Inspection on 23/11/05 for Cottingley Hall Nursing Home

This inspection was carried out on 23rd November 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.

Other inspections for this house

Cottingley Hall Nursing Home 05/02/09

Cottingley Hall Nursing Home 04/12/07

Cottingley Hall Nursing Home 12/12/06

Cottingley Hall Nursing Home 12/07/05

Cottingley Hall Nursing Home 03/11/04

Cottingley Hall Nursing Home 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Cottingley Hall Nursing Home Bradford Road Bingley West Yorkshire BD16 1TX Lead Inspector Kathleen Firth Announced Inspection 23 November 2005 10:25a 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 Cottingley Hall Nursing Home DS0000019866.V251865.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. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cottingley Hall Nursing Home Address Bradford Road Bingley West Yorkshire BD16 1TX 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) 01274 592885 01274 532563 BUPA Care Homes (BNH) Limited No. 2079932 Mrs Susan Sowden Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (51) of places Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That Susan Sowden completes the NVQ level 4 in Care within a timescale of 18 months from September 2005 That Susan Sowden complete units RM1 and RM2 of the Registered Manager’s Award within a timescale of 2 years from September 2005 12th July 2005 Date of last inspection Brief Description of the Service: Cottingley Hall is registered to provide nursing care to people over 65 and is owned by BUPA. It is situated just off the main road between Saltaire and Bingley. Accommodation is provided in thirty single and five double bedrooms. All except one have en-suite facilities. There are two lounges, two dining rooms and a library. There are extensive garden areas with seating provided for the residents. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over 6.25 hours by one inspector on Wednesday 23rd November 2005. The inspector toured the building, examined residents’ records, including care plans, menus, staff rosters, staff files and the Service User Guide. Staff, residents and visitors were very helpful throughout the inspection process. Seven residents, twelve staff members, administrator and three relatives were spoken to during the inspection. The manager was present throughout the inspection and had completed the pre-inspection questionnaire prior to the day. What the service does well: The home provides an excellent standard of accommodation with good quality furnishings and fittings. It is well maintained both inside and out with extensive garden areas. Individual rooms are of a very good size and have been personalised by the residents. The communal rooms are very comfortable and offer a safe environment to the residents. Each resident has a comprehensive care plan in place with all of their needs clearly identified along with the tasks needed to be done in order to meet these needs. Communication amongst the staff is very good and there are good feedback systems to make sure relatives are kept up to date with what is happening. Regular staff meetings and supervision sessions are in place and the manager makes herself available to staff, residents and visitors where this is appropriate. Residents are encouraged to be independent and regular meetings are held where they can put forward any ideas and concerns they may have. The ones spoken to said that they are well looked after and that staff are always kind and polite. Relatives spoken to also made this comment. People are very happy with the food provided at the home and the dining room offers a very comfortable place to eat their meals. A wide range of activities is offered at the home and residents were seen to join in and enjoy some of these. Families and friends are able to be involved at the home and are welcomed. There is a commitment to training at the home and staff confirmed that they are able to access relevant courses. Most of the care staff have completed or are working towards NVQ level 2 or 3. The qualified nurses are able to continue with their post registration education. Recruitment procedures are robust to make sure that suitable staff are employed and that the residents are protected from abuse. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 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. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 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 Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 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, 4, 5, 6 Residents are assessed before being admitted to the home and this makes sure that the home can meet their needs. People are able to visit the home before they decide to come and live there. EVIDENCE: The deputy manager visits all prospective residents to carry out an assessment of their needs. On some occasions the manager may do the assessment and if there is any particular problems then two members of staff will visit. Residents and their families can be confident that their needs will be met at the home otherwise an admission will not be agreed. The manager and staff look at any equipment needs that a prospective resident may have as if this cannot be provided the person cannot be admitted. Also, they look at the type of residents they have to make sure that admitting someone else does not result in staff not being able to meet the needs of those people already living at the home. The pre-admission assessments seen in the files contained sufficient information for staff to decide if they are able to meet the person’s needs. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 9 All prospective residents are invited to look round and spend time at the home as part of the pre-admission procedure. If this is not possible the manager asks their family or representative to so this on their behalf. Some residents spoken to said that they had visited whilst others said that their family had done this on their behalf. The home does not provide intermediate care at this time. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 10 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, 9, 11 All of the residents’ needs including health, social and religious are fully met. Residents are able to stay at the home until their death if this is their wish and staff are able to meet their needs. EVIDENCE: The manager and staff have worked hard on the care plans since the last inspection and all those seen are very comprehensive. Residents’ needs are well documented along with the actions needing to be done in order to meet these needs. Evidence was seen of health professionals’ input into some care plans where this was appropriate. Specific instructions are clearly recorded, as are GP visits, the reason for them, the outcome and any actions required. A photograph of a wound was seen in the file and the wound care sheet was thoroughly completed. Risk assessments are in place as required. There was evidence that any specialist equipment is obtained and weight and nutritional checks are made where these are needed. The care plans are reviewed and updated on a regular basis. Residents are registered with various GPs including some private ones. They receive good support from the local healthcare teams including specialist Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 11 services such as the Tissue Viability Nurse, Diabetic Nurse and the McMillan service. Evidence was seen that arrangements are in place Dental, Optical and Chiropody services. Some people are able to manage their own medication and sign a disclaimer to state that they are taking full responsibility. This is risk assessed before residents are allowed to take responsibility. A lockable space is provided in individual bedrooms for the storage of medication. The home has a policy and procedure in place to deal with the remaining residents’ medication needs. The Nomad system is in use with only qualified nurses administering medication. The deputy manager who is new in post is due to take over the ordering of medication. The home has recently introduced a new disposal box for unused medication. All nurses are able to use this and then record what items they have put into the box. This box then leaves the home as a sealed unit when it is full. All records concerned with medication were maintained correctly. Residents’ photographs and nurses’ signatures are all in the front of the medication file. Residents’ wishes following their death are recorded as soon as possible after admission. If someone wishes to stay at the home to die and their needs can still be met then the manager is happy for this to happen. GPs, families and any specialist services that may be required are all consulted along with the resident before the decision is made. Family and or friends are able to visit the home during this time and stay if they choose. Cottingley Hall Nursing Home DS0000019866.V251865.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, 15 Residents are encouraged to be part of the decision making process within the home and to make choices regarding their own lifestyle. They are able to maintain contact with family and friends who are welcome to visit at any time. The home provides a good, varied, nutritious diet taking into account individual choices. The home offers a good choice of activities for the residents. EVIDENCE: An activities organiser is employed at the home and her working hours have recently been increased by ten hours each week. A list of activities is displayed on the notice board. Entertainers come into the home to perform different things and residents certainly have a good choice of things to do. Tea dances, theme days, flower arranging, newspaper reviews are just some of the activities offered. One to one time is spent with residents where this is their preferred choice. Residents spoken to said they were looking forward to the entertainer due to perform that afternoon. They enjoy the activities and feel well looked after at the home. At the time of the inspection a pre-Christmas dinner was being organised for people whose family will not be able to visit on the actual day. The “Twelve Days of Christmas” is planned with something different happening each day. Fortnightly themed coffee afternoons are held with families and friends invited to attend. Residents at the home raised £1700.00 for cancer at a garden party held in the summer. They were discussing which charity to donate money the residents are hoping to raise at a Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 13 Christmas event. Residents were busy making gift-tags and seemed to be enjoying this. Residents are able to go out and about with family and friends or alone if this is risk assessed and felt to be safe for them to do. This is clearly recorded in their care plan. The local Beaver and Cub group was due to visit the home nearer to Christmas to sing carols with the residents. A Church of England service is held at the home each month and other religious ministers visit to make sure that the residents’ spiritual needs are met. The manager holds a meeting with the residents on a quarterly basis where people are asked to contribute their views. An agenda and minutes are available for these meetings. Residents are able to go to bed and get up at the times they choose and these are recorded so that staff are aware of them. People can sit where they choose and join in with the activities they prefer. There is a library where residents can sit quietly. There is a dining room where residents can hold private parties if they wish. Information from the pre-inspection questionnaire showed that the home serves a good, nutritious and well balanced diet. This was confirmed during the inspection and residents said that they enjoy the food. The dining room is decorated and furnished to a very high standard offering everyone a comfortable place to eat their meals. People can eat in their own room if this is their preferred choice. Cottingley Hall Nursing Home DS0000019866.V251865.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 and their relatives have their views listened to, taken seriously and action taken to resolve issues. Residents can be sure that their rights are protected and that they are safe from abuse. EVIDENCE: Residents, their families and friends are able to speak to the manager and staff if they have any concerns or worries. Examples of this were seen during the inspection and visitors spoken to confirmed that they are able to approach staff at the home if they wish to discuss anything. There have been three complaints since the last inspection, two were not upheld and the third dealt with in an acceptable way as the policy and procedure at the home. Complaints are monitored and details sent to BUPA head office on a monthly basis. There is a Whistle Blowing policy in place at the home. Most of the staff have received Adult Protection training and the manager feels sure that they will recognise the signs and symptoms of abuse and know what to do. The home has a policy and procedure in place to deal with this matter. All residents are registered to vote and most of them do so. This is normally by post but people can be taken to the polling station if this is their choice. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 15 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, 21, 22, 24, 25, 26 The home is furnished and decorated to a very high standard, is regularly maintained and offers a safe, comfortable environment to the residents. People are able to access all parts of the home and grounds. EVIDENCE: The home is well maintained both inside and out and offers a comfortable and safe environment. Furnishings and decorations are of an extremely high standard throughout and the communal rooms offer sufficient space to all the residents. There is a library where people can sit and be quiet if this is their choice. The gardens are extensive and well maintained with easy access for the home. Some residents spend time in their room and they all appeared to be content in these surroundings. There was evidence of people having their personal mementos and things that are important to them in their rooms. Adequate arrangements to ensure privacy are in place where the room is shared. Some of the bedrooms have patio doors leading to a terrace area overlooking the Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 16 garden. This area is furnished in the spring and summer periods. All rooms have en suite facilities. There are enough toilet facilities near to the communal rooms for residents to use and evidence was seen that soap and towels are in plentiful supply. Assisted bathing facilities are available at the home. The home is very clean and tidy and evidence was seen of the domestic staff working throughout the inspection. Equipment is stored in specific areas where it does not cause any problems for staff, residents or visitors. Residents are happy with the level of cleanliness and no malodours were present. Specialist equipment including profiling beds, hoists and mobility aids were all seen during the inspection. The manager said that she is usually able to obtain any specialist equipment required by residents and does not agree to the admission of a person if anything they require is not available. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 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): 27, 29, 30 Residents are supported and protected by robust recruitment procedures. Staffing numbers and skill mix make sure that the residents’ needs can be met. EVIDENCE: There were sufficient staff on duty at the time of the inspection and residents and staff spoken to say that this was the normal pattern. Staff rosters viewed from the pre inspection information confirmed the numbers of staff on duty at any time. The manager said that she would request more staff if she felt it was required. Care staff spoken to thought that more staff were needed but the nursing staff felt that the numbers were sufficient. Where one to one care is needed this can be accessed via the local Primary Care Trust. There is always a mixture of nurses and care staff on duty and no changes to the rosters are allowed without the manager or her deputy’s permission. This is to make sure that the correct skill mix of staff is always on duty. Staff files were seen to contain all the required information. The manager said that all interviews are carried out in line with equal opportunities and any notes taken are retained. POVA, CRB, Visa, work permit checks are made and two references obtained before someone can start working at the home. Regular staff meetings are held at different levels and between the various teams. Agendas and minutes are always made available for these meetings. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 18 Most of the care staff are working towards or have already achieved NVQ level 2 and two people have Level 3. Qualified staff are able to continue their Post Registration Education. Staff can access relevant training and have recently completed wound care, catheter care and Peg feeding through the PCT and are hoping to complete Challenging Behaviour in the near future. One overseas nurse is completing her Adaptation course. Handovers are done before each shift change and communication amongst the staff is good. Evidence of good interaction was seen amongst the staff team and with the manager and residents during the inspection. Cottingley Hall Nursing Home DS0000019866.V251865.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): 31, 32, 33, 35, 36, 38 The home is well managed and the interests of the residents are seen as very important to the manager and staff. The manager offers good leadership to the staff and makes sure that the residents are protected and cared for in a correct manner. EVIDENCE: The manager holds a management qualification and has many years working in the care home field. She is working towards NVQ Level 4 in care. Staff, residents and visitors were all seen to have a good rapport with her throughout the inspection. She has had to work very hard at the home with the staff team, as she is not a qualified nurse. Earlier difficulties appear to have been surmounted and staff all spoke highly of the support she offers them. One nurse said that the nursing staff are now given more responsibility than previously and that they appreciate this. Staff are involved in the manager’s appraisal and she recently gained a high score from them. The manager holds Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 20 regular meetings with the residents and has a very visible presence in the home. Good interactions were seen between her, the staff, residents and visitors. An open door policy is in place and this was very evident on the day of the inspection. Regular staff supervision sessions are in place with written agreements and records. There is a good self-assessment tool in place for quality assurance. An annual questionnaire sent to residents and families has produced mostly positive results. The Local Authority report from a questionnaire sent to relatives during the summer produced some very positive comments about staff and the services provided at the home. Financial records seen for monies spent on behalf of the residents were correctly maintained and receipts available. The Bursar deals with all of these matters and is responsible for all the financial matters at the home. The manager has overall responsibility for Health and Safety at the home although all staff receive training in this during their induction and then by distance learning. A staff member chairs the Health and Safety meetings. There is a Health and Safety committee and this carries out any risk assessments. All the necessary safety checks are carried out as required including weekly testing of fire bells. One person is responsible for fire training at the home whilst another is the Movement and Handling trainer. There is always someone trained in first aid on duty. Cottingley Hall Nursing Home DS0000019866.V251865.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 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 4 X 4 4 4 4 4 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 4 Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 22 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. Refer to Standard Good Practice Recommendations There were no recommendations from this inspection. Cottingley Hall Nursing Home DS0000019866.V251865.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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. 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