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Inspection on 24/08/05 for Hebburn Court Nursing Home

Also see our care home review for Hebburn Court Nursing Home for more information

This inspection was carried out on 24th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Home provides a very pleasant and homely environment with comfortable and domestic furniture and furnishings. The Home had a very welcoming and friendly atmosphere, which residents and visiting relatives informed the Inspector, was always the case. All visitors to the home were made welcome and treated with courtesy and respect by the staff. A number of staff employed have worked at the home for a considerable time and provide consistency and continuity of care to the residents. A good level of social activity is offered to residents. Residents and visiting relatives spoke well of the staff. Some made such comments as; "I`m very happy with the home, no complaints", "It`s lovely here, couldn`t ask for more", "I`d speak up if I wasn`t happy but I am" and "I get lots of cups of tea `cos I get up early and love tea then".Meals are varied and choices and alternatives are available. The residents enjoy `home style` cooked foods and they were very complimentary about the quality of foods served.

What has improved since the last inspection?

Some bedrooms and toilets have been decorated, with plans for more to be done. New bedroom carpets have been provided where they were needed. The Home has had devices fitted to the fire doors that need to be kept open and were previously `choked` open, in order to ensure fire safety within the home. A new and larger television has been provided, which improves the quality of viewing in the large lounge. More features and facilities are available in the patio area for residents to enjoy both reminiscing and relaxing.

What the care home could do better:

The Manager needs to inform residents in writing that the home can meet their needs. Improvements must continue to make sure that all the necessary documentation is recorded in residents care plans. Nurses must make sure that medicines are kept safe at all times in order to protect residents from potential harm. It was recommended that staff look at the order of serving residents meals to allow them all to eat at the same time on one table.

