Inspection on 05/01/06 for Cookham Riverside Nursing Home

This inspection was carried out on 5th January 2006.

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

Cookham Riverside Nursing Home 13/01/09

Cookham Riverside Nursing Home 23/02/07

Cookham Riverside Nursing Home 16/08/05

Cookham Riverside Nursing Home 09/12/04

Cookham Riverside Nursing Home 29/06/04

Cookham Riverside Nursing Home 16/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Cookham Riverside Nursing Home Berries Road Cookham Berkshire SL6 9SD Lead Inspector Susan Burton Unannounced Inspection 5th January 2006 09:45 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 Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cookham Riverside Nursing Home Address Berries Road Cookham Berkshire SL6 9SD 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) 01628 521249 Hamilton House Medical Limited Miss Patricia Doreen Hadley Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: Cookham Riverside is as its name suggests, is situated on the bank of the river, in the Thames-side village of Cookham. The home provides nursing care for up to 35 older people. It was purpose built in the 1970s and lies towards the end of a private road just off Cookham High Street. Many rooms within the home overlook the River Thames, thus enabling residents to enjoy the pleasant river views. To the front of the property is a car park and to the rear, a patio area, with well maintained lawns and gardens stretching right down to the river. The gardens have level walkways for residents to enjoy and areas to sit, relax and delight in the constant interest and scenery that this unique riverside setting provides. Cookham has public transport, shops and amenities within walking distance of the home; the larger town of Maidenhead is approximately 3miles away. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection on Thursday 5th January 2006. The inspection commenced at 9:45 a.m. and finished at 14:40 p.m. This was a very positive inspection. Residents, relatives and staff confirmed to the inspector their satisfaction with the quality of life and the service provided within the home. The inspection mainly focused on the management arrangements of the home. Some recommendations were made in regard to improving documentation, first aid training and workplace risk assessments. What the service does well: What has improved since the last inspection? The homes infection control procedures are now more readily available for the staff to use. Information for residents on the menu choice of the day is provided in resident friendly format in the dining room. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 6 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. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Pre-admission information is adequately recorded. EVIDENCE: From the care plans seen during the inspection pre-assessment information in regard to an individuals medical history and care needs had been appropriately documented to enable a plan of care to be developed. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 11 Care plans in the home are basic and limited in the information that they provide. Nursing staff use standardised plans which also limit the individuality of the care plan. Residents health care needs are documented. The recording of the treatment and progress of wounds or pressure sores needs to be more detailed. Lengthy discussion took place with the manager with reference to a situation that has occurred locally in regard to the verifying/certification of a residents death. EVIDENCE: The manager of the home wished to express her very great concern about a local decision that had been made by the out of hours GP surgeries in East Berkshires arrangements for the certifying of a residents expected death. This issue was outside the scope of CSCIs regulatory arena and may become a training issue for staff in the future. The manager had taken a very pro-active and responsible approach to the issue to ensure appropriate protection for residents and staff in her home. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 10 The inspector examined the care plan of one resident currently being treated for a wound/pressure sore. The care plan did not robustly evidence the management or improvements being made; there was no evidence of graphs, grids or photographs to reflect the progress, which would be good practice. Staff may need to refresh their tissue viability training. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 the following standard(s): 13, 14,15 Residents maintain contact with family, friends and relatives and the local community wherever able. Residents confirm they have choice and control over their lives but documentary evidence is not available to fully support this. A recommendation from the previous inspection that the home provide menus in a resident friendly format had been resolved. EVIDENCE: The inspector spoke to a relative whose husband had been in the home for a number of years. The lady was able to confirm to the inspector her satisfaction with the care given, she said that the staff were marvellous. She confirmed that family and friends are actively encouraged to visit and her daughters often bring in their small children who are made to feel very welcome when they visit their grandfather. The home is visited every Sunday by a visitor from the Roman Catholic Church and the Church of England curate visits every three weeks as does the mobile library. The activity organiser will ensure that events such as a visit from local singers takes place on a regular basis. The manager advised the inspector that over 80 people visited the home on Christmas Day to enjoy the celebrations with their relatives. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 12 Those residents spoken to during the inspection were able to confirm that they felt that they had control and choice over their lives and more or less their routines within the home. Care plans did not clearly evidence consultation with the residents in regard to their choices and wishes in regard to routines such as, what time they wished to be helped to get up in the morning and when they wished to go to bed. The home has started recording detail in regard to individuals social history and any likes and dislikes. At the last inspection the inspector found that menu choices were displayed at the far end of the dining room on a single small menu, a large white wipe board situated by the serving hatch did not appear to have been used. At this inspection the home was seen to have acted on a recommendation made to improve this by writing up the menu for the day on the board by the serving hatch in resident friendly writing to enable the residents to read it wherever they were situated. