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 26th September 2005 10:00 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.V254061.R01.S.doc Version 5.0 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.V254061.R01.S.doc Version 5.0 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.V254061.R01.S.doc Version 5.0 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. 9th December 2004 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.V254061.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the first 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 a full day and was carried out by the home’s designated lead inspector and an accompanying inspector. The inspectors undertook a full tour of the home, including bedrooms, lounge and dining areas, laundry and bathrooms. All areas were very clean, hygienic and pleasantly furnished. The inspectors looked at the policies, procedures and administration records for the management of the home, all of which were well presented and very informative. Comment cards were received from residents, relatives and GPs prior to the inspection; all were very positive and showed that everyone is satisfied with the care that they receive. The inspectors spoke privately with a number of the residents, and had group discussions with several other people living at the home. All were more than happy with their care. There was one visiting relative available during the inspection visit who readily praised the home and the staff for their care. The owners, nurses and care staff spoke with the inspectors 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 with the inspectors throughout the visit. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 6 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. 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. The inspector found the carers 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 told the inspector that they enjoyed their own personal routines and lifestyles, particularly those who preferred a quieter day. 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 here.” “The Matron is very nice and friendly.” “The carers are very kind.” “Nothing is too much trouble for the staff.” The visiting relative said, “I looked at 25 homes before I brought my husband here. This is the top one.” All of the residents who spoke to the inspectors 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 the inspectors noted that there were five carers assisting seven residents with their meal. This is commendable. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 7 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. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 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.V254061.R01.S.doc Version 5.0 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): 1,2 & 5 Anyone who is considering entering The Cornmill is supplied with enough information to help them make that decision, and every resident is given a written contract of care. EVIDENCE: There is a very informative Statement of Purpose and Service Users Guide in place; this is a set of written information that tells you about the care service that is offered, who the owners, manager and staff are and what the resident can expect if he or she decides to live at the home. The inspectors commend this information. The inspector looked at three resident’s files, one of which was the most recent admission to the home; and each had a contact of care in place. Two residents who spoke to the inspectors confirmed that they had a contact of care and that they were happy with these.
Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 10 Residents told the inspector that so long as it was practicable, they were invited to the home to meet the staff and other residents, prior to making their decisions: Care staff told the inspectors that this was the usual practice. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 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): 10 The people living at The Cornmill are treated with dignity and respect and their right to privacy is upheld: This means that residents are valued and protected. EVIDENCE: The residents spoken to said that they were more than happy at the home and that the staff were very kind; they also said that their privacy and dignity is always looked after. Staff confirmed to the inspectors that they were very aware of the residents’ right to privacy and dignity and that they were given training on this as part of the home’s induction and training programme. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 12 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): 12,13 & 14 The owners and the staff fully support the residents in exercising choice and control over their lives. Relatives are welcomed and there is a good programme of social and recreational activities. EVIDENCE: Residents told the inspectors that they are supported in their preferred daily routines. They said that they could go to their room or to bed whenever they wished and that they made their own choices about what time they got up in the morning: They also said that they are given options of joining in with any activities that were provided, or to have quiet time in the lounges or their rooms. There is an activities co-ordinator at the home who organises personal and group activities. These include theme events such as Burns Night with a Scottish piper, Town Cryer, Chinese NewYear and VE Day celebrations: Quizes, gardening, clothes parties, pet therapy, flower arranging and crafts, reminiscence and music and movement sessions are also provided along with many other choices. The residents make crafts for the Summer and Christmas Fayres and the proceeds are used to sponsor a child in Africa. The home has regular visiting speakers and the mobile library visits regularly.
Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 13 The residents told the inspectors that they enjoyed their activities and entertainment. The inspectors commended this. Visiting relatives are always welcomed to the home and there are excellent links with the local community. Religious ministers visit regularly and the local school and community centre have good contact with the home. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 14 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): 16,17 & 18 Residents are able to voice their complaints and know who to speak to if they have any concerns. Adult protection and quality checks are in place, which means that residents live in a safe environment where their satisfaction is assured. EVIDENCE: There is a written complaints procedure for the residents and their relatives and this is included in the Statement of Purpose. The residents spoken to said that they had no complaints at all. Residents also said that they could get in touch with their relatives, solicitors or anyone else that they might need for help, if they wished: There are advocacy information leaflets and advice available, which is for anyone who is without relatives and needs someone to speak on their behalf. There is also a complaints procedure for the home for the external provision of supplies and service, which is in place to promote and maintain quality services to the home. There are very robust policies in place for the protection of vulnerable people and the care staff are given training on abuse awareness. The inspector commended this policy and its approach to the prevention of abuse issues.
Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 15 There has been one complaint to the Commission for Social Care Inspection, which was investigated and not upheld. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 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): 19,20,21,22,23,24,25 & 26 Residents are provided with very clean, homely and pleasantly furnished surroundings and bedrooms are personalised and comfortable; this means that people feel at home with their photographs and belongings around them. EVIDENCE: There are thirty-eight single and five double rooms, and each bedroom is personalised with pictures, photographs and small items of furniture. Eight single rooms have en-suite facilities and there are adequate toilets and bathrooms throughout the home. All lounges, dining areas and bedrooms are very comfortable and furnished to a high standard: There is an ongoing refurbishment programme in place.
Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 17 The inspectors saw that there are aids and adaptations such as grab rails in toilets and special lifting and bathing hoists for the residents who need help with their mobility. There are also assisted baths for residents that cannot get in and out of the bath without help. Laundry systems make sure that there are no problems with cross-infection and the laundry area is kept very clean and tidy. The inspectors generally commend the standard or furnishings and cleanliness of the home. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 18 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): 27,28,29 & 30 The residents care needs are met through good levels of staff, who have the appropriate qualifications and experience necessary to give a good care service. Recruitment policies make sure that residents are protected. EVIDENCE: The list of staff on duty showed that there are good levels of nurses, carers and domestic staff on duty at the home. The inspector spoke to carers, who were very friendly and helpful and showed that there is a very good mix of people in place. National Vocational Qualifications (NVQ) training programs are in place and 85 of staff have achieved this, with the remaining staff enrolling for the course. This is commendable. The recruitment policies and procedures are very robust and make sure that the residents are in safe hands. The inspector looked at a sample of staff training and personal files and each contained all the required information about the training programmes that had been undertaken and Criminal Records Bureau (CRB) checks. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 19 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): 32,33,34,35,36,37 & 38 The home makes sure that the best interests of the residents are protected, in that their health and safety is promoted through robust policies and procedures. EVIDENCE: Policies are in place for the protection of residents from any financial abuse. Those residents who spoke to the inspectors said that they either looked after their own money or their relatives did it for them. All records are stored in locked filing cabinets and staff look at them only when they need to find out about that particular person’s care needs.
Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 20 There are planned supervision programmes in place and the inspector looked at a sample of staff files to confirm this. Care staff also told the inspectors that they had regular supervision sessions. The inspectors examined the Health & Safety check records and equipment servicing certificates, and all were current. The inspectors also noted that there are extensive contingency plans in place for the health and safety of the service users, staff and the environment. The inspectors commended this. Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 21 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 4 3 X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 4 17 3 18 4 4 3 3 3 3 4 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 4 4 3 4 3 4 Cornmill Nursing Home DS0000006034.V254061.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NA 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.V254061.R01.S.doc Version 5.0 Page 23 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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