Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 31/01/06 for County Homes Nursing Home

Also see our care home review for County Homes Nursing Home for more information

This inspection was carried out on 31st 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

NHS and other health professionals are actively involved in the care of residents as needed. The residents spoken to told the inspector that the staff are kind and caring, and it was observed that the staff respect their privacy and dignity. An increasing range of activities is offered by the designated activities co-ordinator who works for 40 hours per week; with both individual and some group activities, including outings, being available. Ongoing training and development was seen for most staff.

What has improved since the last inspection?

Environmentally, the home has undergone a transformation in terms of the standard of decoration, personalization, furnishings and bedrooms. Most areas are now homely, safe and clean; with the areas identified in the main body of this report planned to be refurbished and redecorated very soon.

What the care home could do better:

Continue with the refurbishment and redecorating programme, including additional personalization of rooms and corridors (as far as practicable).

CARE HOMES FOR OLDER PEOPLE County Homes Nursing Home 40 New Hey Road Woodchurch Birkenhead Wirral CH49 5LE Lead Inspector Julie King & John McCabe Unannounced Inspection 31st January 2006 09:00 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 County Homes Nursing Home DS0000020949.V277771.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. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service County Homes Nursing Home Address 40 New Hey Road Woodchurch Birkenhead Wirral CH49 5LE 0151 604 0022 0151 604 0066 county.homes@ashbourne.co.ujk 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) Modelfuture Limited, Paula McCabe Care Home 90 Category(ies) of Dementia - over 65 years of age (88), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2) County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Five named adults under 65 years of age within the maximum number of 90 Two named adults in the category MD(E) within the maximum number of 90 2nd August 2005 Date of last inspection Brief Description of the Service: The Home is a purpose built two-storey building. The Home is registered to provide ninety beds for the care of older people with dementia. The Home is divided into three separate units, which are named after northern cities, Chester, York and Lancaster. A First level registered nurse is in charge of each unit, day and night. All three units have access to a secure garden area. The home is situated on the Woodchurch estate close to all amenities such as shops, libraries. The M53 motorway is close to the home, which affords motorway access to Liverpool and the North Wales coast. There are six double bedrooms and eighty-four single bedrooms that have a shared en-suite toilet. There is a service lift on each unit to access the first floor. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory unannounced inspection took place over six hours and was completed by CSCI Inspectors Julie King and John McCabe. A full tour of the premises took place. A range of records such as care plans, staff personnel files, policies & procedures and medication charts were examined. A selection of staff on duty, and a number of residents were spoken to during the course of this inspection. What the service does well: 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. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 6 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 County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 7 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): 1,2,3,4,5. The residents assessed needs are being met, and the home is able to provide assurances to residents and their representatives that assessments will be a continuous process throughout the resident’s stay. EVIDENCE: Residents are only admitted into the home on the basis of a full assessment is carried out prior to they move in. All pre-admission assessments are carried out by either the acting manager or senior nurse, and include direct input from the prospective residents’ family / representative as agreed. Multidisciplinary healthcare team members such as the residents’ social worker, physiotherapist or NHS ward nurse, are part of this process. Specialist healthcare professionals continue to be involved in the care of residents after they are admitted into County Homes. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 8 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): 7,8,9,10,11. There is a consistent care planning system in place for most residents. This provides staff with the information they need to satisfactorily meet the residents’ needs. EVIDENCE: Individual care plans had been documented for each resident, and all seen were in the process of being updated and reviewed with the involvement of the individual residents as far as possible. Improvements were seen in the care plan detail and in the way they are recorded on a daily basis, and improvements were seen regarding the recording of observations following falls by residents. Systems are in place to ensure good communication between the care home, the NHS and other professionals involved in the care of all the residents. Medications, the medication rooms and related records and documents were examined as part of this unannounced inspection and found to be satisfactory. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 9 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 supported to participate in the local community through the use of healthcare and leisure facilities. The routines within the home are flexible, which means family, and friends are welcome to visit at any time and residents can go about their day as they choose. Residents receive a varied nutritious diet that is in accordance with their preferences. EVIDENCE: Residents at the time of their admission are asked about their lifestyle preferences. Each resident, with help from a family member, is encouraged to complete a “Getting to know you” questionnaire, which is a “Work life History” of the resident, and includes past significant events such as schooling, work, hobbies, as well as food likes and dislikes etc. This information is used to plan organised activities for the resident. The home has employed an activities co-ordinator full time, who also has an input in arranging meetings and training courses with other activities coordinators in the company. