Inspection on 31/10/06 for Henry Nihill House

This inspection was carried out on 31st October 2006.

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

Henry Nihill House 26/01/06

Henry Nihill House 19/07/05

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 Mr David Hastings Key Unannounced Inspection 31st October 2006 09:30 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 Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Henry Nihill House Address 94 Priory Field Drive Hale Lane Edgware Middlesex HA8 9PU 020 8905 4200 020 8958 4713 nuns.osb.edgware@btclick.com 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) The Community of St Mary at the Cross Mrs Susan Margaret Teresa Sinfield Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. 26th January 2006 Date of last inspection 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 Marys 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. The current scale of charges range from £560 to £662 per week. A copy of this report is available on the CSCI website or/and from the home. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 31st October 2006 and lasted six hours. Nine residents and six staff were spoken to. Prior to the inspection the CSCI received eight feedback cards from residents and relatives as well as feedback from the local GP. Comments received were overwhelmingly positive 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: Two requirements and three good practice recommendations have been issued as a result of this inspection. Staff would benefit from updated training around adult protection issues. The home must formalise its quality assurance systems in order that current and potential residents know how well the home is doing in meeting its aims and objectives. A more detailed system of analysing falls could identify any potential trends. The manager should carry out a training audit to identify any staff who have not completed the required mandatory training at the home. In light of a number of fires occurring at night in residential homes across the country, it would be prudent for night staff to undertake fire drills every three months. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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 Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 4 (6 not applicable) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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. 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. Although there are some service users at the home of different faiths the manager acknowledged that the service user guide Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 9 would benefit from having a clearer statement regarding how the home encourages a more diverse service user group. The manager informed the inspector that she would be carrying out a review of this document shortly. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. 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 were being reviewed monthly with a brief summary recorded regarding how the service user has been getting on and any input from medical professionals also being recorded. Service user’s comments about their care were also being regularly recorded. These were two requirements from the last inspection that have both been complied with. Risk assessments in relation to falls were seen on service user files. All falls are being recorded appropriately and the Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 11 manager uses this information to highlight any potential trends and refers service users at risk of fall to the “falls clinic”. The inspector discussed with the manager how a more detailed analysis of falls might further highlight potential trends. A good practice recommendation has been made regarding developing a system of analysing falls in the home. 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. 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. All records were detailed and accurate. A requirement relating to the recording of medication received by the home has now been complied with. The manager informed the inspector that the home’s doctor reviews one service user’s medication each week when he visits the home. This is very good practice. 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 confirmed that staff always knocked on their doors before entering. Staff interviewed were able to give clear examples of how they maintain service users’ privacy. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users can choose from a range of interesting activities both inside and outside the home. Service users are able to maintain contact with friends and family and visitors are encouraged. Service users are able to exercise choice and control over their lives. Service users receive a wholesome and appealing diet in a pleasant and relaxed environment. EVIDENCE: Service users were keen to tell the inspector about activities available to them at the home including dancing, flower arranging and arts and crafts. Some service users have completed training courses at colleges and other service users enjoy regular swimming trips. Service users can attend chapel every day if they so wish and there is a well-tendered garden with raised flowerbeds. The inspector also saw staff sitting and talking with less mobile service users. Service users informed the inspector that visitors to the home are welcomed. The record of visitors also confirmed that relatives and friends could visit service users 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. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 13 Lunch was sociable and enjoyable. Service users said the food was very nice at the home. Staff were observed offering discreet assistance were needed. One service user commented that the food was, “very good”. The cook came out of the kitchen after lunch to see how service users had enjoyed their meal. One service user commented that, “it is a pleasure to eat in the dining room”. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and dealt with properly by the management of the home. Service users are protected from abuse by clear procedures and policies. EVIDENCE: The record of complaints was examined. There have been two recent complaints. The first complaint was investigated and dealt with by the manager in an appropriate manner and action taken accordingly. The second complaint concerned a service user falling during the night and night staff not informing the relative until the morning. The relative had expressly requested that they be informed of any matter of concern at any time of the day or night. The manager admitted that mistakes had been made in relation to communication. The inspector was satisfied that new procedures had been implemented as a result of the complaint to ensure that this situation would not reoccur at the home. 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 interviewed were aware of the general issues of abuse however records indicated that staff training on adult protection had taken place some time ago. Staff would benefit from further adult protection training, which would raise awareness of the issues faced by vulnerable service users. A requirement has been issued in the relevant section of this report. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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. 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 Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 16 who is responsible for a group of domestic staff. The domestic staff are to be commended for their hard work in ensuring the home is clean and free from offensive odours. The laundry area is accessed through the Convent. Washing machines wash at the correct temperatures to minimise the risk of cross infection. Training records indicated that staff have undertaken training in infection control. Staff awareness of this issue minimises the risk of cross infection and better protects service users. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing levels at the home are good and staff have the appropriate training and the skills needed to meet the needs of service users. Service users are supported and protected by the home’s recruitment policy and practices. EVIDENCE: Present on the day of the inspection were the manager, two nurses, seven carers, two handypersons, three domestics, one cook and a kitchen assistant. The staffing rotas examined reflected this. The manager stated that there is always at least one trained nurse on duty. The home has employed two senior nursing staff to assist the manager with management tasks as well as working with service users. This is a very positive step forwards for the organisation. Service users said they were satisfied with the level and quality of staff at the home. One service user commented that the staff were, “very good” another service user said the staff were “caring and helpful”. Of the twenty-one care staff, thirteen have completed NVQ level 2 or equivalent training. This means that 62 of the care staff have now completed the training required by Standard 28 of the National Minimum Standards. This Standard has been met. Three staff files were examined. These files, of the most recently employed staff, contained all the information required by standard 29 of the National Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 18 Minimum Standards. This included CRB disclosures, proof of identity and two written references. This Standard has been met. The manager has developed a training plan for the coming year and all staff have an individual training plan. Staff that the inspector spoke with were very positive about the training opportunities available to them. A recommendation has been issued that the management carry out a training audit for all staff to ensure that everyone has attended mandatory training. The home has an excellent induction system for all new staff. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and service users and staff benefit from the professional and open approach of the registered manager. Service users have a say in how the home is run and their financial interests are safe guarded by clear policies and procedures. The home has good policies and procedures to monitor health and safety compliance and promote and protect service users and staff safety. EVIDENCE: Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 20 The registered manager is a qualified nurse, and also has a certificate in NVQ level 5 in management and BSc in professional nursing practice. Both service users and staff that the inspector spoke with were very positive about the manager’s role within the home and her ability to create an open and inclusive atmosphere. The registered provider carries out monthly visits to the home and provides written reports to the CSCI. Service user meetings take place approximately every three months and service users’ views about the home are being recorded monthly. Satisfaction surveys are available to service users and their representatives. In order to fully meet this Standard the results of these surveys must be published and made available to existing service users as well as potential residents to the home. A requirement has been issued, relating to this, in the relevant section of this report. Feedback received from service users and their representatives was overwhelmingly positive regarding the quality of care provided by staff at the home. All service users have a lockable safe in their room. Small amounts of money are held in these safes and most service users manage their own financial affairs. The inspector checked a random sample of accounts that the manager assists service users with. All these accounts were accurate and clear audit trails were in place including appropriate receipts. Records in relation to fire safety were examined. A requirement was issued at the last inspection that the fire emergency evacuation plan must be reviewed and a copy sent to the local fire officer. This requirement has now been complied with. A good practice recommendation has been issued that night staff receive fire drills every three months. The last recorded fire drill for night staff was 18/10/06. The fire alarm was serviced on 07/08/06 and fire call point checks were being carried out weekly. Water temperatures are being monitored weekly and all radiators seen were appropriately covered. Portable appliance checks are carried out by the maintenance staff who have been trained to do so. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 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 3 X 4 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 X 4 X X 3 Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP18 Regulation 13(6) Requirement The registered manager must ensure that all staff undertake adult protection training in order to update their knowledge and awareness about this issue. The registered manager must ensure that results of service user satisfaction surveys are published and made available to current and prospective service users, their representatives and other interested parties, including the CSCI. Timescale for action 01/04/07 2. OP33 24(1) 01/03/07 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 OP7 Good Practice Recommendations The registered manager should develop a system for monitoring and analysing falls and accidents at the home. This could include information regarding where and when the fall took place as well as the name of the service user and staff on duty at the time. DS0000010452.V318084.R01.S.doc Version 5.2 Page 23 Henry Nihill House 2. 3. OP30 OP38 The registered manager should carry out a training audit in order to identify staff that have not completed the mandatory training required. The registered manager should ensure that night staff undertake fire drills every three month so that all night staff are confident they know what to do in the event of a fire occurring in the home at night. Henry Nihill House DS0000010452.V318084.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000010452.V318084.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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