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Inspection on 31/07/05 for Coalville Nursing & Residential Home

Also see our care home review for Coalville Nursing & Residential Home for more information

This inspection was carried out on 31st 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

Residents and visitors spoken with spoke highly of the staff employed at the home and described them as very kind and helpful. One visitor said she felt she could put her trust in the staff employed and found them very capable. Visitors also said they felt welcome at the home and could visit at anytime. The inspector observed interactions between staff and residents and found these to be positive and respectful. Staff spoken with demonstrated a good understanding of their roles, they possessed very caring attitudes and were obviously working towards serving the best interests of the residents. Medication records and procedures appeared to be in good order and each service user has a care plan specifically for medication. This lists the medication each resident is prescribed and any potential side effects. Two of the residents spoken with praised the quality of the meals provided and confirmed that a choice was always available and the menu varied. The premises and environment appeared very clean, comfortable and well maintained. All rooms have en-suite facilities and there are two spacious lounge/dining rooms and adequate assisted bathing and toilet facilities.

What has improved since the last inspection?

Since the last inspection the acting manager has been through the registered managers process and interview and is now registered with the CSCI.

What the care home could do better:

While care plans were on the whole comprehensive, well written and regularly reviewed, not all assessed needs were recorded. If all assessed needs are recorded and a plan of care devised then staff could ensure that all appropriate care and traetment is provided. If staffing levels were reviewed and planned with regards to the dependancy levels of residents accomodated, then staff numbers and skilll mix would be sufficient to meet the needs of residents accomodated.

