Inspection on 21/12/05 for Eastcotts Nursing Home

This inspection was carried out on 21st 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

Eastcotts Nursing Home 13/05/09

Eastcotts Nursing Home 18/04/06

Eastcotts Nursing Home 21/06/05

Eastcotts Nursing Home 03/11/04

Eastcotts Nursing Home 20/05/04

Eastcotts Nursing Home 11/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Eastcotts Nursing Home Eastcotts Nursing Home Calford Green Kedington Haverhill Suffolk CB8 7UN Lead Inspector Kevin Dally Unannounced Inspection 21st December 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 Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eastcotts Nursing Home Address Eastcotts Nursing Home Calford Green Kedington Haverhill Suffolk CB8 7UN 01440 703178 01440 763435 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) Raveedha Care Ltd Mrs Olive Angelina Silva Care Home 59 Category(ies) of Dementia - over 65 years of age (27), Old age, registration, with number not falling within any other category (59) of places Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2005 Brief Description of the Service: Eastcotts is a Care Home with Nursing, registered to care for a total of 59 older persons in the categories of dementia and older persons not falling into any other category. Located in a small rural hamlet near Haverhill, Eastcotts is set in its own grounds with car parking. The home is a converted three-story period property, with a single storey extension. The home is divided into 3 main areas, Main Home, Jasmine and Lavender Unit, each with their own lounge and dining room. There are 33 single and 13 double bedrooms, with some of the newer rooms having en-suite toilets and showers. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced early morning inspection of Eastcotts was undertaken after the Commission for Social Care Inspection (CSCI) received an anonymous complaint about the early rising of service users. This inspection was also combined with the home’s second annual inspection, which was due. Eastcotts is a care home offering nursing care for 59 residents. The inspection was carried out over 8.5-hours on a weekday between 6.45am and 3.15pm. Mrs Angelina Silva, the manager, was present throughout most of the day, and registered staff were also available to answer any questions. As this was the week prior to Christmas, the home was very busy in its preparations for the celebratory period. A number of family members were observed visiting their relatives. This inspection focused on the outcomes for residents so 11 residents, 5 relatives, 3 care workers and 2 registered nurses were spoken with during the day, and who provided feedback about the quality of the service provision, and the nursing care received. One service user’s and two care staffs’ records, administration records, and some policy documents were checked, and a tour of the premises was completed. This inspection revealed that of the 23 standards inspected, 16 were assessed as fully met with 7 standards as almost met. Further the home continued with the positive provision of a nursing care service to residents with medical problems, including dementia. What the service does well: Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 6 This unannounced inspection found that the quality of the personal and nursing care was to an acceptable standard. Residents confirmed that the care they received was good and that they were able to make choices about the daily care and support received. Relatives commented that when they visited the home, staff were helpful and caring. During the inspection staff were observed to be supportive and patient with residents. Vulnerable residents were observed to be supported by staff with their daily care and activities. The home was found to be clean, warm and maintained. Resident’s records were found to show good detail, had been maintained to show the times when care was given. Staff employment and recruitment records were checked and found to be up to date. The management of the home continued to be responsive and maintained “a hands on approach” to the various tasks that needed undertaking. Two of the home’s four owners worked in the home during the week. Staff supervision was found to be in place, and staff spoken with confirmed this. What has improved since the last inspection? What they could do better: This inspection was the result of an anonymous complaint, which stated that residents were being got up early to suit staff, and not the residents. Although this was not seen at this inspection, it was noted in discussion with staff that they had been asked on one previous occasion to assist a resident to rise at 6.50am, and the that the particular resident was incapable of making this sort of choice. Records checked for this person stated that their preferred rising time was between 8 and 9am. Therefore this element of the complaint was upheld. It was a requirement that all residents rising times especially those people incapable of stating these be reviewed, and staff must ensure that these are strictly followed. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 7 During the inspection it was noted that a number of curtains available in the double bedrooms did not fully screen residents. It was a requirement that these are altered to ensure residents are provided with complete privacy. Some resident’s finance records were checked and one was found to be incorrect, although the reasons for this were not known. A requirement was made that the home’s finance system were reviewed and monitored to ensure the complete security for residents’ personal money. On the environmental tour, it was revealed that the laundry walls were not lined, and the floor only partly covered. It was agreed with the owners that these would be replaced to ensure the complete health and safety of the area. Although staffing levels had been appropriately maintained, 1 staff member was moved from the dementia unit for a 1-hour period during the morning. This practise should be reviewed to ensure that adequate staff is maintained within the dementia unit at all times. 