Inspection on 09/06/05 for Euroclydon Nursing Home

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Euroclydon Nursing Home 11/06/09

Euroclydon Nursing Home 22/07/08

Euroclydon Nursing Home 31/01/08

Euroclydon Nursing Home 10/09/07

Euroclydon Nursing Home 13/02/07

Euroclydon Nursing Home 04/07/06

Euroclydon Nursing Home 17/11/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Euroclydon Nursing Home Chantry Retirement Homes Drybrook Gloucestershire GL17 9BW Lead Inspector Janet Griffiths Announced 9 June 2005, 09:30am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Euroclydon Nursing Home Address Chantry Retirment Homes Ltd Drybrook Gloucestershire GL17 9BW 01594 543982 01594 544352 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Chantry Retirement Homes Ltd To be appointed OP Old Age 48 Category(ies) of OP (48) registration, with number of places Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To accommodate 5 (five) named service users under the age of 65 years. Date of last inspection 2 November 2004 Brief Description of the Service: Euroclydon Care home is located in the Forest of Dean on the outskirts of Drybrook and is registered to provide both nursing and residential care. The accommodation comprises of three areas referred to as the original Main House, the single storey extension and ‘the link’ extension, which joined the two previously separated areas in 1996. Residents are accommodated on two floors in the Main House and the link. Two shaft lifts facilitate access to the upper levels.The home offers thirty-eight single and five double rooms. Twenty-eight rooms offer en suite facilities. In addition, there are a number of assisted bathrooms and toilets on each floor and in each extension. Communal areas include a lounge and large dining room with an adjoining conservatory and small smoke room in the Main House; a smaller lounge in the link extension and another large lounge and sun lounge currently used as a dining room, in the single storey extension. The home is positioned on high ground and most upper floor rooms offer a magnificent view of the surrounding countryside. The gardens are well maintained and accessible to all residents and a summerhouse was built last year to provide shelter from the elements. The home has its own tail-lift mini-bus. A new Company- Chantry Retirement Home recently took over the business from the previous registered owner. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on one day in June 2005, over 8 hours and 30 minutes. Opportunity was taken to tour the premises, examine records and policies and talk to residents and staff. A number of residents and one visitor were spoken with during the inspection to include a number of residents who had been admitted since the last inspection and several of the younger adults accommodated. The new proprietor and acting manager were present throughout the inspection, which was announced in order to meet them both. An additional inspection took place earlier in the year when the previous provider was at the home, regarding concerns with recruitment processes and this was followed up during this inspection, as the acting manager had also been involved in these concerns. Most of the requirements from the last inspection have been met in full. Where they have not, this will be described in the report. What the service does well: What has improved since the last inspection? Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 6 The home appears to have a fuller activities programme in place and from the reports given and evidence seen some of the residents derive much pleasure from the activities organised. The workforce appears to be more settled and stable now and the home has been accredited to take adaptation students from overseas once more. All the staff have also attended an accredited induction course. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 3 The home has a Statement of Purpose and Service Users Guide but this does not reflect recent changes to the homes management and is not easily available. The absence of pre-admission assessment documentation makes it difficult to assess if the home can adequately meet the needs of the service users EVIDENCE: The current Statement of Purpose is available in each service users room but the service users guide is kept in reception, which was an arrangement made by the previous owner. As certain facts are now inaccurate with the change of management both documents must be reviewed and then the service users guide issued to each service user or their representative. A selection of records was seen during inspection to include those for a number of newly admitted service users. Although the acting manager stated that she carried out a pre-admission assessment on each service user, there was little documented evidence to support this. However, when speaking to some of the newly admitted Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 9 residents it was apparent that their needs, with one or two exceptions, were being met. Some social service assessments were seen. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9,10 There is a satisfactory care planning system in place, which reflects multidisciplinary working. This means that staff are properly informed about the most of the needs of the service users. However, the lack of relevant training for staff in identification and care of pressure sores means that some service users are being put at risk. The medication procedures in this home are well managed promoting good health. Service users feel they are treated with respect and their right to privacy is upheld. EVIDENCE: The records of seven service users were selected and examined during the inspection. All were found to have assessments completed and care planned and regularly reviewed. All records must be signed and dated as legal documents. A new handover sheet has been introduced and acute care plans are to be introduced shortly. One service user on respite care did not have any care plans despite have a number of problems identified and had not had a pressure relieving risk assessment completed. