Inspection on 19/09/05 for Evergreen Lodge Nursing Home

This inspection was carried out on 19th September 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

Evergreen Lodge Nursing Home 01/10/07

Evergreen Lodge Nursing Home 07/08/06

Evergreen Lodge Nursing Home 05/01/06

Evergreen Lodge Nursing Home 04/02/05

Evergreen Lodge Nursing Home 20/09/04

Evergreen Lodge Nursing Home 28/01/04

Evergreen Lodge Nursing Home 15/09/03

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

CARE HOMES FOR OLDER PEOPLE Haddon Nursing Home Haddon Road Rock Ferry Birkenhead Wirral CH42 1NZ Lead Inspector Leila Mavropoulou Unannounced Inspection 16th September 2005 11:00 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 Haddon Nursing Home DS0000034955.V252408.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. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Haddon Nursing Home Address Haddon Road Rock Ferry Birkenhead Wirral CH42 1NZ 0151 643 1068 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) Haddon Nursing Home Ltd Elizabeth Ann Nolan-Davies Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named person under 65 years of age Date of last inspection 4th February 2005 Brief Description of the Service: Haddon House is purpose built care home providing personal care and support for 34 older people with dementia. The home is located in the Rock Ferry area on the Wirral and is easily accessible by public transport. All of the residents’ accommodation is provided in single bedroom on the ground and first floor of the home. The home has a large sitting room, conservatory and dining room on the ground floor. The home is staffed twentyfour a day by a qualified Registered Mental Health nurse. The home has various aids to promote the residents’ independence and safety such as: grab rails, assisted baths, passenger lifts and hoists. The benefits from regular maintenance of the building and bedrooms are decorated when they become vacant. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted four and half-hours. During this time resident files and staff files were inspected as well as other records the care home is oblige to keep. Three staff and two residents were spoken to, as well as the manager of the home. What the service does well: What has improved since the last inspection? What they could do better: The staff at the care home should ensure that the residents are stimulated through direct interaction and communication with the residents, as this is not only for the activities person role. The communal lounge could be better ventilated to remove the stale odour that exists in the lounge to improve the environment for the residents. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 6 The staffing level should be reviewed to reflect the high dependency level of the residents to ensure that their care needs are met in a manner that promote their independence and choice. 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. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5,6 Staff assesses prospective resident prior to admission to ensure that the home can provide the necessary care to the resident. EVIDENCE: Inspection of resident file and discussion with the manager confirm that the staff at the care home assesses the residents needs prior to admission to ensure that the home would be able to meet the needs of the residents. The staff uses the Care Management Assessment to inform their assessment and the initial resident’s care plan and risk assessment. Where possible the home would support and encourage the resident to visit the home and to enable staff to assess the resident in the home environment. However, discussion with the manager indicated that this does not happen frequently, as the resident is usually in hospital. However, in most instances the prospective resident family visits the home and make a decision on their behalf. The home does not provide intermediate care. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 9 Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The nursing staff have developed detailed care plans and risks assessments to ensure that the needs of the residents are met. EVIDENCE: Inspection of a sample of residents’ file show that a care plan in place showing how their assessed needs would be met together with how risks identified would be minimised. The nursing staff with the resident key worker would review the resident care plans monthly as evidenced in the care plans seen. The nursing staff would change aspect of the resident care plan to reflect changes in the care that resident require. The nursing staff carries out various other assessment that inform the resident care plan such as: nutritional assessment, moving and handling, weight chart etc. The staff at the care home records significant conversations with the resident’s family and other health professional is recorded to enable staff to trace what action was taken, when and by whom. The health care of the residents’ is met through regular monitoring by the nursing and care staff and where necessary advice from other health professionals would be obtained. This include support from the Tissue Viability Nurse, Community Psychairtric Nurse, the continence adviser, GP, speech Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 11 therapist etc. The home has various aids in place to prevent pressure ulcers from developing such as pressure relieving mattresses and cushions. In addition the residents have regular health checks from the dentist, optician and chiropodist. The nursing staff at the care home administers all of the residents’ medication in the care home. The staff maintains a record of all of the residents medication received into the care home and returned to the pharmacist. The recording of administration of residents’ was generally good. However, there were a couple of omissions of signatures when medication should have been administered. Observation of staff supporting the residents showed that the residents are treated with respect and dignity. This was evidence by staff assisting the residents to the toilet and enabling them to take part in the sing-a-long. All of the accommodation provided at Haddon House is in single bedrooms. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The residents exercise choice over all aspects of their daily lives and are supported to maintain contact with the community and their family to promote their emotional/psychological well being. EVIDENCE: The daily routines in the home is flexible to meet the needs of the resident eg.if a resident had a disturbed night they are able to stay in bed the following day until late morning. The activities person tries to gather information about the residents’ interests to ensure that she is able to incorporate their likes into the activities programme. The activities person spends time with individual residents, if they do not like to participate in the group activities and a record is kept of stimulation provided to the residents. The home organised a trip to Chester Zoo and an outing on the ferry recently to enable the recent to access community facilities. In addition entertainers are brought into the home from time to time. The home has an unrestricted visiting policy and residents are able to choose where to see their visitors. The residents are unable to manage their own finances due to their illness. Thus, residents’ monies are managed through their family or solicitor. A Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 13 secure place is provided to store residents’ valuables and monies in accordance with the home’s policy. The staff would give the resident’s family a receipt for item handed over for safekeeping. Where items are bought or expenditure made on behalf of the residents eg. Hairdressing, a written record is maintained and receipts are kept. The catering staff maintains a record of food provided to residents and the nursing staff provide information to the catering staff about the dietary needs of the residents. This may include soft diet or diabetic diet. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has various policies and procedures in place to protect its residents from all forms of abuse. EVIDENCE: The home has a complaints procedure, which the management encourage residents and their family to use. The home’s complaints procedure is displayed in the reception area. Discussion with the manager is that often if the resident or family has any concerns they would speak to a member of staff or her and the issue would be address before it is formalised. The home adheres to the Wirral Adult Protection Procedures and has a Whistle Blowing Policy. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home is well maintained internally and externally to promote the safety of the residents. EVIDENCE: The home is generally well maintained both internally and externally. The home employs a general maintenance person who is responsible for ensuring that minor repairs are undertaken once they are reported to the manager. Since, the last inspection some of the vacant rooms have been redecorated and new chairs have been purchased for the conservatory. The cushions of the chairs in sitting room are sunken and would not provide adequate support to the residents. Thus, the registered persons should consider the renewal/reupholstering of the chairs in the sitting room in the planned maintenance programme and budget. The grounds of the home are clean, well maintained. The lounge, conservatory and the dining room could be used Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 16 for a variety of activities. The wheelchair users in the home are able to access the rear garden easily. The home has a various aids to promote the safety and independence of the residents such as: passenger lift, assisted baths, grab rails, raised toilets, call system in all parts of the home. However, the residents are unable to use the call system due to their illness. The home provides various aids to enable residents to be transferred easily and safely and to protect the staff from injury. The accommodation provided is in single bedrooms. All of the bedrooms are easily accessible. The residents are encouraged to bring into the care home the care home their belongings to make settling in easier and to personalise their bedroom, as evidence in residents bedrooms seen. The accommodation throughout is centrally heated, well lit and ventilated except for the sitting room. The manager explained one of the causes for the lack of change of air in the sitting room and ways were discussed how this could be improved, which she would discuss with the staff. Emergency lighting is provided throughout the home and is checked regularly, as evidenced in the home fire records and water temperatures are checked regularly and records are maintained. The home has a large laundry room on the second floor, which is located away from the food preparation area. The home has various policies and procedures in place to prevent the spread of infection. Observation of staff showed that the necessary protective clothing is provided and used by the staff at the home to promote the health of the residents. Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,28 The staffing level of the home must be reviewed to reflect the assessed needs of the residents to ensure that their needs are met in a manner, which promote their independence and choice. EVIDENCE: The home maintains a record of all staff employed in the care home and what capacity they are working. Inspection of the staffing rota, observation of residents and discussion with the manager and nursing staff indicated that given the high dependency level of the residents and the category of care provided at the home, the residents would benefit from improved quality of care, if the staff hours in the morning is increased to reflect the level of activity during that time. In addition to care staff, the home employs domestics to ensure the cleanliness of the building. At the time of the inspection the home was clean and free from malodour. The manager has planned a various training courses for the staff to attend to improve the quality of care provided and to promote both the resident and staff safety. The home is currently working towards 50 of its staff group achieving the NVQ level Care Award. In addition training for trained staff have been organised in the following areas: catheter training, assisted feeding certificate, dementia training fire instructions and Load Management. The home has recently joined an infection control group and is one of the homes being used for a pilot study for nutritional assessment screening (MUST). Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 18 Inspection of some of the staff records show that two written references and a Criminal Records Bureau check for all staff are obtained, before the staff could commence their employment in the care home. This is to protect the residents from all forms of abuse. The staff files show that they are given a written terms and conditions of employment. Haddon Nursing Home DS0000034955.V252408.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): 32,3336,37,38 The management of the home promote the safety of the residents through regularly reviewing all aspect of the homes operation. EVIDENCE: Discussion and observation with the manager showed that she is approachable and accessible to residents, their family and to staff at all times. Discussion with the staff shows that the manager provides direction and leadership and work towards improving the quality of care provided in the home. The home continually works towards improving the quality of care provided at the home. This is evidenced by the home maintaining the ISO 9000 quality Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 20 award and the Investors In People Award, which focuses on staff having the necessary training and skills to meet the aims and objectives of the home as set out in the home’s Statement of Purpose. The home has implemented “one to one” supervision of staff and a record is maintained of issues discussed in supervision. The residents are able to access their records in accordance with the home’s policy on access of information. It was observed that residents’ records were kept in a secure place. The health and safety of the residents is promoted through the staff receiving appropriate training in food hygiene, first aid, moving and handling and fire awareness. Fire drills are carried out regularly as evidenced in the home’s fire records. In addition regular routine maintenance to the building and servicing of equipment is carried out in accordance with the manufacturer instructions or Health and Safety Executive such as:- maintaining records of all accidents/incidents to residents and staff. The manager of the home carries out a detailed risk assessment of the building, which is review monthly to promote the health and safety to the residents and the staff. The home informs the Commission of any significant event in the care home. Haddon Nursing Home DS0000034955.V252408.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 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 3 3 N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 2 x 3 x 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 3 x x 3 3 3 Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 22 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 OP9 Regulation 13 Requirement Some staff including night staff are attending a course on Emergency Lift Management to promote the safety of the residents. The registered person must ensure that suitable chairs are provided to meet the needs of the residents. The registered person must ensure that the number of staff employed in the care home at all times are appropriate for the health and welfare of the service users. Timescale for action 01/11/05 2 OP20 16 01/11/05 3 OP27 18 01/11/05 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 Haddon Nursing Home DS0000034955.V252408.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Haddon Nursing Home DS0000034955.V252408.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!