the activities are reviewed at regular intervals to ensure that they are compatible with service users interests The home operates an open visiting policy and relatives were seen to be coming and going at liberty throughout the inspection. Advocacy arrangements are made known to the residents and have been used professionally. Comments from residents, visitors and staff indicated that the menus are wholesome and varied. The residents are involved in menu planning and staff are fully aware of individual preferences. All those spoken to were complimentary regarding the catering at the home and the choice offered at meal times. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 12 Observation and discussions indicated that the mealtimes are unhurried and people are given sufficient time to eat. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16-18 The home has a well publicised complaints system and there is evidence that residents feel that their views are listened to and acted apon. EVIDENCE: A satisfactory complaints procedure is available and is well publicised. Through discussion and observation it was evident that service users are able to voice their feelings and that their opinions matter. It was considered that the residents legal rights are protected. Advocacy services available are publicised in the home. All necessary policies and procedures are in place relating to the protection of vulnerable adults, including staff training. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19-26 The standard of the environment is good providing the residents with a safe well-maintained environment to live in. The standard of cleanliness showed the dedicated work that domestic staff put in to the home. EVIDENCE: It was evident through inspection of the premises that the residents live in a comfortable homely safe environment. A programme of routine maintenance is undertaken by the handyman, and it was seen that replacement carpets in the communal areas on the ground floor and necessary redecoration on the first floor had taken place. Following the Fire Officers inspection in December 2004 recommendations made had been complied with. The home provides three lounges and three dining areas, they were seen to be generally well maintained. Carpets had been replaced in several areas that required it at the last inspection. All areas in the home are accessible to residents. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 15 A variety of aids, hoists and mobility equipment is available in the home and risk assessments are in place. The home was clean and tidy and the domestic staff are to be commended for their hard work. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 The home is staffed to a level that ensures that residents needs are met at all times. EVIDENCE: The staff seen on duty and the duty rota indicated that there were sufficient staff in numbers and skill mix to meet the service users needs. Three Registered Nurses , ten carers, and eight ancillary. The home has achieved the ratio that 50 of care staff must be trained to NVQ Level 2, and further training is being undertaken. A thorough recruitment process is undertaken and CRB checks made. Staff files seen were well organised. All new members of staff have induction training and are not on duty unsupervised until both the supervisor and supervisee feel competent and confident. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 The Management Team are developing an attentive staff group in the homes quest to constantly improve the quality of care service to meet the residents needs. Good systems of communication are in place and the health and safety of residents is promoted fully by the safe working practices in place. EVIDENCE: The home is now jointly managed by Susan Brown and Rachel Roscoe. Both individuals are qualified nurses and are undertaking the Registered Managers Award, they have a good working knowledge of the National Minimum Standards and are keen to develop their management roles. Through observation and discussion with the managers, staff on duty and residents it appears that the management approach in the home is open and positive. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 18 A positive approach to views and opinions from anyone concerned with the home is taken and they are enabled and encouraged to effect the way the home is run and the service is delivered. An Annual Development Plan for the home is available for perusal and Residents and Relatives Surveys are used and the results of these are published. Personal Allowances are not dealt with by the home, and residents have secure facilities for safe keeping of money and valuables in their individual bedrooms. Arrangement for induction and supervision of staff takes place regularly in the home and in different forms ie: practical and theoretical. Training achievements were good and the stated they were well supported. The General Manager is an accredited Manual Handling Trainer. Risk Assessments are in place for residents care and safe practice procedures. Matters pertaining to COSHH appeared satisfactory, and General Service Certificates were well organised. The Managers were well aware of their responsibilities under Health and Safety Legislation. Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement None Made 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 None Made Good Practice Recommendations Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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 Churchill House Nursing & Residential Home E56 S22242 Churchill House V214732 UAI 190705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!