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 11 The majority seen had monthly pressure sore risk assessments completed but in some instances where someone was identified at high risk, appropriate action was not taken. Two-service user who were very frail, one on bed rest and both at high risk of pressure sores were placed on low risk mattresses. One of these was changed after discussion at inspection. Another with a heel pressure sore had a high- risk mattress but no cushion when sat out all day. Someone admitted with a pressure sore did not have a record of the size /state of the sore on admission which is a useful tool for monitoring improvements or otherwise and where mapping was done this should be continued weekly. Wound care charts were in place where regular dressings are carried out. There were many references to multidisciplinary referrals and advise within the care records. The local doctor visits every week and the continence advisor was visiting during the inspection. She reported that she was happy with the continence care being received at the home. However it was noted as part of the continence care plan for one service user, instructions were to ‘toilet regularly’. This needs to be more specific to ensure that continence is maintained. A large proportion of service users who have been into hospital have been discharged with catheters, which remain in situ. A number of service users were spoken with during the inspection, some with very complex health needs and all were satisfied with the standards of care provide and also stated that there had been no fall of standards with the change of management and other personnel. Administration of medicines was observed throughout the day and is considered to be safe. Medicine records of those service users who had their care records examined, were seen and were well maintained. The home plans to transfer to a new pharmacy provider shortly, using blister packs and printed medication record sheets, which will save staff a lot of time by not having to handwrite records. Observation during the inspection showed that staff have a good awareness of how to protect residents ‘ privacy and dignity. They were seen to knock on doors and wait for a response before entering and spoke to residents in a respectful way. Three rooms are being shared currently, one by a married couple and two by service users who have consented to do so. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Residents experience a fairly stimulating and varied life at the home with visitors encouraged, various activities made available and days out organised. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Two staff generally provide 24 hours activity provision each week, but unfortunately both were off sick during the inspection. However, a programme of activities is in place and evidence of some of the crafts, to include a large decorative mural, was on display. Residents spoken with stated that there was plenty to occupy them during the day, some choosing to remain in their rooms and pursue their own interests. Spiritual needs are met through monthly Church of England and weekly Roman Catholic communions and a few occasionally go out to their local churches. A few residents attend local clubs/day centres but more effort is needed to ensure that the younger adult group especially are enabled to maintain links in the community and are offered a stimulating environment through the pursuit of interests. One had just taken a photograph of the home for the proprietor as he has a particular interest in photography, Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 13 another related that she was going out to tea with her social worker the next day. Many were reading and watching television. The home has their own mini-bus and regular outings are organised. Visitors are welcomed to the home and one remarked on the friendly atmosphere and good rapport between staff and residents. It was one residents’ birthday during the inspection and everyone congregated in the dining room to sing Happy Birthday and present a birthday cake with a lighted candle. Those residents spoken with confirmed that they were able to choose how and where they spend each day and were offered choice and variety at each meal. The Environmental Health Officer inspected the kitchen in April 2004 and was very satisfied with what they found, awarding a certificate for their high standards. Menus were provided for the inspection and are balanced and interesting, catering for special dietary needs and for those who require a soft diet and assistance. The meals seen during the inspection looked well presented and the residents confirmed that they were of a good quality. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home has a complaints procedure within the service users guide and on display. Residents spoken with confirmed that they are confident to talk to either the acting manager or owner if they have any problems and feel that they will be dealt with. A record of the complaints received and incidents that had occurred was seen during the inspection. It was advised that a more detailed action plan must be in place as part of the complaints procedure to ensure that complaints are dealt with effectively, for example when someone complained that there was no heating, there must be a record of why this occurred and what action was taken to rectify this. When checking these records it was also noted that there were some increasing behavioural problems occurring with one resident. A referral has been made to the mental health team for reassessment and it may be that the home is no longer suitable for the needs of this service user. The inspector wishes to be kept informed of what action is taken. A whistle blowing policy and a policy on protection from abuse is available in the home and further staff training is to be arranged. This is included as part of the induction process. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 The standard of the environment within in the home is good providing service users with an attractive and homely place to live. EVIDENCE: A tour of the premises revealed that most areas are well maintained and in good decorative order to a standard that creates a comfortable and homely ambience. There is some evidence of wear and tear in some rooms particularly in the extensions and the new owners plan to start a programme of redecoration and refurbishment to further improve the environment. Rooms are generally redecorated as they become vacant. Many of the residents’ rooms have items of their own furniture and personal possessions which helps create a homely and individual environment for them. All areas of the home smelled pleasant and were cleaned to a high standard. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 After a period of some instability there is now a good match of qualified and appropriately trained staff offering consistency of care within the home, with the exception of standards identified in Standards 7 and 8 above. Recruitment practice has improved but the home must maintain this standard to protect the service users from unsuitable staff. EVIDENCE: Staffing levels were adequate at the time of inspection to meet the needs of the current service users. These levels must be constantly monitored against the needs of the residents, many of whom have high dependency and highly specialised needs. Since the last inspection a number of new staff have been appointed, to include two registered nurses and four care staff. All of these came to the home from another care home, where the new acting manager had also worked. All were appointed without satisfactory references from their past employer and the majority gave references for each other. This was investigated at a recent additional visit carried out by an inspector and regulation manager. The current owner and acting manager are still attempting to resolve this situation but all the staff are still employed at the home and are said to be satisfactory. Records of all the staff appointed since the last inspection were again checked. With the exception of the records noted above, all had the required Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 17 documentation. The acting manager and proprietor were reminded of their responsibilities in ensuring a robust recruitment process. The pre-inspection questionnaire listed recent training for moving and handling, nutrition, strokes, catheter care, fire and wound care. The home has recently been reaccredited to take students from overseas for adaptation and there are currently two staff undertaking NVQ 2 and four who already have NVQ 2. All staff have complete the TOPPS induction training and further training is planned on food hygiene, stroke updates, fire and wound care. It was advised that all qualified staff should attend update training on pressure sore prevention from observation made in standards 7-11. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,38 The home is managed fairly efficiently but the acting manager lacks some aspects of leadership, guidance and direction to staff, which could impede the health, safety and welfare of the people using the service. EVIDENCE: There is no manager registered at present but an acting manager has been appointed and her application is being considered by the CSCI. Residents made positive comments about the new management of the home, stating that any queries/requests were dealt with immediately and the standards of care had not dropped with the change of management. All of the residents spoken with stated that they had met the new owner and found him very approachable and had been advised to go to him if they had any concerns. Records indicate that regular servicing and maintenance of equipment is being carried out. Mandatory staff training is continued. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 19 One health and safety risk was identified and is to be addressed at once; several upper floor windows have no restrictors fitted and could pose a serious risk to the safety of residents and their visitors. Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 x x x x x x 2 Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 6 Requirement The registered person shall keep under review the Statement of Purpose and Service Users Guide and shall supply a copy of the revised service users guide to each resident/ their representative and the CSCI. The registered person shall not provide accommodation to a service user at the care home, unless they have been assessed by a suitably qualified or suitably trained person and a copy of the assessment is obtained and kept under reviewed. The registered person shall prepare a written plan of care for each service user, in consultation with the service user or their representative where possible and keep it under review. The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. All required documentation as identified in Schedule 4; Regulation 17(2) of the Care Homes Regulations be held in staff files Timescale for action 9/9/05 2. 3 14 9/7/05 3. 7 15 9/7/05 4. 8 13 9/7/05 5. 29 19 9/7/05 Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 22 6. 30 18 7. 38 13 Ensure that the persons employed by employed by the registered person to work at the care home receive training approriate to the work they are to perform. The registered person shall ensure that all parts of the home to which service users have access, are so far as reasonably practicable free from hazards to their safety. 9/9/05 9/7/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 8 Good Practice Recommendations Service users are assessed by a person trained to do so, to identify those service users who have devceloped or are at risk of developing, pressure sores and appropriate intervention is recorded in the plan of care. The incidence of pressure sores, their treatment and outcome, are recorded in the service usersindividual care plan and reviewed on a continuing basis. Equipment necessary for the promotion of tissue viability and prevention and treatment of pressure sores is provided. The registered manager ensures the health and safety of service users and staff through the provision and maintenance of window restrictors being fitted based on the vulnerability of and risk to service users. 2. 3. 4. 8 8 38 Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park, Brockworth Gloucester, GL3 4AB 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 Euroclydon Nursing Home D51_D03_63477_Euroclydon_227833_090605_AI_Stage4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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