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Coalville Nursing and Residential Home Albert Road Coalville Leicestershire LE67 3AA Lead Inspector Debbie Williams Unannounced 31/07/05 10:00 am 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 and Care Homes for Adults 18 – 65*. 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. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Coalville Nursing and Residential Home Address Albert Road Coalville Leicestershire LE67 3AA 01530 817441 01530 817441 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) Rushcliffe Care Limited Miss Linda Mary Tozer Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (10), Physical disability of places over 65 years of age (40), Sensory impairment (2), Sensory Impairment over 65 years of age (2), Terminally ill (2), Terminally ill over 65 years of age (2) Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No one falling in categories PD may be admitted to the home where there are 10 persons of category PD already accommodated within the home.No person to be admitted to the home in categories SI or SI(E) when 2 persons in total of these categories/combined categories are already accommodated in the home.No person to be admitted to the home in categories TI or TI(E) when 2 persons in total of these categories/combined categories are already accommodated in the home.To be able to admit the named person of category PD as identified in correspondence with the pervious health authority.No one under the age of 65 may be admitted to the home. Date of last inspection 6/01/05 Brief Description of the Service: Coalville Nursing and Residential Home, first registered in 1995 and part of Rushcliffe Care Limited, is a purpose built home registered for 40 service users over 65 years of age and accommodates service users of both sexes. It is also registered to provide for a limited number of older service users with physical disability, sensory impairment and/or those who require terminal care. It is managed and staffed by Registered General Nurses, care staff and ancillary staff.The home is situated in North West Leicestershire and is within easy reach of Coalville town centre and also the towns of Ashby de la Zouch and Loughborough. The home is bright and clean with a high standard of décor throughout, with two spacious lounge/dining rooms and has adequate assisted bathing and toilet facilities. All rooms have en-suite facilities. The home is situated on two floors with a 13-person passenger lift servicing the second floor. All areas of the home are accessible to service users in wheelchairs. It has a safe, well-planted and attractive garden. Food is prepared on site, with a choice of menu, and special dietary requirements are catered for. The local bus is located within a few minutes walk of the home and the home is accessible by public transport or car. There is ample parking for visitors. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three and a half hours and commenced at 10.00am on Sunday the 31st of July. The inspection was facilitated by the Registered Nurse in charge of the shift. The inspector spoke with three residents, two staff members and two visitors. The main method of inspection used was ‘case tracking’ which involved selecting four service users and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. This was a positive inspection. Staff were open and helpful. Only specific standards were examined during this inspection. What the service does well: Residents and visitors spoken with spoke highly of the staff employed at the home and described them as very kind and helpful. One visitor said she felt she could put her trust in the staff employed and found them very capable. Visitors also said they felt welcome at the home and could visit at anytime. The inspector observed interactions between staff and residents and found these to be positive and respectful. Staff spoken with demonstrated a good understanding of their roles, they possessed very caring attitudes and were obviously working towards serving the best interests of the residents. Medication records and procedures appeared to be in good order and each service user has a care plan specifically for medication. This lists the medication each resident is prescribed and any potential side effects. Two of the residents spoken with praised the quality of the meals provided and confirmed that a choice was always available and the menu varied. The premises and environment appeared very clean, comfortable and well maintained. All rooms have en-suite facilities and there are two spacious lounge/dining rooms and adequate assisted bathing and toilet facilities. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 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. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Standards Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6-10 and 18–21) (Standards 11–17) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37–43) Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. 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. Prospective service users have an opportunity to “test drive” the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Residents have their needs assessed prior to admission, this ensures their needs can be met. EVIDENCE: Care and assessment records were inspected for four residents. Assessment records were comprehensive and included risk assessments and information regarding the social and recreational needs of residents. Residents spoken with confirmed their needs had been assessed prior to admission. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6-10 and 18 –21 (Adults 18-65) 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. Including their physical and emotional health needs. 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. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. Service users receive personal support in the way they prefer and require. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 7, 9, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for standard(s) 7,9 and 10 Service users are protected by the home’s medication policies and procedures Staff treat service users with respect and promote privacy, dignity and independence. Not all assessed needs were addressed within individual care plans, therefore the home could not demonstrate that all health care needs were fully met. EVIDENCE: Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 10 The care plans of four residents were inspected. Care plans were mostly comprehensive and set out the actions staff needed to take in order to meet resident’s needs. A quick reference care plan was also in place. Medication administration records for the four case tracked residents were inspected. Records appeared accurate and in good order. Residents spoken with confirmed that their correct medication was administered by staff and at the correct time. Each service user has a care plan specifically for medication. This lists the medication each resident is prescribed and any potential side effects. This is commended as good practice. Residents and visitors spoken with confirmed that staff treated them with respect and maintained their privacy and dignity. Interaction observed between staff and service users appeared positive and respectful. Both visitors spoken with praised the attitudes of staff towards them and their relatives. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 11 – 17 (Adults 18-65) are: 12. 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. Including opportunities for personal development. Service users engage in appropriate leisure activities. Service users maintain contact with family/ friends/ representatives and the local community as they wish. And have appropriate personal, family and sexual relationships. 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. 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15, 16 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14, and 15 The lifestyle experienced by the case tracked residents matched their expectations and met their social, cultural and religious needs. EVIDENCE: Residents spoken with confirmed that activities of daily living were made flexible in order to meet their needs. Residents were able to choose how and where to spend their day. Residents spoken with were satisfied with the range of activities on offer, these included trips out, bingo and tea mornings. A programme of forthcoming activities was posted on the home’s notice board. Residents spoken said that a minister visited the home on a regular basis and felt their religious needs were being met. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 12 One visitor spoken with felt there was sufficient opportunity for residents to meet their social/ recreational needs and that residents could exercise personal choice and autonomy. Residents spoken with praised the quality of the meals provided and confirmed that a choice is always available as are snacks and drinks. At the time of this inspection diabetic and soft diets were also being provided. Staff were observed assisting residents with their meals in an appropriate and sensitive manner. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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. Including neglect and selfharm. The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 Adult protection policies and procedures afford maximum protection for residents. EVIDENCE: Robust complaints and adult protection policies are in place. Staff spoken with were aware of the correct procedures to follow in the event of suspected abuse. Residents spoken with said they would feel happy to complain to the home’s manager if they were unhappy about any aspect of the service. The company complaints procedure was displayed on the home’s notice board. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) 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. Shared spaces complement and supplement service users’ individual rooms. Service users have sufficient and suitable lavatories and washing facilities. Provide sufficient privacy and meet their individual needs. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. And lifestyles. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 All areas of the home inspected appeared well maintained, comfortable and homely and provided a safe and comfortable environment for residents. EVIDENCE: All areas of the home seen were furnished to a high standard and appeared clean and comfortable. Residents spoken with confirmed their rooms were cleaned every day and they were very satisfied with the standard of hygiene in the home. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 36 (Adults 18-65) are: 27. 28. 29. 30. • • • Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. 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. Service users benefit from clarity of staff roles and responsibilities. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers standards 27, 29 and 30 (Older People) and Standards 34 and 35 (Adults 18-65) the key standards to be inspected at leat once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The numbers and skill mix of staff deployed were not always sufficient to meet the needs of residents accommodated. EVIDENCE: At the time of this inspection there were thirty-nine residents living in the home. Accommodation is over two floors and staff are allocated to work on either the ground or first floor. At the time of this inspection there were seven care staff and one trained nurse working on the morning shift, five care and one nurse on the afternoon/evening shift and two care and one trained nurse at night. The duty roster for the week in which this inspection took place was inspected, there was occasions when morning care staff numbers were down to six care staff. Many of the residents accommodated had high dependency levels. Staffing hours were calculated against the Department of Health’s staffing guidance Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 16 and a shortfall of 78 hours was noted (nursing hours were also included in this calculation). The registered manager is supernumerary and works full time. Staff and residents spoken with felt that the staffing levels should be increased. The nurse in charge said that the home’s registered manager was planning to increase staffing levels when she returned from annual leave. Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 37 – 43 (Adults 18-65) are: 31. 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 a well run home and from competent and accountable management of the service. 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. Service users are confident their views underpin all self-monitoring, review and development by the home. 32. 33. 34. 35. 36. 37. 38. • The Commission considers standards 33, 35 and 38 (Older People) and Standards 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected on this occasion. NA EVIDENCE: NA Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 18 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 x 2 x 3 3 4 x 5 x 6 N/A HEALTH AND PERSONAL CARE ENVIRONMENT Standard No 19 20 21 22 23 24 25 26 STAFFING Score 3 x x x x x x 3 Score Standard No 7 8 9 10 11 Score 2 x 3 3 x Standard No 27 28 29 30 2 x x x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No 16 17 18 Score 3 x 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x 37 x 38 x Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 19 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 7 Regulation 15 Requirement All assessed needs must be recorded in the individual care plan in order to ensure that staff are aware of all assessed needs and treatment required. Staffing levels must be reviewed and the providers must ensure that sufficient skill mix and staff numbers are deployed to meet the needs of residents accomodated. Timescale for action September 30th 2005 2. 27 18 September 30th 2005 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 Good Practice Recommendations Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX 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 Coalville Nursing and Residential Home C51 C01 S1895 Coalville NR V234194 310705 Stage 4.doc Version 1.30 Page 21 - 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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