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Inspection on 22/06/05 for Craigielea Nursing Home

Also see our care home review for Craigielea Nursing Home for more information

This inspection was carried out on 22nd June 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.

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

The home has a varied social programme that is enjoyed by the service users. Most of the service users can make excursions outside the home and staff support this. Extra staff are brought in to provide escorts. The home has it`s own minibus transport. The home has well maintained. It has accessible gardens that are well planted and pleasantly landscaped. The gardens are used and appreciated by service users. A well-appointed hair salon has been provided. This adds interest to service users lives as well as providing a hair dressing service. The staff are strongly committed to providing good care and relatives and service users spoke well of staff`s attitude and enthusiasm. Staff are well trained and supported by the homes management. The kitchen staff are equally enthusiastic and "home cooking" features strongly on the menu. The quality and timing of meals is good. The majority of rooms are well decorated and have a homely feel. The furnishings in bedrooms reflect the service users own tastes and interests.

What has improved since the last inspection?

The home has improved the risk assessments it makes in relation to service users care. In terms of the building, bathrooms have been refurbished and this is ongoing, however the door in the corridor separating the nursing home from the Lodge, care home needs to be upgraded to a fire door. More staff have achieved NVQ level 2 training and the target of 50% has almost been achieved.

What the care home could do better:

The home has not yet addressed the problem of the fire door in the corridor connecting the two homes on the site. Service user`s life histories could be recorded in more detail.

