CARE HOMES FOR OLDER PEOPLE
Cornmill Nursing Home Cornmill Nursing Home Bonds Lane Garstang Nr Preston Lancashire PR3 1RA Lead Inspector
Mrs Christine Marshall Unannounced Inspection 25th January 2006 12:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cornmill Nursing Home DS0000006034.V271662.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. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cornmill Nursing Home Address Cornmill Nursing Home Bonds Lane Garstang Nr Preston Lancashire PR3 1RA 01995 606446 01995 606447 ghill@cornmill.com www.cornmill.com G Hill Limited 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) Mrs Susan Elizabeth Dewhurst Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (7) of places Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The home shall at all times employ a suitably experienced and qualified manager who is registered with the NCSC The home may accommodate 7 service users in the category of physical disability (PD) over the age of 50 years and 41 in the category of old age (OP). The registered person may accommodate up to a maximum of 48 older persons when not utilising those places designated for physical disability. 26th September 2005 Date of last inspection Brief Description of the Service: The Cornmill Nursing Home is situated within its own grounds very close to the town centre of Garstang. The home is registered for a total of 48 older people with a condition of registration for 7 persons over the age of 50, with physical disability, within this total. There are two lounges, a sun lounge and dining rooms, all of which are furnished to a high standard. Bedrooms are individually personalised and residents are given a full choice of daily routines and activities. The registered providers are fully committed to staff training and development and staffing levels are more than adequate for the care of the residents. There is adequate car parking space to the front of the home. A separate private physiotherapy room is accessed through a side door to the home. Residents can benefit from this service if they require. Mrs and Mrs G Hill own the home and Mrs S Dewhurst is the registered manager. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second of two inspection visits, scheduled from 1st April 2005 to 31st March 2006. All of the people spoken to at The Cornmill said that they preferred to be called residents. This unannounced inspection took place over two and a half hours during lunch and afternoon and was carried out by the home’s designated lead inspector. A tour of the home was undertaken, including bedrooms, lounge and dining areas and bathrooms. All areas were very clean, hygienic and pleasantly furnished. Policies, procedures and administration of medication records were examined, as were residents’ care plans. Comment cards were received from residents, relatives and GPs prior to the inspection; all were very positive and showed that everyone is very satisfied with the care that they receive. Residents said that they were more than happy living at The Cornmill. Two visiting relatives readily praised the home and the staff for their care. The owners, nurses and care staff were spoken to and showed that there is a very good team approach to the care given to the residents. Everyone was very friendly, welcoming and co-operative throughout the visit. What the service does well:
The Cornmill provides a very pleasant environment for the people who live there. There is a relaxed and calm atmosphere throughout the home. Residents from all cultures are welcomed at The Cornmill and equality and diversity of care is an integral part of the home’s philosophy. There are three lounges and a dining room; the lounges are very homely and the dining area is very light and pleasant with nice table settings in place. The fabric and furnishings of the home are of a very good standard and the home is kept extremely clean and hygienic.
Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 6 The carers are very friendly and professional in their approach to care and the residents spoken to said that the staff were all very caring and considerate. Daily routines for the people living at The Cornmill are flexible and the residents said that they enjoyed their own personal routines and lifestyles. There is a very good activities programme for the residents and the activities co-ordinator is keen to bring variation into the residents’ daily routines. Residents’ comments included “I am very happy. ” “I get the very best of care.” “It is brilliant. Things happen when I want them to, I just press a buzzer and get help twenty four hours a day.” One resident who needed a special diet said, “The food is prepared to my satisfaction and suits my needs.” The visiting relatives said, “You can’t find anything wrong at this home, it is wonderful.” And “It is fabulous here, no problems at all.” All of the residents who said that the food was good and they were satisfied with the quality and variety of meals that are provided. There are well-kept gardens around the home and the conservatory is very light and nicely furnished. The staff recruitment, induction, training and development are of a very high standard. Robust policies are in place for the safety and welfare of the people who live at the home. Staff are trained to a high standard and there is a good mix of skills amongst the nurses and carers. Staffing levels are very good and take into account the individual needs of the residents living at the home. What has improved since the last inspection?
