Inspection on 14/08/09 for Dove`s Nest Nursing Home

This inspection was carried out on 14th August 2009.

CQC found this care home to be providing an Adequate service.

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

Dove`s Nest Nursing Home 14/08/07

Dove`s Nest Nursing Home 26/02/07

Dove`s Nest Nursing Home 06/03/06

Dove`s Nest Nursing Home 21/09/05

Dove`s Nest Nursing Home 08/02/05

Dove`s Nest Nursing Home 13/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Dove`s Nest Nursing Home 17/19 Windsor Road Clayton Bridge Manchester M40 1QQ Lead Inspector Val Bell Key Unannounced Inspection 14th August 2009 11:00 DS0000021641.V377434.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dove`s Nest Nursing Home Address 17/19 Windsor Road Clayton Bridge Manchester M40 1QQ 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) 0161 681 7410 0161 681 3612 laura@dovesnest.co.uk Dove`s Nest Limited Post vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (14) of places Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home with Nursing - code N, to people of the following gender:Either. Whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category - Code OP Physical disability - Code PD (maximum number of places: 14) The maximum number of people who can be accommodated is: 40 Date of last inspection 14th August 2007 Brief Description of the Service: Dove’s Nest is a nursing home providing 24-hour accommodation for up to 40 people, including 14 places for people with physical disabilities. The home is owned by Doves Nest Limited. The Responsible Individual is Ms Helen Claffey. The home is situated in the North of the City of Manchester. Local facilities and bus routes are within easy walking distance. Parking is provided at the side and rear of the building. The building is an extended and converted detached house set in its own grounds. Accommodation is provided on three floors, served by two passenger lifts. The home is fully accessible to wheelchair users. Bedroom accommodation is on the lower, ground and first floor. There are 36 single and 2 double rooms. All rooms have wash hand basins and bedrooms in the physically disabled unit provide en-suite shower facilities. The double rooms have strategies in place for the maintenance of privacy. There are 4 lounges, a hair dressing room and a conservatory/dining room. A patio, sensory garden and a lawned area overlooking a wooded garden, is provided for people to sit outside in warm weather. A separate building within the grounds of the home provides administration Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 5 and training facilities. Fees charged for the services provided at Dove’s Nest vary according to a person’s assessed needs. Details of fees can be obtained by contacting the provider at the home. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a key inspection, which included a visit to the home by two inspectors. The visit was unannounced, which means the manager was not informed beforehand that we were coming to inspect. During the visit we spent time talking to people living in the home, a visiting relative, the cook, the person-in-charge and members of staff on duty. The registered provider, who had been temporarily managing the home, was on holiday. The provider had completed and returned to us an Annual Quality Assurance Assessment, which is a self-assessment of how well the home is performing. We also received completed satisfaction surveys from eight members of staff. During our visit we looked at care records, policies and procedures and we looked round the home to assess health and safety, cleanliness and hygiene. What the service does well: We found that people have thorough assessments of their needs before they decide if the home will be the right place for them to live. This also ensures that the service provided will be able to meet all their needs. The assessment process also identified any risks in the safe delivery of care and detailed what staff would do to keep people safe from harm. Care plans provided us with evidence of good practice in meeting the personal and healthcare needs of the people accommodated. Staff respected the people they cared for and provided support in a dignified and private manner. The people we spoke to liked the staff and got on well with them. A visiting relative commented that staff were welcoming and ‘very good and down to earth.’ Staff had worked hard to improve the social care needs of people living in the home, although this was hampered by a lack of funding for people assessed as needing continuing care. People using the service praised the quality of the meals provided and we found evidence that people on special diets had their needs catered for well. Staff praised the support they received to fulfil their caring responsibilities and the variety of regular training opportunities provided. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: We were concerned to find that one person’s medication had not been received from the pharmacy on time. This resulted in him being without pain relief for a significant amount of time. Staff told us that this was a regular occurrence. We have asked our pharmacist inspector to visit this home to determine if people using the service are receiving their medication as prescribed by their doctor. We were concerned to find that hot water temperatures were unacceptably high and potentially placed people living and working in the home at risk of harm from scalding. We made an immediate requirement for hot water outlets to be made safe by having the temperature regulated within recommended levels. We were given an assurance, by the person-in-charge, that this would be addressed within 24 hours. On a tour of the building we found significant risks to health and safety in the use of wedges to hold two fire doors open and an upstairs window that did not have its opening restricted to prevent accidental falls. There was no evidence that people living and working in the home had come to any harm. The registered provider assured us that action would be taken to rectify any health and safety risks. Shortfalls were found in relation to identifying peoples’ religious and cultural needs and recording how these were to be met. Risk assessments for the use of hoists should always record the name of the equipment and the size of sling to be used. This will ensure that staff have accurate information for providing support in a safe way. Where assessments of need identify that individuals use non-verbal forms of communication care plans should provide detailed guidance to staff on what they must do to support the person in expressing their needs. The Care Homes Regulations require registered services to notify the Commission, within 24 hours, of any incident that affects the welfare of people using the service. We found that the registered provider had not consistently notified us of such incidents in a timely manner. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 8 The registered person must appoint a competent manager as soon as possible. The person selected will be responsible for ensuring that the welfare and safety of people using this service is protected. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 9 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 Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given good information and have their needs assessed before deciding whether the home will be a good place for them to live. EVIDENCE: The person in charge showed us a copy of the current Statement of Purpose and Service User Guide. Both documents contained all the information required by regulation. We liked the section entitled ‘Your questions answered’. This covered issues that people using this service find important and included clear information about the home’s policies and procedures. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 11 We looked at the care records belonging to four people living in the home. Detailed and thorough assessments of their needs had been carried out prior to deciding that the service would be able to meet their needs. The assessments included identified risks and how these would be managed to keep people safe from accidental harm. Risk assessments on the use of hoists should identify the type of equipment and the size of sling that must be used. This will ensure that the correct equipment is used to transfer people in a safe way. More attention should be paid to assessing how individuals’ religious and cultural needs will be met, as these were not recorded in the four care records that we examined. Assessments contained good evidence of referrals to relevant healthcare professionals, such as physiotherapists, dieticians and speech and language therapists and records demonstrated that staff regularly followed their advice and guidance. This home does not offer an intermediate care service. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Dove’s Nest have their personal and healthcare needs met and this is provided in a manner that protects their privacy and dignity. EVIDENCE: The four care plans we examined had been drawn up from assessment information and these provided good evidence that the personal and healthcare needs of these four people were being reviewed regularly and consistently being met. Nursing and care staff worked hard to follow guidance provided by healthcare professionals, such as general practitioners, physiotherapists, dieticians, psychiatrists and speech and language therapists. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 13 This resulted in positive health outcomes for the people they cared for. We observed interactions between staff and people living in the home and it was evident that their relationships were based on respect and that staff recognised their rights to receiving care and support in a private and dignified manner. With reference to the staff, one person said, ‘they look after me well’ and a visiting relative commented, ‘Staff always make me feel welcome. They are very good and they’re down to earth.’ People using this service can be confident that staff will regularly monitor their wellbeing in relation to nutrition and weight. However, we recommend an improvement to the manner in which the dates weights were being recorded, e.g. May 2009. The actual day on which the weight is taken should be recorded, to accurately alert staff to the exact period of significant weight loss or gain. Similarly, care plans should contain more detail in relation to the methods used by people with non-verbal communication and what staff must do to support them to express their needs. We examined the medication system in place for the four people whose care plans we had seen. Medication administration records appeared to be accurate and up to date and all medicines were stored securely in the clinic room. We observed appropriate medication administration procedures being followed by staff. Several entries on the medication records were marked with the letter ‘O’. The key printed at the bottom of the page stated that ‘O’ meant ‘other’ and that this needed an explanation to be written on the reverse of the MAR sheet. The nurse-in-charge explained that nursing staff write ‘O’ to indicate that medication has been ‘omitted’. Staff must be clear about what this means and should record an explanation of why medication has not been administered. We were concerned that one person’s pain relief medication had run out at the beginning of the week. The person-in-charge and the lead nurse explained that they had ongoing problems with the pharmacist, who regularly delivered an incomplete weekly supply of medicines with messages to say that the missing medication ‘would follow on’. It is not acceptable for people to be without their pain relief, particularly in relation to a person who has no verbal communication and who relies on staff to recognise when he is in pain. We have asked the Commission’s pharmacist to visit this home, because we were concerned that people using this service may not always receive their medication exactly as prescribed by their doctor. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The quality and choice of meals were praised and peoples’ special dietary needs were met. EVIDENCE: During our visit we observed that daily routines in this home were flexible and varied. Since our last visit improvements had been made to recording each person’s interests and activities and generally this provided people with opportunities to participate in the things they liked to do. Books and newspapers were provided around the home. Specialist facilities were available to meet the sensory needs of people living in the home. These included a multi-sensory interactive room and a mobile sensory system that enables stimulation in response to music, light and touch. We were told that particular Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 15 attention had been paid to researching suitable and appropriate community facilities, although there was little written evidence of the considerable work undertaken in this area. The home employs a lifestyle co-ordinator for 20 hours per week to work with people living in the service to build up a picture in identifying their hobbies and interests. We recommend that this is done with the aim of achieving a more person-centred approach that recognises the aspirations and goals of the individual, including what support will be provided to enable people to participate in their local community. A person we spoke to said that a member of his family used to take him out but they were ill so it didn’t happen anymore. He said, ‘On odd occasions I have been to the park.’ His view was that, ‘they did not have the staff spare to go out.’ People were encouraged to maintain relationships with their family and friends and visitors were observed to come and go throughout the time we spent in the home. One of the visitors told us that he was always made welcome by staff and that he visited every day. The meals provided in this home were varied, appealing and nutritious. Special diets were catered for according to the assessed needs of each person living in the home. Staff were on hand to support people who needed assistance to eat and we observed this being done in an unobtrusive manner. Staff told us that snacks and drinks were available at any time and were particularly encouraged for people who are at risk of weight loss. Four people told us that they liked the meals provided. Another person said, ‘we have a choice of meals and we are asked every morning what we want for lunch and in the afternoon for what we want for tea. Breakfast is served from 8am until everyone is up. If you decide to get up at 9.30 you’d be asked what you wanted to eat and you can have a full English breakfast if you want. They cook it fresh for you when you’re ready.’ Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home and their relatives are able to complain and action is taken to respond to their concerns. EVIDENCE: People moving into the home are given written information on the procedure for expressing concerns and complaints. The people that we spoke to said they knew who to speak to if they had any concerns and they were confident that these would be dealt with and resolved to their satisfaction. Eight staff completing surveys told us that they knew what action they must take if someone had concerns about the home. The self-assessment completed by the manager told us that no formal complaints had been received by the home in the previous twelve months. This service had a policy and appropriate procedures in place for responding to allegations or suspicions of abuse concerning the people living in the home. Staff employed by the home had received training in how to recognise the Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 17 signs and symptoms of abuse and what action they must take if a person was suspected of being at risk of harm. The staff we spoke to knew what their responsibilities were in relation to safeguarding the welfare of the people they cared for. There had been two safeguarding referrals made to the local authority in accordance with safeguarding procedures during the previous twelve months. The registered person had failed to notify us about these in a timely manner as required by The Care Homes Regulations. However, we saw written evidence that these incidents had been managed well and that both individuals had been safeguarded from further harm. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 18 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Significant shortfalls in the environment potentially placed the health and welfare of people living and working in the home at serious risk of harm. EVIDENCE: We looked around several areas of the home including bedrooms, bathrooms, dining room and lounges. It was evident that the major refurbishment was almost complete and this had provided a modern and attractive environment for people living in the home. We saw that the newly redecorated areas were Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 19 clean and hygienic and where possible, individualised with people’s personal effects. Specialist nursing beds were in use to aid the comfort of people accommodated in the home. We saw that several carpets in the section of the home awaiting refurbishment were stained and one was identified as a tripping hazard. They told us that they would make the section of the carpet secure. We saw that people did not have the opportunity to lock their bedroom door for privacy, although we were told that this facility was going to be provided during the refurbishment. In one area of the home waiting to be refurbished we saw that a nurse call point had no cover leaving the wires exposed. It was unclear if this presented a health and safety risk. We were later told by the provider that the nurse call system operates on 12 volts and did not constitute a health and safety risk. We saw that three steps up to bedrooms in the same area had no floor covering and could create a hazard for people with poor eyesight or cognitive impairments. We recommended that a risk assessment be carried out on this area. We saw several bedrooms had ‘door guards’ fitted as a means of holding bedroom doors open at the discretion of the people accommodated. Two other bedroom doors were held open with door wedges. Using wedges to secure fire doors may potentially place people at risk of smoke inhalation in the event of a fire. We recommend that only devices recommended by the home’s fire safety officer be used for this purpose. In two bedrooms of the area waiting to be refurbished on the first floor, one room had no window restrictor fitted. All windows above ground level must have their openings restricted to prevent accidental falls A selection of appropriate bathing facilities was available to meet people’s choice and needs, including a hydrotherapy bath. The first floor lounge contained a light and sound interactive system which could be programmed for anyone to use any of the games. These were good facilities that had been provided in the best interests of people accommodated in the home. All the hot water outlets that we tested around the building felt extremely hot to the touch. We left an immediate requirement for all hot water outlets to be tested within 24 hours to ensure that temperatures did not exceed the recommended level of 43˚C. Subsequent to the inspection the provider told us that hot water outlets accessible to people living in the home are protected by thermostatic mixing valves and that slight adjustments have been made to ensure that temperatures are no higher than 43˚C. We were also concerned that one of the bathrooms did not have an available thermometer for staff to test the temperature of hot water before people were immersed in the bath. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 20 Due to building works fire exits had been changed. However, the fire risk assessment that we were shown during our visit had not been updated to accurately reflect these changes. During a subsequent telephone conversation the provider told us that any shortfalls found during the inspection would be addressed and the environment made safe. During the visit we looked at what procedures were in place relating to infection control following an assessment carried out by Manchester Community Infection control team. We saw that foot operated bins, liquid soap and paper towels were in place in bathrooms and toilet facilities and hand washing sinks were accessible. We saw that aprons and latex gloves were available around the home for use. This provided evidence that the action plan recommended by the infection control team had been addressed. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements, recruitment and training ensure that people are cared for and supported safely. EVIDENCE: There were sufficient nurses and support staff on duty when we arrived at the home. All the staff confirmed that this was sufficient in meeting the assessed needs of the people they were caring for. Of the eight staff completing surveys, two said that there were always enough staff and six said that this was usually the case. From conversations with staff on duty and from the eight completed surveys we were told that they were provided with excellent opportunities for training and development and they received the support they needed to meet the assessed needs of the people accommodated. Staff talked about the people they cared for in a respectful manner and they had a good understanding of their needs and how these should be met. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 22 A care assistant told us that she had started work at the home earlier that week. She had several years’ relevant experience and had achieved a National Vocational Qualification in care at levels 2 and 3. She said that she was currently on an induction programme and was shadowing an experienced member of staff. She confirmed that the provider had obtained a Criminal Record Bureau check and two written references before she started work in the home. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and safety of people within the home is not always maintained, which could leave them at risk. EVIDENCE: When we arrived at the home we were told that the provider was on holiday. A suitably qualified and experienced person had been left in charge of the home. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 24 The provider had been temporarily overseeing the day-to-day management of this home since the resignation of the registered manager in October 2008. The provider is not a qualified nurse and we have not been informed of the person who has been appointed to take lead clinical responsibility while a new manager is being recruited. We contacted the provider on her return from holiday to ask her when a new manager would be appointed. She told us about the interviews she had conducted during the past ten months, but had been unable to identify a suitable person to manage the home. We were concerned about the number of health and safety issues found during our visit, which potentially placed people living and working in the home at serious risk of harm. It is important that the provider appoints a qualified person as soon as possible to take day to day responsibility for managing such issues in the best interests of people using this service. The registered person told us that the health and safety issues, detailed under Standard 19 in this report, would be dealt with. The person-in-charge told us that they had recently sent out satisfaction surveys to people living in the home as part of their monitoring of quality assurance, although none had been returned by the time of our visit. People living in the home, who needed support to manage their personal finances, received assistance from their relatives or the client affairs department of Manchester Social Services. Staff working in the home did not act as appointee for any person’s spending money. Records of all personal allowance transactions were maintained in the home’s office. We looked at a sample of health and safety records and were satisfied that equipment used in the home had been serviced on a regular basis. Staff had received the required health and safety training to ensure that working practices were safe. Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 25 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 3 9 3 10 3 11 X 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 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 26 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 13 Requirement Hot water outlets, accessible to people living in the home must have their temperature restricted to a safe level to avoid the risk of harm from scalding. The health and safety risks identified in this report must be remedied to ensure that people living and working in the home are safe from accidental harm. The registered person must appoint a manager who will be in day-to-day charge of the home and who will make an application to be registered with the Commission. Timescale for action 15/08/09 2. OP19 13 21/08/09 3. OP31 8 14/11/09 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 Good Practice Recommendations DS0000021641.V377434.R01.S.doc Version 5.2 Page 27 Dove`s Nest Nursing Home 1. Standard OP3 Assessments of need should record individuals’ religious and cultural needs and care plans should detail how these will be met. Risk assessments should include details of the specific equipment to be used so that staff can support people with their mobility in a safe way. The registered person should ensure that the Commission is notified promptly of incidents affecting the welfare and safety of people living in the home. This will ensure that the wellbeing of people using this service can be monitored. 2. OP3 3. OP18 Dove`s Nest Nursing Home DS0000021641.V377434.R01.S.doc Version 5.2 Page 28 Care Quality Commission Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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