Inspection on 13/12/05 for Donnington Nursing Home

This inspection was carried out on 13th December 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

Donnington Nursing Home 26/11/08

Donnington Nursing Home 01/12/06

Donnington Nursing Home 14/07/05

Donnington Nursing Home 02/11/04

Donnington Nursing Home 03/06/04

Donnington Nursing Home 26/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Donnington Nursing Home Wantage Rd Newbury Berkshire RG14 3BE Lead Inspector Susan Burton Unannounced Inspection 13th December 2005 09:35 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 Donnington Nursing Home DS0000010982.V264297.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. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Donnington Nursing Home Address Wantage Rd Newbury Berkshire RG14 3BE 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) 01635 521272 BUPA Care Homes Limited Miss Joanne Kate Taylor Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Chronically disabled adults under the age of 65 years will not be received except for convalescent or respite care for periods not exceeding three weeks. 14th July 2005 Date of last inspection Brief Description of the Service: The Donnington Residential and Nursing Home was originally a large private house built in the late 19th Century that has been extended and converted. The home, which is owned by BUPA, is registered to provide care for up to 45 older people. The home is located approximately 1.5 miles from Newbury and is in a secluded area away from shops and other facilities.The home enjoys the benefits of an activities organiser who provides a varied programme of in house arts and crafts; exercise classes and trips out. The home also has a computer available for the exclusive use of service users. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection on Tuesday 13th of December 2005, which commenced at 9:35 a.m. and finished at 14.00 p.m. Neither the manager or deputy manager was on duty on the day of inspection. The inspection process was assisted by a senior nurse, the homes administrator and the maintenance man. The inspection looked at standards relating to care planning, medication, infection control, and recruitment and management arrangements. This was a most positive inspection, the home appeared calm and well organised and staff spoken to were positive and enthusiastic about their roles. Positive feedback was given to the inspector by the staff on the managers leadership approach. What the service does well: What has improved since the last inspection? Easy to read menus are displayed on each table in the dining room to assist residents in making their choice of meal. All staff in the home have been provided with infection control training. Sluices were clean and tidy with appropriate hand washing facilities provided. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 6 The organisation has agreed to provide funds in the spring to improve the access arrangements from the lounge to the front garden for the benefit of those residents with poor mobility. 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. Donnington Nursing Home DS0000010982.V264297.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 Donnington Nursing Home DS0000010982.V264297.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): 1,3 The homes Statement of Purpose and Service User Guide are available in the front entrance of the home for residents, their families and any visitors. Pre-assessment information is taken and sought to ensure admissions are appropriate. EVIDENCE: The home keeps a copy of its Statement of Purpose, Service User Guide and latest inspection report in the front entrance of the home to inform families or visitors of the services that they provide. Service User Guides are available for each individual resident. Both documents had been updated to include the details of the current Registered Manager and the staffing arrangements within the home. A sample of the care plans of the most recent admissions were examined during the inspection. A range of information had been provided to ensure that appropriate assessment had been made of the residents care needs and evidenced that the home was able to meet those needs. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 9 Donnington Nursing Home DS0000010982.V264297.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 Care plans provided detailed information of each individuals health and personal care needs. Appropriate nutritional assessments are undertaken. Assessments of psychological and emotional needs were not clearly demonstrated. Medication administration sheets are correctly filled in and controlled/scheduled drugs are stored appropriately. A recommendation from a previous inspection that residents wishes at the time of their death were acknowledged and recorded had been acted on. EVIDENCE: A number of care plans were examined during the inspection, these were detailed and informative and were seen to be reviewed on a regular basis. The inspector was able to see detailed and appropriate nutritional assessments within care plans examined. Residents at risk are provided with fluid balance charts and food wastage charts to enable staff to monitor and assess diet and fluid intake, which is good practice. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 11 Referrals to other health professionals were seen with instructions and guidance provided for staff. Discussion took place with senior nurse on how to ensure that all critical instructions were reflected in care plans. The care plans have a section where individuals social and spiritual needs are assessed, but this did not clearly evidence that appropriate psychological, cognitive and or emotional needs (such as short-term memory loss, confusion or dementia) were undertaken. Care plans need to detail the preventative and restorative care given to those with psychological, cognitive and emotional needs. The inspector examined a number of medication administration sheets, which were all found to be correctly signed for, and completed. The homes drug trolley and controlled/scheduled drugs cabinet were examined. The stock balances were checked and found to be correct. The medication fridge was clean and tidy and the monitoring of the fridges temperature took place on a regular basis. The senior nurse advised the inspector that following a recommendation made at the last inspection in regard to documenting residents wishes at the time of their death, action had been taken and documentation was put in place. Donnington Nursing Home DS0000010982.V264297.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): 13,14,15 The notice board in the entrance for the home displayed a programme of activities, events and visits for the month of December. Residents choices in regard to the time they are woken in the morning are not always acknowledged. The homes kitchen was seen to be clean tidy and well organised. Residents choices in regard to their menu selection are recorded and acknowledged. Special diets are provided for with input from the nursing staff. EVIDENCE: The homes activities notice board evidenced that trips out to carol concerts and pantomimes at the local theatre had been organised. The home has a variety of activities taking place such as arts and crafts; Bible study and a sing-along session, which was taking, place during the inspection. Residents families and friends are encouraged to visit and any queries they may have are effectively handled by the homes administrator and/or the manager. The local priest visits on a weekly basis. A newspaper cutting was displayed showing the local newspaper had featured an article about the homes sports day event from August this year. The home also visits Cirencester Polo club on an Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 13 annual basis where on this occasion the residents had the opportunity to meet members of the Royal family. The inspector spoke to two residents at length in regard to the quality of the service provided and the care given and what they felt the home did well and not so