Two walk-in shower units have been fitted in the bathrooms, this is so that residents can be bathed without having to be lifted or hoisted in and out of the bath. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 7 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. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 8 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 Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 9 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 Anyone considering moving into the home undergoes a full assessment of their needs and strengths so that the home can make sure that they can provide the right service to that person. EVIDENCE: Pre-admission assessments are done to ensure that the right care is given when the person enters the home. The three recently most recently admitted to the home had files that contained a full pre-admission assessment. These are very in-depth assessments that cover every aspect of care that might be needed by any resident; this is then transferred to an initial plan of care and after further assessments, to a full plan of care for the resident. This information and progressive assessment of each resident is commendable.
Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 10 Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 11 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 The information contained in the residents’ files indicates that all their health and social care needs are met. Residents are fully supported in their daily lives. EVIDENCE: Care plans are written records of the care that is given to each person that lives at the home; The Cornmill has a system of care plans of a commendable standard in that each plan contains: A photograph of the resident; admission record; review of care plan with signatures of resident and/or their relatives, this includes a section for comments by the resident and their relatives at each review; daily nursing notes; a plan of the resident’s activities of daily living that includes physical, psychological and social needs; hobbies and interests; any special skills; personal preferences such as wearing make-up, jewellery or particular clothing; personal dislikes such noise, television or particular foods: Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 12 There is also documentation of General Practitioner and other professional visits such as physiotherapy, speech therapist or chiropodist; there are nutritional, continence, skin and pressure sore risk assessments; general risk, moving and handling, wound assessments (if applicable) and a full dependency profile. Each care plan had been fully reviewed at least monthly. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 13 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): 15 Residents benefit from nutritious well balanced food served to them in a pleasant and comfortable environment that supports choice and special dietary requirements EVIDENCE: Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 14 Menus are 4 weekly and these are regularly reviewed with the preferences and opinions of the residents in mind. The menus offer a very full choice and variation of diets. The residents are offered the menu each day, and there are two options for each mealtime with further choices if requested. All meals that are served are recorded and this is then used for the review of residents’ nutritional needs. Hot and cold drinks and snacks are available throughout the day and night if requested. There is a window-fronted fridge in the kitchen for drinks and supplements and the kitchen is kept spotlessly clean. Food is presented in a very pleasant and appetising manner. Nutritional assessments are in place in each care plan. Pureed meals were appetising and served appropriately. Religious/cultural (kosher) diets are catered for when needed. All of the residents spoken to said that they were more than happy with the food. Dining areas are very pleasantly furnished and table settings are attractive. The home holds a Food Safety Award. The last Environmental Officer report raised no issues. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 15 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): No judgement has been made. EVIDENCE: All of the standards were assessed on the previous inspection visit and each was met, with standards 16 and 18 being commended. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 16 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): No judgement has been made. EVIDENCE: All of the standards were assessed on the previous inspection visit and each was met, with standards 19,24 and 26 being commended. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No judgement has been made EVIDENCE: All of the standards were assessed on the previous inspection visit and each was met, with standard 28 being commended. Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 18 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 The home makes sure that the best interests of the residents are protected in that their health and safety is promoted. EVIDENCE: Standards 32 to 38 were assessed on the previous inspection visit and all were met, with standards 33,34,36 and 38 being commended. The manager is a Registered Nurse who is currently in the final stage of completing the Registered Managers Award. Residents and the staff were very friendly towards her when she was speaking to them.
Cornmill Nursing Home DS0000006034.V271662.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 20 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. 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. Refer to Standard Good Practice Recommendations Cornmill Nursing Home DS0000006034.V271662.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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