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 the following standard(s): 18 The homes previous Do not resuscitate policy had been withdrawn and rewritten to ensure that resident rights were protected. EVIDENCE: At the last inspection the home was found to have a blanket Do not resuscitate policy, which was of some concern, as it did not appear to protect the human rights of the residents who may not fully understand or be aware of the implications. The manager of the home had acted quickly and responsively to the concern and had withdrawn the existing policy and replaced it with a more appropriate document. Evidence was seen on care plans of consultation with residents, their signatures and their comments in regard to their wishes at the time of death. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 the following standard(s): 19, 26 The home continues to work towards meeting a fire deficiency notice that had been issued by the Berkshire Fire authority. A recommendation made at the previous inspection in regard to the accessibility of the homes infection control procedures had been acted on. EVIDENCE: The inspector spoke to the homes maintenance man who advised the inspector that works were still in progress to meet the deficiency notice and that the home was still within the given timescale issued from the Berkshire Fire authority. At the last inspection the inspector found that the homes practice and procedures in regard to infection control did not appear to be available to the nursing and care staff. The manager reassured the inspector that information had been removed by some staff to photocopy it to aid compliance. The inspector looked at the homes infection control policies and procedures, these Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 15 now appeared to be readily available for the staff. Discussion took place with the manager on how care plans should reflect in full the homes management of individual residents with chronic and resistant infections. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29, 30 The home has a ratio of 50 of its care staff with NVQ level 2. Residents are supported and protected by the homes recruitment policy and practices. Training and induction is provided to ensure staff are competent to do their jobs. EVIDENCE: The manager was able to provide validated evidence that 9 members of staff from its total of 18 carers had achieved NVQ level 2, which is good practice and is as recommended by the National Minimum Standards. The inspector examined the recruitment procedures of the last two members of staff employed. The homes practice and procedures were appropriate with POVA and CRB checks in place to ensure the protection of the residents. From staff files the inspector was able to see that induction takes place for new members of staff. The home had been concentrating on NVQs in 2005 and now had plans in place for further training in 2006 for topics such as dementia, fire training and activity events. See standard 38 in regard to first aid training. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 in part, 35, 36, 38 The manager of the home is experienced, qualified and competent. Residents and staff benefit from the leadership and management approach in the home. The home appears to be run in the best interests of the residents. Residents financial arrangements within the home are safeguarded. Staff are appropriately supervised. The health, safety and welfare of residents and staff are mostly promoted and protected. EVIDENCE: Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 18 The manager has been in post for a number of years and was seen to be very experienced, competent and capable for her post. She is a qualified nurse and has achieved NVQ level 4 in 2005. Staff interviewed during the inspection were more than happy to confirm their satisfaction with their job roles and the work environment. All were very supportive of the management arrangements and felt there was good communication and support provided. Healthy discussion takes place during team meetings and new ideas are shared and explored. A member of staff commented that she felt safe to work here and that the standard of care is very good, and that any training that she wanted was provided. Staff were asked to score their satisfaction with the management approach in the home, these scores were 9/10 or 10/10, which is most commendable. The inspector examined at the homes complements folder and found a number of thank you cards and letters from friends and relatives thanking staff for their excellent care and attention when looking after their family member. Residents and relatives spoken to during the inspection were most emphatic in their satisfaction of the service provided and the care given by staff, when asked to score their level of satisfaction figures such as 9/10 and 10/10 were given. Inspector examined the homes financial arrangements for keeping residents cash and checked the balances of a random sample of residents monies. Cash and balance sheets evidenced safe and appropriate procedures to be in place. The supervision records of two members of staff were examined during the inspection and were found to evidence that appropriate formal supervision takes place regularly which covered aspects of practice, training needs and general care topics. The health, safety and welfare of residents and staff are mostly promoted and protected by the Registered Manager and the homes maintenance man. Contracts were in place for the maintenance of the fire systems, gas systems, lift and hoist equipment. Fire drills take place on a regular basis and an outside trainer comes in once a year to provide training, the manager was advised that it was good practice to provide refresher training on a six monthly basis. Legionella testing had also been completed. The maintenance man completes PAT testing of equipment bought in by new residents. The Registered Manager and maintenance man were recommended to put risk assessments in place for safe working practices within the home. First aid training/refresher training is recommended for designated first aiders. Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 3 X 2 Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 20 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 OP8 Good Practice Recommendations The management of wounds/pressure sores needs to be appropriately documented in line with current good practice to reflect the treatment provided and progress made. The home needs to evidence more clearly the consultation it makes with the residents in regard to their choice and independence. Up to date first aid training is to be provided for designated staff. Risk assessments are to be put in place for safe working practices. 2. 3 4 OP14 OP38 OP38 Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Cookham Riverside Nursing Home DS0000010981.V273702.R01.S.doc Version 5.1 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. 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