well. Both residents independently of each other commented that the service was very good, that staff were kind and caring and the food was generally good. Both also commented that they were unhappy with the time that they were woken up, both felt it was too early. This concern was communicated to the senior nurse who advised the inspector that the home had been actively trying to improve morning routines so that residents were not woken so early. There is no consultation or written acknowledgement of residents wishes in regard to the times they prefer to be woken and assisted with getting washed and dressed. The home is required to consult with the residents to ensure that autonomy and choice is given in regard to morning routines. The inspector visited the homes kitchen and spoke to the assistant chef who was in charge. The kitchen was seen to be clean, tidy and well organised. Food temperatures are recorded regularly. The kitchen is provided with a list from the nursing staff of any residents needing special or different diets. The dining room was comfortable and well presented. Menus were seen to be displayed on individual tables in an easy to read format. The days choice was displayed along with alternatives that were available, which is good practice. Donnington Nursing Home DS0000010982.V264297.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): None of these standards were inspected on this occasion. EVIDENCE: Donnington Nursing Home DS0000010982.V264297.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): 19,20,25,26 The home had been given written advice from an Environmental Health Officer; there was no confirmation that this advice had been taken. A requirement had been made at a previous inspection of the home to improve its access arrangements to the garden at the front of the home. The inspector was advised that budgetary provision has been made for this work to be undertaken in spring next year. Water temperature monitoring takes place on a regular basis to ensure that there is no risk to scalding. The homes infection control procedures appeared appropriate. EVIDENCE: Following a visit from an Environmental Health Officer in June this year, written advice had been given that the home contacts its local fire officer in regard to Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 16 one of the fire exits. The inspector was not able to see whether this advice had been complied with, the administrator and maintenance man were also unsure in the managers absence what follow-up action had taken place. The home is required to confirm to CSCI that it has followed up this advice. Requirement had been made at the last inspection following a complaint made to the home that the access from the lounge to the front garden be made safe and accessible for residents. The homes administrator and maintenance man both confirmed that the organisation had made provision in next years budget for this work to be undertaken. The progress of this requirement will be followed up at subsequent inspections next year. The inspector was able to see from the maintenance mans log sheets that regular testing of water temperatures supplied two bathrooms and hand basins takes place. One of the homes newly converted shower rooms was not working on the day of inspection due to waiting for a new part to be fitted. The maintenance man advised the inspector that this was a minor problem that would be put right as soon as the part was delivered. The inspector visited all three of the homes sluices; all were seen to be working efficiently and the areas clean and tidy. Suitable and appropriate hand washing resources were made available to prevent the spread of infection. The senior nurse confirmed that the majority of the homes staff had recently completed infection control training. The inspector was able to see that every area of the home she visited was kept hygienically clean and tidy and there were no noticeable odours present. Donnington Nursing Home DS0000010982.V264297.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): 29,30 Recruitment procedures were seen to be efficient and effective. New staff appear to have appropriate induction and training to equip them for their new role. EVIDENCE: The inspector examined to recruitment files of two new employees. The files contained evidence of completed criminal record checks and POVA checks. Contracts and job descriptions were in place and two appropriate references were seen. Efforts had been made to ensure that references were authenticated. The new employees files showed evidence that induction training had been completed and each individual aspect signed for. Training had been provided in infection control, manual handling and health and safety. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35,38 The staff in the home appeared to have a very positive attitude, morale appeared high. The residents financial interests are safeguarded by the homes procedures. The health, safety and welfare of the residents and staff are promoted and protected. EVIDENCE: The inspector spoke to a number of staff during the inspection about the homes atmosphere and management procedures. Staff commented about the positive and friendly atmosphere in the home, on their satisfaction with the management arrangements and the support given by the manager with her hands-on approach. The morale in the home appeared to be high; staff appeared to be enthusiastic and positive about their roles. The new manager was to be commended for her Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 19 efforts in providing an open, positive and inclusive atmosphere in the home where staff feel a clear sense of direction and leadership. The senior nurse that facilitated the inspection appeared knowledgeable and competent and satisfied the inspector that any issues arising from the inspection that were in her remit would be acted on straight away and would then be effectively fed back to the homes manager on her return. The organisation has a personal allowance account, which is banked into a local building society. Each resident has their own individual bank statement, which demonstrated interest payments being paid back to the individuals account. Every month a reconciliation sheet is signed which details every purchase each resident has made with the balance. All records seen by the inspector were accurate and appropriate. The organisation employs a full-time maintenance man who has been working in the home for a number of years and is very familiar knowledgeable about the policies and procedures and maintenance arrangements of his home. Evidence was provided of appropriate risk assessments, PAT testing, fire training, drills and alarm testing. The maintenance man will also check all of the fairy lights and Christmas trees that are put up each year. The homes insurance certificate was in date. Legionella testing had been completed. Maintenance contracts were in date and evidenced that all major utilities had been serviced or checked in 2005, this included the lift; hoists and the homes air pressure mattresses. Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 X X 3 X X 3 Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 21 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 OP19 Regulation 23 (4) Requirement The responsible person confirms in writing that the advice of the Environmental Health Officer has been followed up and any necessary action taken. Residents wishes and choices are acknowledged and documented in regard to their preferences for their individual morning routines. Timescale for action 13/02/06 2 OP14 12 (2) (3) 13/02/06 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 Refer to Standard OP8 Good Practice Recommendations Care plans demonstrate that residents psychological and cognitive health is monitored regularly and preventative and restorative care provided by staff is recorded Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Donnington Nursing Home DS0000010982.V264297.R01.S.doc Version 5.0 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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