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. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 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 Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 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): 3,4 People can expect to have their care needs assessed, and that the home would meet residents needs. EVIDENCE: The manager or an appointed member of the nursing staff would undertake a nursing assessment of a resident’s care needs. This allowed the home to assess the potential service user’s needs and whether the home could adequately meet these needs. One resident’s records were checked, and a detailed “needs assessment”, referred to by the home as “activities of daily living lifestyles assessments”, had been undertaken. The assessment was found to be detailed and included appropriate nursing assessments, and identified the nursing care required. Additional assessments included nutritional risk screening, and general risk assessments were available. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 10 Residents, relatives, records checked and staff spoken with confirmed that the home met residents’ personal care needs. Residents’ comments included “I think that the home has really improved”. “I enjoy seeing the staff and the manager”. “My room is clean and tidy”, and “I have no problems”, or “I have no concerns or worries”. “The quality of the care and attention is good, and I have no concerns”. “We have been impressed by the owners, who we see testing the water”. The home is clean and tidy”. Relative’s comments included, “ the care is good and we are very pleased”, and “our relative is happy”. “The staff are brilliant with our relative”. “They are a happy crowd”, or “I am very impressed”. “The staff are friendly in attitude” and “I have found them to be really nice”. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 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): 7,8,10 People can expect to receive professionally planned care and have their nursing healthcare needs met by nursing staff. People can expect that regular reviews would be maintained of their care assessments. People could not always expect that they would be treated with respect and dignity by staff. EVIDENCE: Care records included an “activities of daily living, lifestyles assessment”, which assessed 13 areas of personal need, in summary form. Care plans would be produced from this assessment. One residents care plan was checked and tracked. The care plan included 14 points of very detailed assessment of this resident’s care needs, and how care should be delivered. These had been signed and updated within the last month, and daily progress records had been maintained. In addition to this professional nursing assessments included moving and handling and nutritional risk assessments, pressure area and falls risk assessments, bedrail/bedsides risk assessments, a body chart, and a turn chart were found to be in operation. These had mostly been reviewed on a monthly basis, which demonstrated a high level of nursing care monitoring. The accident log was examined and found to contain 57 recorded accidents /falls within the last 6 month period. The manager stated that the falls Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 12 coordinator had now been consulted and that a variety of new strategies to prevent falls were being implemented. This included the use of hip protectors, medication reviews, falls assessments and training for staff. The manager also monitored the number of falls, and identified residents who were prone to falling, and the action needed to help prevent more falls. One resident’s records checked revealed that staff had undertaken a falls risk assessment for that person and this had been updated on a monthly basis. In addition to falls monitoring, pressure area care and nutritional care, moving and handling risk assessments had been undertaken and integrated within their care plan. From residents spoken with, observation of care, and records examined, good evidence was found that holistic nursing care practises were in operation at the home. Staff were observed to act in a professional, caring and responsive manner towards residents, were polite and were seen having a laugh with some of these people. Many residents spoken with confirmed that staff were respectful. As part of the early morning inspection, a tour of the premises was undertaken, and some care practice observed. In one instance where two residents shared a room, inadequate curtaining prevented total screening while personal care was being carried out. This was required to be immediately addressed to ensure the total privacy for each resident. Part of the complaint received was about the physical care that residents received. “Turn charts” were observed to be in operation, and were explained by one of the Registered Nurses, and the manager. These had been provided for a number of very unwell residents who had been identified by risk assessment to be at very high risk of developing pressure areas. The complainant had stated that turns were undertaken every 1.5 hours, which they considered, would be disruptive to residents trying to sleep. However from the records checked, it was observed that they were turned every 2-4 hours depending on the severity of their problem. Records were very thorough and regular. The use of continence aids and electric air mattress were also used in conjunction with this practise. There was clear evidence, risk assessment and records for this practise, which was underpinned by collective clinical nursing judgments. Therefore the inspector was unable to comment on these nursing decisions. In discussion with the manager it was recommended that the practise of 2 hourly turns was reviewed to ensure that this was in line with current nursing clinical practice. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 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): 12,13,15 With staff support, residents were enabled to be involved in meaningful recreational activities, mostly exercising personal choice, and usually making decisions about the lifestyle that they wished to pursue. Contact with relatives, friends and family was encouraged. Residents can expect a balanced lifestyle at the home, including the provision of a good diet. EVIDENCE: Residents, relatives and staff spoken with stated that residents were provided with meaningful leisure opportunities to pursue. This included the provision of a programme of activities throughout the week, which had been organised by the home’s activities coordinator. This included a trip to the beach in the summer, a summer fair in the home’s grounds and planned Christmas events. Further, some residents described the activities they preferred like watching the television or reading. Some residents stated that they preferred their own company and the privacy of their room. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 14 Residents confirmed that they could receive visits from friends or family and that there were no restrictions placed on visiting times. At the inspection a number of relatives were spoken with and all confirmed that they were satisfied by the care and activities offered by the home. Further, that staff were welcoming and that there were no restrictions placed on the times when they could visit. As part of the complaints investigation was around the early rising of residents, the inspection was commenced at 6.45am to assess if any residents were up earlier by choice. All three day rooms were inspected and found to be empty, with no residents being brought to the day rooms before approximately 8.15am. Two residents had just been assisted to rise in the main house and were up and dressed and in their own rooms. These residents and the care staff in attendance confirmed that this was by their request. Lavender, the dementia unit, was checked at around 7am, and a one resident was found fully dressed. Again this resident confirmed that this had been by their request. Jasmine was checked at 7.15am and two residents were being assisted to rise. Therefore, on the day, no more than 5 residents were up before 7am, and all were up at their own request. Staff spoken with confirmed that they were aware that the home policy was that residents should not rise before 7am, unless a resident specifically asked them to do so. However, some staff spoken with recalled one occasion at 6.50am where they had been instructed to assist a person to rise, but this resident was not capable of agreeing to this. The resident’s care plan was checked, and it was recorded that they would normally rise between 8 to 9am. Therefore this part of the complaint, (although not true of today), was found to be correct in one instance, based on some staff members’ experience. The home was therefore required to ensure that residents are assisted to rise, only when this is requested. Further, that vulnerable residents who are incapable of expressing a view around their rising times, must only be assisted to rise based on their normal rising times, and as recorded within their care plan. The home was also required to review all residents normal rising times to ensure that these were current and based on residents agreed/ preferred rising times. The home’s three-week rolling menu plan was checked and this was found to provide a balanced, and varied menu with two hot meal choices at lunchtime. Residents spoken with about the meals confirmed that these were acceptable. They confirmed there was a choice of two hot meals and that these were served in sufficient quantities. Two residents stated that they often preferred a cooked breakfast and this was provided on request. The breakfast seen looked and smelt appetising, was in sufficient quantities and was served hot. Staff were also seen assisting some residents to feed. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 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 People could expect that complaints would be properly dealt with and that the home would make every effort to ensure the safety and protection of residents against abuse. Residents’ personal money records may not always be correctly maintained. EVIDENCE: Since the previous inspection in June 2005 the home had not received any complaints. The CSCI had received one complaint, which was investigated at this inspection. One element of the complaint was upheld and 3 elements were not upheld. Since April 2005, the home had activated one Protection Of Vulnerable Adults investigation, but this had now been positively concluded. One employee had been dismissed after investigation of a false declaration on their Criminal Records Bureau Check. The complaints procedure was provided in the Statement of Purpose and was adequate and informative. This included the name and address of the CSCI, which was required, should a service user wish to contact the Commission directly. The policy also stated that a complaint would be investigated within 28 days. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 16 The home had suitable Adult Protection policies and procedures in place and was aware of their obligation to report any allegations of abuse to Social Services, the police and/or the CSCI. The manager had undertaken a detailed risk assessment to ensure that risks to vulnerable residents had been considered. The home’s recruitment procedures included CRB disclosures, references and identity checks for all staff. A sample of staff records checked found these records to be in place. The finance records checked with respect to the personal money held for two residents found a discrepancy with a surplus of £16 43 pence for one resident, against their recorded balance. The other resident’s records were correct. On checking, the discrepancy was due to a member of the team who had loaned their own money to the resident to ensure that they did not go without but had failed to reclaim this from the office. However there was no audit trail for example, petty cash receipt records, to demonstrate who was owed this amount. Further, the management team had not detected the error. The home was therefore required to review its personal finance policy and to ensure that there was an appropriate finance procedure in place, including a paper audit trail and a management monitoring system. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 17 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, 23, 25,26 People can mostly expect a maintained environment with adequate communal provision, but cannot always expect a safely maintained home. People can expect a clean and hygienic home. EVIDENCE: Eastcotts Nursing Home is a privately owned care home for up to 59 residents in the categories of dementia and older people. The home is divided into 3 main areas, Main Home, Jasmine and Lavender Unit, each with their own lounge and dining room. There are 33 single and 13 double bedrooms, with some of the newer rooms having en-suite toilets and showers. The décor and characteristics of each day room is different, mainly neutral in colour and each provided with fixtures, fittings, pictures and carpets. The gardens were maintained and accessible to service users. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 18 At this inspection various residents’ rooms were visited and found to be clean and tidy, warm and properly maintained. Residents could bring some of their own personal furniture if they so wished. A number of residents confirmed that their rooms and the home were being maintained in a clean and hygienic state. Maintenance matters, including the painting of the lounge in Jasmine and the doorframes and kick edges in Main House have now been addressed. A window cleaner had been employed to clean the windows. During the inspection the laundry was checked, the walls of the laundry required lining and the floor required a semi permeable floor covering. The curtains provided in most of the double bedrooms in the dementia area did not completely screen residents, and was required to be addressed without delay. (Refer to standard 10) The lift was observed to have a broken mirror attached to the wall, which may have been a safety hazard to residents. However, the owner removed this immediately. At this inspection two of the residents’ wash hand basin’s hot water temperatures checked were found to be in excess of the recommended level of 43 degrees Celsius and these were immediately required to be reduced to the recommended safe levels. As part of the complaint, staff were spoken to about hot water problems but they were unaware of any current problems. In discussion with one of the owners, it was confirmed that a new boiler had recently been installed which would hopefully improve any hot water problems. At this inspection, which commenced at 6.45am, it was noted that even though cleaning staff had not cleaned the home since the previous day the home had remained clean and tidy, and without any unpleasant odours. Some night staff were spoken with about the availability of cleaning supplies including gloves and cleaning wipes who confirmed they were unaware of any supply problems, and that there were usually sufficient supplies to go around. Staff were also unaware of any directive from the management to cut back on supplies other than to avoid being wasteful. Throughout the day very good quantities of all supplies were noted within resident’s rooms, toilets and bathrooms. Previous concerns around the fact that there had not been any cleaning staff on duty at the weekend had now been partly addressed by the provision of at least one cleaner during the weekends. One domestic spoken with confirmed that they were employed to clean the rooms. They were also observed throughout the day to be cleaning and by the end of their duty the home looked very presentable. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 19 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): 27,29,30 Residents can expect that the home would have adequate staff levels. People can expect that most staff will have received basic training and that trained nursing staff would be able to support and meet residents nursing care needs. EVIDENCE: The previous inspection had identified some shortfalls around the number of care staff available to provide care and support services to residents. The manager had now recruited most of the care staff required. From the staff numbers checked more than acceptable numbers were available to meet the individual needs of the resident group. In previous discussion with the management team it was confirmed that the levels of care staff numbers maintained were as follows: Main, Jasmine and Lavender. Early Shift (7:45 to 2pm) 1 Registered Nurse and 3 Care staff. PM Shift (1.45 to 8pm) 1 Registered Nurse and 2 Care staff. The night shift. 