CARE HOMES FOR OLDER PEOPLE Craigielea Nursing Home 739 Durham Road South Low Fell Gateshead Tyne and Wear NE9 6AT Lead Inspector Tom Moody Unannounced 22 June 2005 10:00 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 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. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Craigielea Nursing Home Address 739 Durham Road Suuth Low Fell Gateshead Tyne Wear NE9 6AT 0191 487 4121 0191 487 0639 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Gateshead Dispensary Nursing Home (Craigielea Limited) Mrs Deborah Doran Care home with nursing 31 Category(ies) of OP Old Age (31) registration, with number PD(E) Physical Disability over 65 (3) of places TI(E) Terminally Ill (4) PD Physica Disability (1) SI(E) Sensoory Impairment over 65 (1 MD(E) Mental Disorder over 65 (1)l Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 One person may be in category (MD(E) for length of placement or as long as the Home can continue to meet their needs appropriately 2 One person may be in category PD for length of the placement or as long as the Home can continue to meet their needs appropriately Date of last inspection 17 February 2005 Brief Description of the Service: This home is a three storey, stone built building with a slate roof. It is a converted building. A sympathetically styled extension has provided additional communal and bedroom space. It is located in a residential area, close by the A167 in the Low Fell area. It has 31 places and is registered to provider care, including nursing care, to elderly persons. The home is run on a “not for profit” basis by a registered charity. It is close to local facilities and main bus routes. It stands in its own grounds. These are well kept and planted, and are easily accessible to service users. There is limited parking in the home but street parking is possible in the area around the home. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out, by a single inspector, on the 22 June 2005. Care practice was observed and a tour of the premises took place. Service users and relatives were spoken to. Discussion also took place with manager and staff members. Records and care plans were examined. The home has three floors and all were seen during the inspection. Some refurbishment work was taking place in bathrooms. What the service does well: The home has a varied social programme that is enjoyed by the service users. Most of the service users can make excursions outside the home and staff support this. Extra staff are brought in to provide escorts. The home has it’s own minibus transport. The home has well maintained. It has accessible gardens that are well planted and pleasantly landscaped. The gardens are used and appreciated by service users. A well-appointed hair salon has been provided. This adds interest to service users lives as well as providing a hair dressing service. The staff are strongly committed to providing good care and relatives and service users spoke well of staff’s attitude and enthusiasm. Staff are well trained and supported by the homes management. The kitchen staff are equally enthusiastic and “home cooking” features strongly on the menu. The quality and timing of meals is good. The majority of rooms are well decorated and have a homely feel. The furnishings in bedrooms reflect the service users own tastes and interests. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5 All of the assessments matched the needs of service uses ensuring that needs will be met. Relatives visit the home and look at the accommodation and receive sufficient information during the process of selecting a placement, including a written contract to ensure the placement meets their needs. EVIDENCE: The manager of the home stated that the service users receive an information package about the home. This includes a feedback section on how the admission process was for service users and their relatives. An example of this was seen and it allows users to comment on the process and staff attitude and approach to them during the period of admission and the weeks following this. Service users and their relatives confirmed that they received sufficient information and made comments such as, “The family were fully informed” and “All of the information that was given was very helpful”. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 9 The manager spoke of service user’s and their relatives being able to make trial visits to view rooms and sample meals and facilities. She did caution that most of the referrals to the home were people whose physical frailty often made trial visits in person unrealistic, although their relatives usually did this for them. Relatives who were spoken to confirmed this. The manager confirmed that service users are assessed by community care nurse assessors and hospital based professionals. The home manager and her deputy will also make an assessment before admission under normal circumstances. Assessment documentation in care plans is comprehensive and matched to service users needs. Staff are well qualified and receive regular in service training to ensure they have the skills to meet the service user’s needs. Service users and relatives confirmed that they were able to visit before choosing to stay in the home. One service user particularly confirmed that she wanted to stay in this home because it was in the locality she had lived all of her life. The manager said that most service users have a local authority, social; services contract but the home has contracts for service users who are self funding. Examples of contracts confirmed this. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10 Service users care plans are comprehensive and guide staff in providing the correct care to meet service user’s needs. The care practice in the home was good and the planned care is being carried out by care staff, ensuring service user’s needs are met. Care practice did enhance dignity and privacy of service users. EVIDENCE: Each service user has an individual plan of care. This covers all aspects of care, including social and aspirational needs, as well as clinical details. The manager said that these were regularly updated and reviewed. An examination of a sample of plans confirmed this. The manager spoke of the home having a good relationship with the local primary healthcare teams and GPs. The care plans indicate that the home accesses local chiropody and dental practitioners, as well as more specialist services such as tissue viability nurses and dieticians. Relatives confirmed this. One person stated that the home had arranged eye tests and new spectacle very soon after their relative had arrived in the home and that whenever service users needed to see the doctor this was quickly arranged. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 11 Staff said that examinations and interviews are carried out in service users own rooms to safeguard their privacy and self respect. Such an interview was taking place at the time of inspection. Service users confirmed that the staff were respectful and spoke appropriately to them. All of the staff who were seen dealing with service users behaved and spoke appropriately to them. The home has appropriate equipment to deal with health related conditions, including variable height beds, pressure relieving mattresses and moving and handling equipment. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15 The home endeavours to provide a lifestyle that matches service users needs and preferences and contacts are maintained with the community. Service users can exercise a good degree of control over their lives and the home promotes this. Meals are of good quality and the timing and choice can be varied to meet service users needs. EVIDENCE: Individual’s preferences are well recorded in the care plans that were sampled. Those service users who were in their rooms were noted to be engaged in their own past times, for example, watching television or reading and others described their interests to the inspector. On the day of inspection a lay minister was visiting the home. There is a minibus available for outings and the manager and service user’s spoke of a recent outing to The Blue Reef Aquarium at Tynemouth. The majority of service user’s comments about their experience of being cared for in the home were positive. Service users said, I love it in here.” Relatives also confirmed that, “The staff are all very nice.” Relatives confirmed that they can visit at any time and one relative confirmed that they spent most of the day with their spouse and were able to have meals at nominal cost in the home. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 13 The home has an activities co-ordinator and the social programme includes one-to –one activities such as arts and crafts, as well as entertainments and excursions. One service user and their visitor spoke of a recent “Ascot” day that included extravagant hats and a “flutter” on the horses. The home has pleasant and accessible gardens and one service confirmed that he regularly uses it and meets with other service users in the garden “for a chat.” The home has recently opened a hairdressing facility that compares well with commercial salons in the community. The modern décor and coffee machine make service users feel they have had “a trip” to the hairdressers even though they are too frail to journey out. The meal that was seen looked appetising and was well presented. Service users were very positive about the quality and presentation of the food in the home. Service users who needed assistance to eat were provided with discrete and appropriate support. All who were spoken to confirmed that they enjoyed the food in the home, one commented, “It’s good food in here.” Several service users confirmed that the chef sought out their opinions and preferences. The kitchen is well stocked with a variety of foodstuffs and it is tidy and well organised. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 standard(s) 16, 18 The homes policy on adult protection reflects the multi agency approach to adult protection, and local procedures and staff know how to use it. This should ensure the protection of service users. Service users and their relatives are confident in the complaints process and how staff will operate it particularly that staff will listen to them and take them seriously. EVIDENCE: The complaints procedure is appropriate and the level of recording, seen by the inspector, is good. The complaints policy is prominently displayed on the homes notice board as well as being in the service user’s guide. Service users and relative all said that they felt they could raise issues with the staff and found the manager approachable. The home has involved independent advocacy to represent the interests of service users and the manager has a good aware of these issues. The whistle blowing policy is appropriate and staff confirm that they are aware of this policy and would act upon it as a means of protecting service users. The current policy on adult protection is appropriate and takes into account the latest guidance. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 standard(s) 19,20, 21, 22, 23, 24, 25, 26 The environment is maintained regularly and kept clean and free from unpleasant smells, ensuring the safety and comfort of service users. The home has sufficient equipment to ensure service user’s needs are met and rooms are comfortable, furnished to service users tastes, and contain service users own possessions. EVIDENCE: The care environment has a homely feel and some bedrooms have a very domestic appearance. The design and layout of the building is suitable for the home’s stated purpose were found to be accessible. The grounds are well designed and maintained. There are paved areas accessible to service users. The home was noted to be clean, decorated to a good standard and generally well maintained. There is a useful variety of communal space spread across several separate areas and providing a different ambience in each area. This included a quiet lounge and service users were found to be making use of all areas. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 16 There is the required number of bathroom and washing facilities. One bathroom was in the process of refurbishment. The old bath was being replaced with a modern purpose built unit and the floors were being relayed. Hoists and handrails are provided and these areas are clean. Thermostatic temperature controls are fitted in bath and shower outlets. The home does have a “loop” induction coil system, for hearing aid users, installed and working in the lounge. Rooms are appropriately furnished and conversations with service users indicate they are happy with their rooms. Suitable locks are fitted to all bedrooms. The home is well lit and adequately ventilated. The temperatures were pleasant in all areas although the outside temperature was high on the day of inspection. The home is clean and there were no unpleasant odours. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 The manager ensures that the home operates safely and sufficient staff are available to meet service users needs. The home’s recruitment policy is robust and the manager ensures it operates to protect service users. Service users are looked after by staff who are well trained and up to date in their knowledge. EVIDENCE: On the day of inspection the home had 3 Registered nurses on duty, including the manager. There were also 6 carers on duty. There are normally 5 but an additional staff member had been brought in to accompany a service user to an appointment outside the home. This level of staffing is entirely appropriate for the 30 service users accommodated in the home and staff were able to respond promptly to service user’s needs. The homes recruitment policy is appropriate and samples of staff records were seen that confirmed the manager carries out the policy. 36 of the staff now have NVQ level 2 or higher qualifications. A number of staff have submitted portfolios for assessment and the home should meet the target of 50 very shortly. The homes aim is to make this 100 and the attainment of this qualification is being made a condition of employment. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37, 38 The manager is experienced and competent and the home is well managed. The manager is professional and ethical and service users benefit from the way she carries out her duties. The home is run in service user’s best interests. Staff are supervised and appropriately trained. EVIDENCE: The Registered Manager is an experienced Registered Nurse and has managed the home successfully for some time. She is completing the “Registered Managers Course”. She has also completed a student mentorship course. The staff confirm that they can approach the manger or her deputy and staff meetings take place. Relatives and service users said that they feel that they can approach the manager and senior staff. Staff and manager have a relaxed but respectful attitude to one another. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 19 Service user feedback is encouraged to promote service improvements through the use of service user questionnaires, which are included in the service user’s guide, in which service users are invited to comment on their admission experience. Service users are also surveyed on a 3-4 monthly basis. The manager said she carries out a six monthly review of the service, taking this information into account. In the past staffing rotas have been modified to reflect and meet the changing needs of service users, and in response to their feedback. The home’s policies cover induction and training. Inspection of records and discussion with staff confirm this takes place, and that training is of good quality and provided by reputable agencies. Supervision also takes place within an established framework and records are kept. Most issues of health and safety are satisfactorily addressed. Risk assessments are carried out and records, and inspectors observations, indicate that the home is well maintained. The only exception was the issue of upgrading the fire precautions in the corridor linking this home to The Lodge, residential home. Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 21 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. 1. Standard 19 Regulation 23 Requirement The door between the home and the neighbouring lodge should be upgraded to fire check standard. Timescale for action 2 / 9 / 05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT 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 Craigielea Nursing Home B52-B02 S18171 Craigielea Nursing Home V217703 220605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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