Inspection on 24/10/05 for Durban House Nursing Home

This inspection was carried out on 24th October 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

Durban House Nursing Home 30/01/07

Durban House Nursing Home 01/06/05

Durban House Nursing Home 17/01/05

Durban House Nursing Home 16/09/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Durban House Nursing Home Woodley Lane Romsey Hampshire SO51 7JL Lead Inspector Anita Tengnah Unannounced Inspection 24th October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Durban House Nursing Home DS0000060803.V260742.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. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Durban House Nursing Home Address Woodley Lane Romsey Hampshire SO51 7JL 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) 020 8954 0239 J Sai Group Limited Miss Belinda Jane McClatchey Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (6), Physical disability of places over 65 years of age (33), Terminally ill (6), Terminally ill over 65 years of age (33) Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 6 beds may be used at any one time for service users in the category PD between 50-65 years of age. No more than 6 beds may be used at any one time for service users in the category of TI between 50-65 years of age. 1st June 2005 Date of last inspection Brief Description of the Service: Durban House is a registered care home providing nursing and personal care to 33 service users in the older person catgory. The home is situated in a residential area in the village of Romsey on the outskirt of Southampton. Accommodation is provided on two floors with passenger lift and stair lift that allows access to all parts of the home. The manager is aware that certain parts of the home that is not accessible to wheelchair users and take this into consideration when allocating bedrooms. There are five shared rooms and the rest are single and are all fitted with wash hand basin or en suite facilities . There are a variety of aids and adaptations that are available to maintain and promote service users independence. J.Sai Group Ltd owns the service with another home in the Hampshire area. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place over a day on the 24th of October 2005. This was the second visit to the home for this year. As part of the inspection process a tour of the building was undertaken. The inspection took place over six hours. The inspector spoke to 9 service users, 2 relatives, 6 staff and management. The process included examining care records, discussion with service users, staff and visitors. Service users and relatives spoken to expressed a high degree of satisfaction about the care that they were receiving. The home was clean, comfortable and welcoming. What the service does well: There is an ongoing programme of refurbishment in place to improve the environment. This includes the planned extension of the communal area on the ground floor that will provide a designated dining room and larger lounge. The current dining room space is very limited and service users do not use this at present. The home has a warm and welcoming atmosphere and was well maintained. Service users and relatives spoken to expressed a high degree of satisfaction with the care they are receiving. Comments included “best home around” “nothing is too much for the staff”. Care planning is well managed with evidence of pre assessment, risk assessments that are reviewed and updated regularly to reflect any changes in service users’ needs. The home has a thorough recruitment procedure in place and ensures that all checks are undertaken prior to employment. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 7 contacting your local CSCI office. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 8 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 Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 9 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): 1,3,6. The lack of comprehensive information relating to the service users’ guide falls short of meeting the service users’ needs. The home has a good pre admission process in place to ensure that they can meet the needs of service users. The service does not [provide intermediate care EVIDENCE: The manager said that the service users guide and the statement of purpose are being updated. This was discussed with the manager as information is given verbally and may not be consistent. The manager must ensure that all prospective service users should have up to date information as per the statement of purpose, in order to make an informed choice and meet the requirement as schedule 1. The manager or her deputy undertakes pre admission assessments of service users prior to admission. There were detailed records of these assessments available in a newly admitted client record seen. Care management assessments are also sought as part of the admission process as applicable. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 10 The service does not provide intermediate care. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The care planning is good and ensures that service users needs are met. However the lack of evidence of service users involvement in formulation of care plans and consents for bedrails is lacking. This may be detrimental to service users’ welfare. The access for service users to other health care professional is satisfactorily managed and meets the needs of service users. The management of prescribed medication received is poor and can be detrimental to the safety of service users. Personal support is offered in such a way as to promote and protect service users’ privacy and dignity. EVIDENCE: The records of 5 service users seen demonstrated that care plans were formulated and included risk assessments and manual handling assessments. These were updated and reviewed regularly to reflect any changes in the needs of service users. The recording of personal care given by carers were lacking in some service users records. This was discussed and record of all care should Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 12 be detailed and current. There was some evidence that service users/ advocates are involved in care planning. The manager is aware that this needs to be developed for all service users. Risk assessment for the prevention of fall was available, however consent for the use of bedrails must be sought and recorded in care plans, as these were not available. Equipment for the prevention and treatment of pressure ulcers were available in conjunction with Waterlow score that calculated the risks. Advice was sought from other health care professionals such as tissue viability nurses and incontinence assessments are undertaken. The GP visits regularly and records of any change in treatment were recorded to inform practice. The home has policy and procedures in place for the management of medication to inform the staff. The procedure for the disposal of medication has been put in place and this has been contracted out following the recent change in legislation. The home has put in place procedures for staff that are responsible for this. The procedure for the recording of medication received was poor. Records on Medication Administration Record (MAR) sheets seen showed that not all medication received were recorded. These included records of any dressings received although there were four service users receiving treatment for pressure ulcers for which dressings had been prescribed. The manager discussed that a review of the recording on MAR sheet would be undertaken and printed MAR sheet will be put in place. This will eliminate the current practice of staff transcribing on MAR sheets and reduce the risks of possible errors. It was also noted that there was a large quantity of dressings that did not have the name of service users for whom these were prescribed. A review of the drugs returned procedure need to undertaken to ensure that staff follow the guidance and home’s policy for returned medication. All the service users spoken to say that they had autonomy and choice with regards to the activity of daily living. They stated that staff were kind and respected their choice of remaining in their rooms as they chose. Comments from service users and relatives included “ staff are very kind” “ I feel safe” “ I like spending my time in my room and it is not a problem”. Service users confirmed that they are treated with respect at all times. One relative said that she came in at different times of the day and that her husband always looks clean and that staff are very friendly and they could not have chosen a better home. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 13 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): 13,15 The visiting process is good and meets with the needs of the service users. The meals at the home are well managed offering choice and variety. EVIDENCE: The home has an open visiting policy. This was evidenced by records of visitors to the home and confirmed by service users and relatives. Two relatives said that they visited at different times of the day and are always welcomed. A relative of a newly admitted service user said that he spent a lot of time with his wife, as there was no restriction on visiting. The home has a planned menu that is rotated on a four weekly basis. The manager reported that staff were reviewing the winter menu and will include more alternate choices available. Meals were nicely presented and appeared wholesome and nourishing. Hot and cold drinks are available at all times. Comments from service users included that meals were always very nice and plentiful. One service user said that he did not like meals cooked in sauces and an alternative was provided. Most of the service users took their meals in their rooms or in the lounge, as there is no designated dining room a present. This Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 14 would be addressed with the planned extension of the service starting in November 2005. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a complaint procedure and service users confirmed that they are able to use. The lack evidence in recording and details of action taken may be to the detriment of service users. The procedure for adult protection is satisfactory. However the lack of training in adult protection may not safeguard service users welfare. EVIDENCE: The home has a complaint procedure and a complaint log was available. Service users spoken to said they had no complaints and would approach the manager or nurse in charge if they needed. Others said that they would talk to their relatives. Following discussion with staff it was noted that not all complaints are recorded. This was discussed with the manager as staff dealt with issues raised and did not record these in the log. The manager should ensure that all complaints and action taken are recorded. The home has in place the Hampshire adult protection procedures. The manager is aware of the need to record and report all allegations of abuse to the appropriate authority. Discussion was undertaken with management about adult protection training/ guidance for staff. The manager has confirmed that training in adult protection and the prevention of abuse will be accessed for all staff to inform practice and safeguard service users as none have undertaken this training. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 16 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): 19,26 The environment provides service users with a warm and comfortable home. There is a good infection control procedure at the home to safeguard the welfare of service users. EVIDENCE: The environment is homely clean and comfortable. Service users spoken to were complimentary about their rooms and confirmed that it met their needs. Bedrooms were personalised and it was evident that service users are encouraged to bring into the home items of personal belongings. Comments from service users included that they spent their time in their rooms and watched their favourite programmes. One service user who was new to the service said that she had settled down well and she has all her things around her and that made her feel at home. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 17 Furnishing was of good standard, clean and appropriate to service users needs. The home has large well-maintained gardens that were safe and accessible to wheelchair users. A programme to extend the communal lounge and include a dedicated dining room is in place. The work is due to start at the beginning of November. The policy on infection control practices was in place. Staff were seen to observe these and used different coloured aprons for providing nursing/ personal care. Gloves were available and procedures for dealing with infected materials were in place. All parts of the home visited on the day were clean and there were no adverse odours in the home. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 The home has appropriate staffing to meet the current needs of service users. The recruitment process is good and ensures that service users are protected. EVIDENCE: The duty roster shows that there are two trained nurses and 6 carers on the morning shift. In the afternoon there are five carers and one trained staff. Night duty has one trained staff and two carers. Service users and relatives spoken to said that there were “always staff available when you needed them”. Service users said that call bells were answered promptly and “staff can’t do enough” for them. The manager reported that dependency levels are reviewed regularly and reflected by staffing and service users needs. The home has a robust recruitment procedure in place. The records of four staff were seen as part of the inspection. All staff completed an application form, all relevant checks were undertaken and records maintained as required. There is an induction process in place for all new staff. A contract with the terms of conditions of employment is issued to staff following the completion of the probationary period. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35,36,38 The home’s procedure for dealing with service users’ finances is good and safeguard service users interests. The staff supervision process is in place and satisfactory. The procedures and practices for the health and safety of service users and staff are good. EVIDENCE: The home does not manage any of the service users’ money. All service users have either relatives or attorneys who deal with their finances. The financial records seen showed that receipts and invoices for all transactions that are entered on behalf of service users are kept. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 20 The service users who were financed by Social services had contracts in place. These were signed by the provider and in some cases the service users. The provider should ensure that evidence of service users/ advocates agreement are also kept as part of these contracts. The home did not issue individual contract with the terms and condition of residency to these service users. This was discussed and need to be addressed. Contracts should also contain details of all payment for example the amount paid for nursing. The home has developed and started a structured supervision programme for all carers. This has been well organised as a number of staff attended a supervision update to gain further information and knowledge. The trained nurses are responsible for supervising a group of carers who meet at regular intervals. The supervision programme is also linked to the training and development programme for the service. This in turn will benefit service users and staff. A sample of the servicing record was seen. The manager said that there is a rolling programme for the servicing of equipment that is contracted out to external agencies. All materials that may be dangerous to health were stored appropriately. Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 2 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 14 15 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 X X X X 3 3 X 3 Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4(1)(2) Requirement The provider must put in place an up to date statement of purpose and service users’ guide that is available to all prospective service users. The manager must ensure that staff adhere to the policy for the receipt, recording, storage, administration and disposal of medicines received for service users. The manager must ensure that all complaints are recorded in the complaint log to include any action taken. Timescale for action 15/12/05 2 OP9 13(2)17(1) (a)sch3(k) 15/12/05 3 OP16 17(2)sch 4(11) 15/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Durban House Nursing Home DS0000060803.V260742.R01.S.doc Version 5.0 Page 24 - 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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