CARE HOMES FOR OLDER PEOPLE Hebburn Court Nursing Home The Old Vicarage Witty Avenue Hebburn NE31 2SE Lead Inspector Mrs PA Worley Announced Wednesday 24 August 2005 at 09:30am th 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. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hebburn Court Nursing Home Address The Old Vicarage Witty Avenue Hebburn NE31 2SE 0191 428 1577 0191 483 5555 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) Southern Cross Home Properties Limited Mrs C A Craig-Gilby Care Home with nursing 68 Category(ies) of OP Old age - 68 registration, with number PD (E) Physical Disability over 65 - 15 of places Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14th March 2005 Brief Description of the Service: Hebburn Court Nursing Home is a purpose built home situated in a quiet and discreet residential area of Hebburn, at the site of an old vicarage. The rear of the building provides a pleasant garden view and ample privacy. The Home is registered to accommodate up to 68 older people who require personal and/or nursing care, including up to 15 people with physical disabilities. There are 44 single bedrooms, and 12 double bedrooms that are used for single occupancy. En-suite facilities are not provided but there are adeqaute toilets and bathroom facilities throughout the building. The Home has two floors that are accessible by a passenger lift and stairs. A large central reception area on the ground floor provides seating, in addition to the large lounge/dining areas, and is available to service users and visitors. A separate smoking lounge is provided. A large patio with seating facilities is provided to the rear of the ground floor lounge. Access for wheelchair users is available throughout the Home. The Home is within easy reach of public transport facilities, and the local shops and amenities. The Home is about one mile from Hebburn town centre and approximately two miles from the nearby town of Jarrow. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced, and was carried out by one Inspector over one day. Before the inspection a questionnaire had been completed by the Manager, which gave up to date information about the Home to allow more time to be spent with residents on the day. A tour around the home to check the cleanliness, health and safety matters, and maintenance and decoration was carried out. The Inspector spoke with sixteen residents, four visiting relatives, and eleven staff including the Manager, Deputy, Activities Co-ordinator, care staff and nurses, domestic supervisor and maintenance person. The Inspector also had lunch with some residents in one of the two dining rooms. A number of records and documents were examined including residents’ care plans and staff files. An action plan had been received from the Provider following the last inspection when only two requirements were made, one has been dealt with and the other not yet fully dealt with. Not all standards were looked at this inspection and from those that were; three requirements and one recommendation were made. A number of CSCI comments cards were received before the inspection and all were generally very complimentary about the Home and the staff. What the service does well: The Home provides a very pleasant and homely environment with comfortable and domestic furniture and furnishings. The Home had a very welcoming and friendly atmosphere, which residents and visiting relatives informed the Inspector, was always the case. All visitors to the home were made welcome and treated with courtesy and respect by the staff. A number of staff employed have worked at the home for a considerable time and provide consistency and continuity of care to the residents. A good level of social activity is offered to residents. Residents and visiting relatives spoke well of the staff. Some made such comments as; “I’m very happy with the home, no complaints”, “It’s lovely here, couldn’t ask for more”, “I’d speak up if I wasn’t happy but I am” and “I get lots of cups of tea ‘cos I get up early and love tea then”. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 6 Meals are varied and choices and alternatives are available. The residents enjoy ‘home style’ cooked foods and they were very complimentary about the quality of foods served. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 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 Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 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) 3 & 4 Appropriate assessments of service users needs are carried out prior to and following admission, and subsequent assessments ensure that residents’ needs are met. EVIDENCE: Examination of a sample of resident’s records and discussion with the Manager and Deputy Manager indicated that prior to admission to the Home prospective residents had an assessment carried out by the Care Managers and a preadmission assessment by the Home staff. Following admission a further assessment is carried out. Following assessment written confirmation that the Home can meet their needs is not given to residents or their representatives by the Home. A number of residents in the Home stated that their needs were being met to their satisfaction and activities that could be observed throughout the day indicated that they were. Comments received from a service user and one relative included: “I’m well looked after here, got everything I need”, “my aunt has improved greatly since she came here”. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 9 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. Service users appeared well and spoke of staff meeting their health and personal needs. Residents’ care plans are in place, but do not fully reflect their observed needs. This can limit the guidance available to staff regarding care practice and consistency. The safety of medicines was not upheld on one occasion, thereby not fully protecting residents from potential hazards. EVIDENCE: In conversation with the Manager, Deputy and other staff, they displayed a good knowledge of individual residents and their needs. They were able to say how those needs would be met and how identified risks were managed. A sample of care plans were examined and contained some good basic information but more and specific detail, about the needs and care delivered, and addressing changing needs should be recorded. The Provider Company has introduced new care plan documentation format and this is still being implemented, and includes a range of assessment tools and care plan formats. Health related risk assessments were carried out and care plans as to how they were to be acted upon available, but the information in these needed to be Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 10 expanded upon. The care plans contain information and records of the input by GP’s and other relevant professionals. Residents who were spoken with described how their health care needs were met. One resident said, “they tend to my health care very well”, and a relative who visits daily said “ my husbands health is much better since he came here”. Since the last inspection there has been an improvement in care planning documentation, however further development must be undertaken. Although the standard concerning medicines was not assessed on this occasion, a practice was observed that compromised the safety of medicines in that a medicines trolley was left unsecured and unlocked during an administration of medicines ‘round’. This was discussed at the times with the person concerned who acknowledged the error in practice, and also reported it to the Manager. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 11 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 & 15. Residents are offered the opportunity of participating in a wide range of leisure and social activities. Links with family, friends and the community are encouraged, supported and maintained. Residents are offered and receive varied, wholesome, nutritious and wellpresented meals, in a pleasant environment. EVIDENCE: Conversations with the Manager and staff, including the Activities Co-ordinator, and a number of residents, and reference to the programmes displayed, confirmed the range of various activities, events and outings available. Photographs of residents and staff, taken at various outings, are displayed to highlight the events. The Activities Co-ordinator spoke of and showed the increased facilities and features provided through donation and fund raising in the patio area, for the interest and leisure of residents. These included the ‘Olde Shoppe’, which contained items of reminiscence, a conservatory attached to the rear of the building and the gazebo, which contained garden furniture to enable residents to relax sitting outside, but be shaded from the sun if they chose. In conversations with residents it was clear that these were welcome and appreciated. Comments received included: “It’s good to have different things of interest” and “the ‘Shoppe’ brings back so many memories”. The Activities Co-ordinator stated that one to one sessions are carried out with Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 12 residents and relatives to ascertain individuals’ lifestyles and interests, also stimulation activities and entertainment events as well as trips out to various locations. One relative spoke of the “good level of activities and opportunities to go out”. During the afternoon of the visit entertainment was provided by a singer in the style of ‘Elvis Priesly’ and appeared to be very popular with residents. The level of conversation and interactions between residents, visitors and staff indicated that residents were happy with the social opportunities available. A number of residents who preferred to stay in their bedrooms were observed to occupy themselves according to their choices such as reading, crosswords and watching television. They stated that staff respect their wishes not to join in with group activities. The Inspector joined some residents in one of the lounge/dining rooms, for lunch. The tables were very pleasantly set with condiments, serviettes, sugar and milk, and were pleasantly decorated. Hot and cold drinks were offered during the meal and the meal was tasty and well presented. A menu board in the dining room indicated in a clear and legible way, what the meals of the day were. Laminated menus are also present on each table. Alternative choices were served to those people who requested them. Residents confirmed that such facilities and choices were offered on a daily basis and that they always enjoyed their meals. During the lunchtime however, meal meals were served to residents at different times where choices differed, rather than all being served their meal on one table at the same time so all could eat their main meal together. Also, whilst residents commented that the food was good, a number felt that portion sizes were too large and this was off putting to some. Staff were attentive and offered assistance to those who needed it, in a discreet, courteous and unhurried manner. The environment and the atmosphere were sociable and pleasant with very good interactions taking place between residents, staff and visitors. Fresh fruit and jugs of fruit juice, and glasses were available in all lounges throughout the day. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 13 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) 18. Appropriate adult protection procedures are in place and staff have good knowledge and understanding of Adult Protection issues, which protects service users from abuse. EVIDENCE: The Home has a Protection of Vulnerable Adults Procedure (POVA) in place and a copy of the Local Authority’s Procedural Framework for the Protection of Vulnerable Adults, is available to staff. Staff who were spoken with confirmed that they had received POVA training and were able to satisfactorily describe what actions and procedures should be taken on suspicion of abuse or if abuse was seen to take place. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 14 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. The environment of the Home is clean, safe, well maintained and decorated, and appropriate furnishings and equipment are provided for residents’ safety and comfort. EVIDENCE: A tour of the building revealed that the home was clean to a good standard and well maintained. Some areas have been decorated and ongoing plans are in place for continued decoration of bedrooms and toilet and bathrooms. The furniture and furnishings are domestic in character and homely in appearance. All bedroom carpets have now been replaced and provide a safer surface without ‘ripples’ as previously. Since the last inspection self-closure devices have been fitted to fire doors that were previously choked open. A new, large television has been provided in the ground floor lounge, which provides easier viewing in the large room and for those with visual impairment. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 15 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) 29 & 30. Residents are supported and are in safe hands as staff have and continue to receive the appropriate training. The procedures for the recruitment of staff provide the safeguards to offer protection to people living in the Home. EVIDENCE: Inspection of two staff files confirmed that appropriate checks are carried out prior to staff taking up post that includes Criminal Records Bureau (CRB) and POVA register checks, and two written references being obtained. Evidence was also seen of induction training for new staff. In discussions with the Manager and Deputy, and some staff in the Home it was confirmed that a good range of training has been provided. This has included all statutory training required and also a range of specialist and clinical training appropriate to individuals’ roles, such as challenging behaviour, customer care and communications and care of the dying. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 16 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) 36 & 38. Staff receive appropriate supervision, which assists in promoting and safeguarding the best interests of service users. The health and safety of service users and staff is promoted and protected by a well managed Home. EVIDENCE: Discussions with a number of staff confirmed that they receive regular and appropriate supervision, notes of which are kept, and evidence of this was seen. Staff commented that they felt valued and that the Manager and senior staff were approachable and helpful. All staff receive training in health and safety, which includes moving and handling, first aid, food hygiene, Control of Substances Hazardous to Health (COSHH), fire safety, infection control and risk management. Throughout the day staff demonstrated awareness of good health and safety practice. Moving and handling procedures by staff with the residents, were observed to be good Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 17 with appropriate practices carried out. No hazards were identified at this inspection, although it was recommended to the maintenance person and Manager that a particular empty bedroom should have the lux lighting levels checked before a resident moved in, as the lighting in that room appeared to be dim. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 18 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 x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x 3 x 3 Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 19 Yes 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. 2. 3. Standard 4 7 9 Regulation 14(d) 15(1) 13(2) Requirement The Home must confirm in writing that it can meet service users needs. Service users care plans must reflect all known needs and how they are met. The safekeeping of medicines must be ensured at all times. Timescale for action 30/9/05 30/9/05 24/9/05 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 15 Good Practice Recommendations The Manager should review the order of the meals served to enable all residents on one table to eat their meal together. Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT 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 Hebburn Court Nursing Home B52 B02 S39411 Hebburn Court V188839 240805 Stage 4.doc Version 1.40 Page 21 - 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. 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