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Inspection on 26/08/05 for Coach House Nursing Home

Also see our care home review for Coach House Nursing Home for more information

This inspection was carried out on 26th August 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

Residents were most complimentary about the staff, and the facilities available to them at the home The service makes sure that residents` health care needs are met. Residents said they were treated with respect and the care was excellent. Visitors are made welcome to the home. Food provided, according to residents, is excellent with a good choice for breakfasts and teas. Residents and relatives are encouraged to make comments about the service provided.

What has improved since the last inspection?

Since the last inspection the home has formalised a system to review the residents` care needs with their representatives. The comments from these are most positive. A system for reviewing quality care has been introduced. Formal staff supervision has been introduced and the records were available at the inspection.

What the care home could do better:

The quality care review highlighted that some residents would like more activities the manager is currently reviewing this.The results from the quality assurance should be audited and available at the home.

CARE HOMES FOR OLDER PEOPLE Coach House Nursing Home Broome Clent Worcestershire DY9 OHB Lead Inspector Christine Potter Unannounced 26 August 2005 11:50 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. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Coach House Nursing Home Address Broome Clent Worcestershire DY9 OHB 01562 700417 01562 700417 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) Mr and Mrs E Lane. Ms T Bradley CRH 17 Old age Dementia - over 65 Terminally ill 17 17 4 Category(ies) of OP registration, with number PD(E) of places TI Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24th February 2005 Brief Description of the Service: The Coach House is registered to provide nursing care for 17 elderly residents. The home is a grade two listed building and is located in the grounds of Broome House residential home. The home is privately owned by Mr and Mrs Lane. Mrs Lane is also a registered nurse with many years experience working in the health care sector and care of the elderly. The manager is Miss T Bradley, who is also a registered nurse with many years experience working in the health care sector and care of the elderly. The home has been tastefully modernised in the Georgian style providing a pleasant environment for the residents. Accomodation for the residents is available in both single and double rooms. Other areas of the home used by the residents include lounges and dining area. The home stands in well maintained grounds providing a picturesque view. When the weather permits, furniture is provided for the residents to sit outside. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours. The inspection focused on the requirements from the last inspection, a tour of the environment, care documentation and staff records. On the day of the inspection the home was accommodating 15 residents. During the inspection three residents were spoken to. Staff questionnaires were left for staff to complete and return to the CSCI. What the service does well: What has improved since the last inspection? What they could do better: The quality care review highlighted that some residents would like more activities the manager is currently reviewing this. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 6 The results from the quality assurance should be audited and available at the home. 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. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.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 Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.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, 2 and 5. The admission procedure remains comprehensive to ensure that there is a proper assessment prior to people moving into the home. This helps to ensure that care needs can be met. EVIDENCE: The admission procedure was satisfactory to guide staff on the actions to be taken to ensure that new residents’ needs are properly assessed and planned for. Individual records are kept for each of the residents, and inspection of the records for three residents had full assessment information recorded. Residents who were interviewed all said that they felt that the home was effectively meeting care needs and they had been provided with the appropriate information to assist them in making their choice about the home. The homes Statement of Purpose and Service User Guide have been updated since the last inspection and contain relevant details of the services the home provides. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.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, 8, 9 and 10. There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet residents’ needs. EVIDENCE: Individual plans of care are available, and these had significantly improved since the last inspection. Plans reviewed were detailed, up to date and had been regularly reviewed. Significant events in the home had been recorded, daily entries into case records had been made and entries available gave an indication of the actual care given. Three residents who were spoken to were complimentary about the home, staff and care provided. The home has implemented a system to review the resident’s care documentation with the resident and their next of kin. The comments were meaningful and assisted the staff to ensure they are meeting the residents needs. The homes medication records were examined, and were being managed well. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 10 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) 12,14, and 15 Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: Residents were spoken to and everyone who commented on the food said how good it was and that they welcomed the daily choices offered. The homes feedback forms also acknowledged the choice and quality of the food provided. Catering staff have a detailed knowledge and understanding of individual residents’ dietary preferences and requirements. The homes routines are individualised to the residents needs and a record is available within the residents’ care documentation. Activities are limited in The Coach House, however a couple of residents expressed an interest for more activities and the manager is pursuing this. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 11 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, and 18. Complaints are handled objectively and residents are confident that their concerns will be listened to, taken seriously and acted upon. A vulnerable adults procedure is available to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a simple and clear complaints procedure, and the complaint records indicated that this is followed. A copy of the complaints procedure had been given to all residents, and was available to visitors and relatives. Residents were aware of the complaints procedure. A procedure for responding to allegations of abuse is available and senior staff had attended a recent training day to update their knowledge. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 12 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, 22, 24, 25 and 26. The home continues to ensure that a high environmental standard is maintained, creating a comfortable and safe environment for those living there and visiting. EVIDENCE: The home is on one level, and provides lounges, and dining area for the residents to use. The home stands in spacious well maintained grounds providing a pleasant outlook and area for the residents to use when the weather permits. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 13 Each bedroom seen had been furnished with residents’ personal possessions, thereby generating ownership and a sense of autonomy for individuals. The standard of the environment within the home is good, providing residents with an attractive and homely place to live. Residents confirmed that they appreciated the physical environment. All areas of the home were clean and tidy, no odours were evident in any part of the home. Hot water temperatures have been risk assessed and had been regulated to prevent people being accidentally scalded when they have a bath. Water temperatures checked at the time of the inspection indicated that the thermostatic control valves were in need of being serviced, the water temperature was in excess of 44 degrees Centigrade. The home employs a “handyman” who undertakes maintenance, gardening and decorative work. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 14 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) 27,29,30 Staffing levels and competencies are suitable to ensure that residents’ needs are identified and effectively met. EVIDENCE: There were suitable nursing and care staff on duty to provide care and support for the people who were resident in the home at the time of inspection. The manager confirmed that maintaining staffing levels had been difficult during the holiday period. The home maintained cover for the home without using Agency staff. Three staff files examined contained appropriate information and relevant checks had been completed. A formal staff supervision program has been commenced for all grades of staff, and the manager confirmed this has been most helpful. Training has been provided to staff, and includes infection control, first aid and moving and handling. Training was identified as a result of the needs of residents, to ensure that care delivered was appropriate to and in response to the needs of residents. Over half of the care staff had undertaken and completed National Vocational Qualification Level 2. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 15 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) 31,32,33,36,37,38 There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The manager is competent and appropriately qualified and experienced to manage the service. Staff and residents spoke very highly of her and she related well with the residents. Residents expressed their opinion that the home was being run in their best interests. The home operates a quality assurance system, this needs to be formalised to meet the requirement fully. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 16 Records inspected indicated that regular health and safety checks are carried out including fire safety tests. A formal staff supervision programme is in place. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 17 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 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x 3 3 2 4 STAFFING Standard No Score 27 3 28 2 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 x 3 3 3 3 x x 3 3 3 Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 18 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 25 Regulation 13 Requirement Ensure the thermastatic valves on the hot water outlets are serviced to ensure water is delivered at a safe temperature i.e. 37 - 44 degrees Celsius. Timescale for action Immediate and ongoing. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 33 29 Good Practice Recommendations The results from the quality assurance should be audited and available. Photographs should be included on the staff file. Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 19 Commission for Social Care Inspection The Coach House John Comyn Drive Droitwich Road Worcester WR3 7NW 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 Coach House Nursing Home E52 S4104 Coach House NH V241762 260805.doc Version 1.40 Page 20 - 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. 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