1 Registered Nurse and 4 Care Staff Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 20 From observation of the night duty rota revealed that 5 staff had been in attendance during the night. Further, staff on duty during the day and in the morning was the manager, 3 Registered Nurses (RN’s) one of whom was the deputy, 9 care staff, and one kitchen/feeding assistant from 7pm. The staff rota was viewed and revealed that staffing numbers had increased but did sometimes vary from day to day. Wherever possible when there were staff shortages, the home employed agency staff when they were needed. Some staff spoke of their concerns about the dementia unit, and how one staff member was routinely moved for an hour during the morning to help in the high dependency unit, which was currently very busy. This was discussed with the manager who was clear that this was a necessary move, and that the home had positively provided a permanent registered nurse to staff the dementia unit. However the redeployment of staff from the dementia unit was of some concern due to the possible high level of care needs and challenging behaviour that might be experienced by people within this unit. It was recommended that staff were not moved as routine, and only in emergencies. Further that when other areas of the home became busy additional staff are employed to ensure that all residents care needs can be met. Residents and relative’s views of the staff group were received from direct feedback and discussion throughout the inspection. Very positive comments were received. (Please refer to standard 3 of this report). Two staff member’s records were checked (1 Registered Nurse) (RN) and 1 care staff) revealed that the home continued to undertake appropriate recruitment and employment checks, which included Criminal Bureau Checks (CRB), references, identity checks and a medical declaration of health status. The home had also checked the RN’s Professional Identification Number (PIN) to ensure that they were currently registered with the Nursing and Midwifery Council (NMC). Both staff members’ records revealed that they had received good levels of training relating to their various responsibilities. This included specialist training around dementia care, and all basic training including moving and handling, food hygiene, fire, infection control and health and safety. The care worker had additionally completed a National Vocational Training Qualification (NVQ), and the RN had undertaken a wound care course. Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35,36,38 People can expect the home to be well managed and would take account of resident’s views. They could mostly expect the environment to be safely maintained. Staff had received appropriate health and safety training for the protection of residents. People cannot always expect that residents’ personal money would be correctly handled. EVIDENCE: The manager, Mrs Angelina Silva, is a Registered Nurse who has had a career in care since 1981. This includes work as a carer, registered nurse in a variety of hospital settings, a clinical trial nurse, a senior sister of a day hospital and a lecturer and NVQ assessor. More recently she has managed two nursing homes including Eastcotts. Further, Mrs Silva has a National Business Certificate in Business Studies, with honours, the Registered Managers Award Level 4, and is also qualified in teaching and assessing of nursing staff (ENB 998). Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 22 Comments received from residents, relatives and staff, confirmed that the home continued to operate in an open and transparent way and that it continued to be responsive to the concerns of residents or relatives. Residents and staff meetings continued in order to receive feedback and determine how improvements could continue to be delivered. It was determined in discussion with one of the owners that they were available at the home on a daily basis and very much in touch with the day-to-day problems that may arise. Further, one relative confirmed their appreciation of the “hands on” approach of the owners. Staff records checked confirmed that regular supervision had been undertaken, and staff spoken with confirmed this. The finance records of two residents were checked and an explainable error was found with one. This was largely the result of poor finance procedures and systems, and follow-up auditing which was required. (Please refer to standard 18) This inspection confirmed that the home continued to undertake routine and maintenance tasks to maintain a safe environment, although two wash hand basins hot water temperatures checked revealed that these were excessive, and required reducing. (Please refer to standard 25) Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 23 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 x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 3 x x 3 x 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x 2 3 x 2 Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 24 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 OP10 Regulation 12(4)(a) Requirement Complete screening must be provided for residents to ensure that their dignity is maintained, when care is being given. Vulnerable residents who are incapable of expressing a view around their rising times must only be assisted to rise based on their normal rising times as recorded within their care plan. The home must review all residents normal rising times to ensure that these were current and based on residents agreed/ preferred rising times. The home must review its personal finance policy for residents, to ensure that there are appropriate and robust finance procedures in place including a paper audit trail and management monitoring systems. The laundry walls must be lined, and the floor provided with a semi permeable floor covering Resident wash hand basins, hot water temperatures must be maintained around 43 Degrees Celsius. DS0000055177.V274894.R01.S.doc Timescale for action 23/01/06 2 OP12 12(2)(3) 23/01/06 3 OP12 12(2)(3) 23/02/06 4 OP18 17(2) Sch 4(9) 23/01/06 5 6 OP19 OP25 23(2)(b) 13(4)(a) (c) 23/04/06 23/01/06 Eastcotts Nursing Home Version 5.1 Page 25 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 The manager should review the practise of 2 hourly turning to ensure that this was in line with current clinical nursing practice. The home should review the practise where staff are moved as routine from the dementia unit. Further that when other areas of the home become busy, that additional staff are employed to ensure that all residents care needs can be met. 2 OP27 Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Eastcotts Nursing Home DS0000055177.V274894.R01.S.doc Version 5.1 Page 27 - 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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