Inspection on 21/12/05 for Hernes Nest House

This inspection was carried out on 21st December 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

Hernes Nest House 22/05/07

Hernes Nest House 26/04/05

Hernes Nest House 28/10/04

Hernes Nest House 27/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Hernes Nest House Hernes Nest Off Park Lane Bewdley Worcs DY12 2ET Lead Inspector R McGorman Unannounced Inspection 21st December 2005 10:00 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 Hernes Nest House DS0000018464.V268709.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. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hernes Nest House Address Hernes Nest Off Park Lane Bewdley Worcs DY12 2ET 01299 402136 01299 403150 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) Community World Limited Mrs Stella Ann Gurney Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (21), of places Physical disability over 65 years of age (21) Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home may accommodate a named person under the age of 65 years with a physical disability. 26th April 2005 Date of last inspection Brief Description of the Service: Hernes Nest House is registered to provide residential care for up to 21 older people who are frail and unable to live independently, who may have physical or sensory disabilities and who may have mental health problems. Short term placements can be provided in the form of respite or rehabilitative care when a bed is available. Day care can also be provided. The home is owned by Community World Ltd. The managing director is Mrs Stella Gurney, who is also the registered manager and responsible for the dayto-day management of the home. Hernes Nest House, which is an extensive Georgian building, occupies an elevated position in a tranquil part of Bewdley, with panoramic views over the surrounding countryside. It is situated approximately half a mile from the town centre. The property has been sensitively upgraded and extended to provide a high standard of accommodation, and the pleasant gardens are accessible to residents. Hernes Nest House is committed to providing quality services by caring, competent, well-trained staff, in a supportive environment, where service users are enabled and encouraged to live as full, interesting and independent lifestyles as they are able. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine, unannounced inspection was to monitor the care provision at Hernes Nest House, in relation to the stated aims and objectives. The inspection took approximately 3 hours, and time was spent talking with residents, staff, and visitors, to ascertain their views on living and working at the home. The Care Manager was not on duty as she had been unwell, but the Deputy provided assistance throughout the visit, and her help and co-operation were greatly appreciated. Several areas of the home were observed. The care records of residents were seen, and also some staff files. The records kept in respect of the maintenance of equipment and safe working practices were also checked during the course of the inspection. What the service does well: Hernes Nest House is a happy home, where each person is treated as an individual, and where their opinions and views are considered to be valid. A friendly, welcome is given to everyone, and there is a calm and relaxed atmosphere evident throughout the house. The high standard of care is maintained consistently, and the ongoing training provided for staff, ensures that they are given the relevant skills to deliver appropriate care to residents. Comprehensive information is available for residents, their families and interested parties, about the home and what can be provided for the people living there. Only positive comments were received from everyone both verbally and in response to questionnaires. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 6 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. Hernes Nest House DS0000018464.V268709.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 Hernes Nest House DS0000018464.V268709.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): 1,2,& 6 Extensive information is available to residents, and their family or representative, and relevant documentation is in place, to enable an informed decision to be made about future care arrangements. EVIDENCE: A statement of purpose has been produced, and together with the service users’ guide, provides prospective residents with the relevant information to enable them to make a decision with regard to their future care needs. A statement of terms and conditions of residence is provided to each service user as a formal document, which requires a signature by the registered provider, the resident and their representative to confirm acceptance. Intermediate care is not provided at Hernes Nest House. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 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 the following standard(s): 7 & 11 The health and personal care needs of residents are identified, recorded, promoted and monitored on a continuous basis, resulting in effective care being provided. Training is provided for staff to ensure a greater understanding of the issues regarding death and bereavement. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 10 EVIDENCE: Residents, and their relatives, confirmed their satisfaction with the high standard of the care provided and the respectful manner of staff. The courtesy and consideration with which each individual is treated was evident during the course of the visit, and was confirmed in the many positive comments made by everyone, which included: • Staff are always friendly and helpful • The home is committed to providing the best care for everyone • A super home • Residents interests are put first at all times • Staff are very competent • My father is always shown compassion • I am very satisfied with the care provided • This is a very nice home • Living here couldn’t be better • I like living here but I would rather be at home An extensive policy and procedure, that details the action to be taken in the event of a service users death, has been produced by the management of the home. The privacy and dignity of the service user who is dying is maintained at all times, and support from specialist nurses in the care of the dying person is also provided. Training has been organised at the Home recently, with the McMillan Nurses providing a course on ‘Care of the Dying’. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 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 the following standard(s): 12 & 13 The wishes and preferences of service users are constantly respected, in regard to all aspects of their daily lives, which enables a good quality of life to be maintained. Links with the community and family and friends is maintained, and this helps to ensure that the lifestyle of each service users meets their expectations. EVIDENCE: Residents at Hernes Nest House have complete freedom of choice in regard to their contacts, both within and outside the home, and they are enabled to make choices with regard to all the activities of daily living. An extensive programme of activities is provided, with the support of the Activities Organiser, for those who wish to be involved, and residents are consulted individually about their particular interests. Service users are actively encouraged to maintain the social contacts with which they had been involved prior to admission to the Home. There are no restrictions on visitors except in regard to compliance with health and safety regulations. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 12 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 & 17 The culture of the home positively encourages comments, and the procedure for dealing with any concerns ensures that the home is run in the best interests of the service users. The policies implemented at the home ensure that service users are protected, and that their rights are promoted. EVIDENCE: The home operates an appropriate complaints procedure, and information about how to make comments, suggestions or complaints is given to each service user and their representative. A recent complaint had been received from a relative about the care of her mother. The records indicated that an appropriate response had been made, and the matter resolved to the satisfaction of all parties. The policy of the home acknowledges the rights of service users in every respect, and residents are assisted to access medical, legal, advocacy and civic services depending on their individual needs and wishes. Arrangements are made for postal voting where service users are not able to attend the polling station in person. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 13 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): 19,21,23,24 & 26 The standard of cleanliness is excellent, the décor and furnishings are in good condition and the building is well maintained throughout, providing a very comfortable and homely environment for residents. The needs of residents are met in relation to the environment in which they live, and their safety and wellbeing is assured as far as possible at Hernes Nest House. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 14 EVIDENCE: Hernes Nest House is a Georgian building, which has been sensitively developed to provide a pleasant environment for service users. The standard of cleanliness is excellent, the décor and furnishings are in good condition and the building is well maintained throughout. There is an on-going programme of maintenance and decoration and the gardens, which are accessible to service users are well kept. The management consult with the Environmental Health Officer regarding all aspects of health and safety. The report of a recent visit to the home confirmed that there are no outstanding matters. Asbestos was identified in the cellar following a routine check, and this has been removed recently. The home has not received a recent visit from the Fire safety Officer, although the building, and the fire protection procedures have previously been compliant with requirements. There are three bathrooms and one shower room, each with a toilet, suitably located around the building. In addition, there are three separate toilets on the ground floor and one on the first floor. Two double and one single bedroom have en suite facilities. There are a variety of sizes and shapes of rooms occupied by service users, all of which meet legislative requirements. The policy of the Home is to provide shared accommodation only to those people who have expressed a wish to share. Service users are encouraged to personalise their bedrooms and each room is furnished to a comfortable standard. Three bedrooms have recently been decorated The high standard of cleanliness and consistently pleasant atmosphere throughout the home is commendable. Infection control procedures are implemented, and protective clothing is provided for staff. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 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 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): 29 & 30 Recruitment and selection procedures are detailed and thorough, and help to ensure the protection of residents. Staff are well trained and experienced, and competent in their understanding of the needs of residents, which enables the appropriate delivery of care. EVIDENCE: These standards were not inspected in detail on this occasion, but were met previously. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 16 The staff group is usually quite stable, although recent trends have been for staff who had received training at the home to move to more senior positions elsewhere. There have been a number of changes during the past 12 months. The Inspector was able to speak with several members of staff, who were all very happy in their work. They confirmed that appropriate recruitment procedures are followed, and that opportunities for training are provided. A thorough recruitment and selection procedure is followed, with verbal and written references being obtained. The files are maintained to a satisfactory standard, and contain relevant information. The employment of a member of staff had been terminated earlier in the year, for failing to disclose relevant information during the selection process. The matter had been dealt with appropriately, although the Commission had not been notified under Regulation 37. A commitment to training is evident at the Home. A record of the training provided for staff is maintained, and also the training needed by each member of staff is identified. Currently 3 staff have the NVQ Level 2 in Care, and 5 carers have applied to commence their training in the new year. In addition 3 staff have achieved Level 3 in Care. There are 3 NVQ Assessors on the staff team. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 17 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): 31,34,35 & 37 The management arrangements at the home are satisfactory, and residents and staff benefit from the positive approach and the leadership they receive. Suitable accounting arrangements are in place to ensure satisfactory management of the business, and the financial procedures safeguard the interests of service users. The policies, procedures, and records maintained at the home, comply with legislative requirements, and therefore help to safeguard the rights of service users. The health, safety and welfare of residents and staff is promoted at the home, and procedures are in place to ensure that they are protected in respect of all safe working practices. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 18 EVIDENCE: Mrs Gurney, the Registered Manager, has many years experience in the care of older people, initially training in secretarial work and then in nursing and midwifery. Mrs Gurney has also undertaken the ENB998 course in Teaching and Assessing in Clinical Practice. She is a NVQ Assessor. In October 2002 she achieved the Diploma in the Management of Care Services. The Care Supervisor, Heather Tong, is becoming more involved in the day-today management of the home, and gradually taking on additional responsibilities in support of the Manager. She commenced the Registered Managers Award in September, and is also a NVQ Assessor. Staff do not have responsibility for managing the financial affairs of any service users. The families or a representative deal with any financial matters, on behalf of service users who are unable, or do not wish to manage their own affairs. Safe storage of valuables is available. An administrator and accountant deal with the financial aspects of the business and an annual plan is produced, although not inspected on this occasion. Appropriate insurance cover is maintained, in respect of all aspects of the business, as evidenced by the certificate. The records were not checked in detail during the inspection, although those seen had been completed to a satisfactory standard. Contracts are in place for the regular servicing and maintenance of equipment. The Fire Log indicated that weekly checks of the fire alarm system, and practice evacuations are undertaken. The Accident records had been completed appropriately, and Regulation 37 Notifications made to the Commission, when appropriate, with one exception. Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 19 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 3 X 3 X 3 3 X 3 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 3 X X 3 3 X 3 X Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 20 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 OP38 Regulation 37 Requirement Notification must be made to the Commission of the occurrence of all accidents, injuries, illness and incidents, in accordance with Regulation 37 and Standard 38. Timescale for action 31/12/05 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 Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Hernes Nest House DS0000018464.V268709.R01.S.doc Version 5.0 Page 22 - 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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