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 10 The home has a large activities room, plus a “Bar” which residents and staff can celebrate birthdays and other events. Every day eight-residents from the different units are escorted to the bar where they have lunch, served by the coordinator. This small group gives the residents an opportunity to get to know each other, socialise and have lunch in quiet surroundings. This is good practice, its therapeutic and will benefit the residents. The home central garden area has improved since the last inspection, it is now safer for the residents to walk in. In the summer moths seating will be placed in the garden for both relatives and residents to sit out. The activities coordinator escorts one or two residents out to the local supermarket for personal shopping. Residents who participate in activities, the outcome are recorded in their personal file. Visitors are allowed in the home at any reasonable time of day and residents may entertain their visitors either in the communal lounges, or in their own bedroom. The home has an experienced chef. The resident’s menus are printed and are planned on a four-week rota. Resident’s menus are displayed on white boards in the various lounges and dining rooms. Residents who need assisted feeding have sitting at lunch, this helps to maintain their dignity. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 11 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. An efficient complaint and adult protection policy and procedure were in place to help ensure the safety and welfare of residents. EVIDENCE: County Homes has an efficient complaint and adult protection policy and procedure in place to help ensure the safety and welfare of residents that they, their relatives and staff can access when necessary. This procedure includes information on ‘whistle-blowing’, in accordance with the Department of Health ‘No Secrets’ guidelines. Most of the staff have, or are in process of completing training in adult protection, with the remaining having training planned for the near future. However all staff do receive basic training in the protection of vulnerable adults during induction. Some advocacy information was available if required by residents or their relatives. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 12 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. The standard of decor within this home is improving, with evidence of continuing improvements, through maintenance and planning. The home is being to present as a homely, safe and comfortable environment for the residents. EVIDENCE: Since the last inspection, all the main corridors and bedrooms in the home have been redecorated and painted. Many new pictures have been hung on the walls, which had recently been painted. There is documented research which states that people with dementia benefit from extra light especially throughout the daytime hours; the new ‘light and airy’ look of the home should benefit the residents. Many of the resident’s bedrooms have been personalised with photographs and memorabilia. All wardrobes are now secured to the wall to prevent accidents; toiletries are kept in the upper part of the wardrobe out of reach of the residents to help avoid any accidental ingestion of the products County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 13 It was noticed that many of the resident’s hand/bath towels were beyond repair, some were torn, and others were threadbare and useless for purpose. The acting manager told the inspector that they would be taken out of service immediately. The homes kitchen was clean and tidy; chef was preparing liver, or mince, and vegetable pie for lunch. Food is available throughout the 24 hours for residents. Many of the residents enjoy sweet food at nighttime and various biscuits/cakes are available for them. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 14 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. There are sufficient numbers of staff with complementary skills to meet the needs of residents. EVIDENCE: The home is staffed with adequate numbers required to meet the needs of the residents, with a qualified nurse and four or five care staff on duty in the daytime on each unit. Additional staff are brought in to accompany residents to hospital appointments, etc. The staff rota evidenced a much lower use of agency than in previous inspections; with the homes own staff covering the majority of hours. Staff spoken to during the inspection confirmed that a range of mandatory and specialist training was now available, with the majority of the cost being paid for by the care home. This approach to training is a positive aspect of County Homes, as it helps ensure that residents are being cared for properly and their needs are being met in accordance with current good practice guidelines. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 15 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): 31,32,33,34,35,36,37,38. The home regularly reviews aspects of its performance through a programme of self-review and consultations, which include seeking the views of residents, relatives and staff. EVIDENCE: More quality assurance is now in place, with feedback and minutes of staff meetings kept. The staff made positive comments and suggestions by all spoken to, and are pleased with recent positive changes brought by the acting manager. Patient’s monies are kept in separate, secure facilities, and records of all transactions were seen. The acting Certificates of worthiness for gas, electric and public (employee’s) liability were up to date and valid, as were fire certificates and training. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 16 The acting manager completes a monthly accident audit of all falls that residents have, and Regulation 26 & 37 forms are sent into the Commission on a regular basis. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 17 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 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 18 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. 1. Standard OP26 Regulation 16 Requirement The registered person must keep the care home clean and free from malodour at all times – refer to the one double room identified during the inspection. The registered person must ensure that all staff receive specialist training relevant to the residents group, and records of this are kept. Timescale for action 31/03/06 2 OP 30 18 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP19 OP22 Good Practice Recommendations Additional pictures are obtained for the corridors and communal areas. It is strongly recommended that a set of weighing scales, suitable to the physical and mental health needs of the current residents, are obtained as soon as practicable. This was identified in the previous inspection and has not been actioned upon. County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Liverpool Local Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 County Homes Nursing Home DS0000020949.V277771.R01.S.doc Version 5.1 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!