Inspection on 19/07/05 for Henry Nihill House

This inspection was carried out on 19th July 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

Henry Nihill House 31/10/06

Henry Nihill House 26/01/06

Henry Nihill House 31/01/05

Henry Nihill House 02/08/04

Similar services:

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Spring Lane Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE HENRY NIHILL HOUSE 94 Priory Field Drive Hale Lane Edgware, Middlesex HA8 9PU Lead Inspector David Hastings Announced 19 July 2005 @ 09.30 am 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. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Henry Nihill House Address 94 Priory Field Drive, Hale Lane, Edgware, Middlesex HA8 9PU 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) 020 8905 4200 020 8958 4713 Sister Mary Theresa Zelent of The Community of St Mary at the Cross Susan Sinfield N Care Home with Nursing 30 beds Category(ies) of PD - Physical Disability (9 beds) registration, with number OP - Old Age of places HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home shall not accommodate more than 9 physically disabled persons, some of whom may be elderly, at any one time. Date of last inspection 31 January 2005 Brief Description of the Service: Henry Nihill House is a modern, purpose built care home registered to provide personal care and nursing care for a maximum of thirty older people, nine of whom can be physically disabled from the age of 18 years and upward. The home is owned by a religious order called The Community of St. Mary at the Cross. The stated aim of the home is to provide a secure, relaxed and homely environment in which service users’ well being and comfort are of prime importance. The home is a large detached two storey building situated in the extensive grounds of the convent of St Mary’s at the Cross. It has thirty single bedrooms of which are spacious and have en-suite facilities. There is a kitchenette on each floor. The communal areas are a spacious lounge/sitting area that can be divided into two rooms, an open plan dining room is on the ground floor, two day/quiet rooms, a small attractive front garden and an open landscape garden at the back. The home has recently built a conservatory area, which opens out on to a paved patio area for service users to walk at their leisure. The home has its own driveway and provides parking facilities for visitors and staff.The home is about half a mile from the A1 and close to Edgware shopping area, restaurants and pubs. Public transport facilities are also near and the nearest underground transport link is Edgware. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.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 Tuesday 19th July and lasted six hours. Nine residents, three visitors and five staff were spoken to. One relative and one resident returned completed comment cards to the CSCI prior to the inspection. Comments received from both residents and relatives was overwhelmingly positive regarding the home and all residents indicated that they were happy at the home. A tour of the premises took place and case notes where examined. The inspector was assisted by the registered manager who was open and helpful throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Although records in relation to the administration of medication have improved, better recording of the receipt and disposal of medication at the home is needed. Residents should be given the opportunity to take part in the review of their care plan if they want to. One radiator in room 18 needs to be fitted with a safety guard and thermometers need to be available in all bathrooms. Six requirements have been issued as a result of this inspection and the inspector is confident that the manager will comply with these within the timescales given. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 6 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. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.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 HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.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) 3 and 4 (6 not applicable) Service users have their needs assessed by professionals so that they know the home will be able to meet their needs before they decide to move in. The home is able to meet the needs of the service users living there. EVIDENCE: Six service user files were examined. These all contained detailed pre admission assessments undertaken by people trained to do so. There was evidence that comprehensive assessments had been carried out prior to any service user being admitted to the home. There was also evidence that service users had attended reviews after a six-week settling in period. The assessments covered all the requirements of Standard 3 of the National Minimum Standards. Service users that the inspector spoke with were very positive about the care they received from the staff at the home. It was clear from these discussions and from the care plans examined that the home was able to meet the needs of the service users living there. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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, 8, 9 and 10. Service users health, personal and social needs are known to staff and recorded in individual care plans. There is good access to health care professionals such as doctors, dentists and chiropodists. Service users get the right medication that has been prescribed for them at the right times and by properly trained staff. Better recording of the receipt and disposal of medication is needed. Service users are treated with respect and dignity. EVIDENCE: Six care plans were examined. The care plans examined were detailed and outlined how individual needs were to be met. Risk assessments contained practical information regarding how to minimise potential risks. Care plans are being reviewed monthly. This was a requirement from the last inspection that has now been complied with. Some care plans did not detail how the service user was involved in the monthly review. A new requirement has been issued relating to this matter. A requirement was issued at the last inspection that one specified service user with complex needs must have a comprehensive care plan including palliative care input. This care plan was examined and the level of detail was very good and appropriate to the needs of the service user. This requirement has been complied with. Risk assessments in relation to falls HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 10 were seen on service user files. All falls are being recorded appropriately and the manager uses this information to highlight any potential trends and refers service users at risk of fall to the “falls clinic”. This was a requirement from the last inspection that has been complied with. It was clear from discussion with service users and from information recorded in care plans that service users have good access to health care professionals. One service user commented that the home was very good at organising ongoing appointments The management of pressure ulcers in the home is satisfactory and there were detailed records in relation to this. Records in relation to the receipt, administration and disposal of medication were inspected. A requirement was issued at the last inspection that all medication administered to service users must be recorded accurately. Records examined indicated that this requirement has now been met. The receipt of medication coming in to the home is not always being recorded accurately. It was also noted that the records in relation to the disposal of medication was not always accurately detailed. A few self-medication forms had not been signed by the doctor to indicate that the service user had been assessed as being able to self-medicate. Three requirements in relation to these issues have been made in the relevant section of this report. Apart from these issues the medication records and storage were satisfactory. During the inspection there were clear examples seen of staff respecting the privacy of service users. Service users that the inspector spoke with said staff treated them with respect and one service user commented that “the staff are very polite” another service user said that “they look after you”. Service users confirmed that staff always knocked on their doors before entering. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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, 13, 14 and 15. Service users can choose from a range of interesting activities both inside and outside the home. Involvement in the local community is encouraged and visitors to the home are welcomed. Service users receive a wholesome and appealing diet in a pleasant and relaxed environment. Staff at the home respect service users’ privacy. EVIDENCE: Service users were keen to show the inspector craft items they have made at the home. Some service users have completed training courses at colleges and other service users enjoy regular trips swimming and fishing. Service users can attend chapel every day if they so wish and there is a well tendered garden with raised flower beds. The inspector also saw staff sitting and talking with less mobile service users. Visitors to the home that the inspector spoke with said they were always made welcome and records examined indicated that service users could receive visitors at any reasonable time. It was apparent from talking with service users that they were able to exercise choice and control over their lives. A choice of menu is offered. Lunch was sociable and enjoyable. Service users said the food was very good at the home. Staff were observed offering discreet assistance were needed. Two requirements relating to the labelling of frozen food and the recording of food provided by the home have both been complied with. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 12 HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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) 16 and 18 Complaints are taken seriously and dealt with properly by the management of the home. Service users are protected from abuse by clear procedures and by a properly trained staff team. EVIDENCE: The home has a clear and comprehensive complaint policy and a recording log. One compliant has been received since the last inspection and records indicated that the manager had dealt with this in a satisfactory and timely manner. All the service users interviewed were aware of the complaints policy and procedure however none had any comment to make about the home apart from praise and complements. The home has a satisfactory adult abuse policy, which is in line with the local authorities procedures. Staff files examined indicated that staff have been trained in adult abuse awareness. Staff interviewed had a good understanding of the types of abuse and what they would do if they suspected abuse was occurring at the home. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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 and 26. Service users live in a safe and well-maintained home, which is decorated to a very good standard. EVIDENCE: Henry Nihill is a modern, purpose built care home registered for a maximum of thirty older people, nine of whom can be physically disabled from the age of 18 years upwards. All the bedrooms are spacious with en-suite shower facilities to accommodate wheelchair users. The communal areas consist of a large lounge/sitting area, which can be divided into two rooms for activities, open plan dining area, conservatory, and small meeting/quiet areas on the ground floor. The corridors are very wide to accommodate at least two wheelchair users passing. The grounds are beautiful and well kept. There are car park facilities for visitors and staff. During the tour of the building it was evident that that the home was very clean and well maintained. The home employs a housekeeper who is responsible for a group of domestic staff. The laundry area is accessed through the Convent. Washing machines wash at the correct temperatures to minimise the risk of cross infection. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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) 27 and 29 Staffing levels at the home are satisfactory and staff have the skills needed to meet the needs of service users. Service users are protected by clear staff recruitment procedures. EVIDENCE: Present on the day of the inspection were the manager, two nurses, seven carers, two handypersons, three domestics, one cook, one cook assistant, one admin person and one receptionist. The staffing rotas examined reflected this. The manager stated that there is always at least one trained nurse on duty. Service users said they were satisfied with the level and quality of staff at the home. One visitor told the inspector that the staff, “really do care about the people living in the home”. The home has a satisfactory recruitment procedure, which include the need for a CRB disclosure and two written references before any staff are employed at the home. Four staffing files were examined. These all the contained the required information to meet this standard. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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) 38 Overall the home has good policies and procedures to monitor health and safety compliance and promote and protect service users and staff safety. EVIDENCE: All health and safety certificates examined were up to date and records seen in connection with fire safety were satisfactory. The accident book was in order and the manager uses the information to identify any patterns of falls. Water temperatures are being monitored weekly, however all bathrooms need thermometers for staff to check temperatures. All radiators seen were appropriately covered with the exception of one radiator in room 18. This will need to be covered. Portable appliance checks are carried out by the maintenance staff who have been trained to do so. HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 17 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 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 18 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 7 Regulation 15(2)c Requirement The registered manager must ensure that records indicate that service users have been involved in the monthly review of their care plan if they so wish. The registered manager must ensure that all medication recieved by the home is accurately recorded. The registered manager must ensure that any disposal of medication in the home is accurately recorded. The registered manager must ensure that self medication risk assessments are signed by the service users doctor to confirm the service user is able to self medicate. The registered manager must ensure that thermometers are available in all bathrooms in order check water temperatures are safe. The registered manager must ensure that the radiator in room 18 is covered with a safety guard. Timescale for action 01/10/05 2. 9 13(2) 01/09/05 3. 9 13(2) 01/09/05 4. 9 13(2) 01/09/05 5. 38 13(4)b 01/09/05 6. 38 13(4)b 01/10/05 HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 19 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 Good Practice Recommendations HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London, N14 6HA 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 HENRY NIHILL HOUSE G59 S10452 Henry Nihill House V231024 21.07.05 Stage 4.doc Version 1.30 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. 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!