Inspection on 22/08/05 for High Peak Nursing Home

This inspection was carried out on 22nd 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 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

High Peak Nursing Home 09/05/07

High Peak Nursing Home 01/09/06

High Peak Nursing Home 09/02/06

High Peak Nursing Home 28/02/05

High Peak Nursing Home 26/07/04

High Peak Nursing Home 08/02/04

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

CARE HOMES FOR OLDER PEOPLE High Peak Nursing Home Main Lane Kenyon Warrington, Cheshire WA3 4AZ Lead Inspector Wendy Smith Unannounced 22 August 2005 nd 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. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service High Peak Nursing Home Address Main Lane Kenyon Warrington Cheshire WA3 4AZ 01925 764081 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) European Care (UK) Limited Care Home 41 Category(ies) of OP Old Age (41) registration, with number of places High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 2 This home is registered for a maximum of 41 service users in the category OP, old age not falling within any other category. Staffing must be provided to meet the dependency needs of the service users at all times, and will comply with any guidance which may be issued through the Commission for Social Care Inspection. The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3 Date of last inspection 28th February 2005 Brief Description of the Service: High Peak is a nursing home for older people set in a rural area between the towns of Warrington and Leigh. It belongs to a small group of homes. The home is currently registered for 41 people, however a total of 35 places are now provided, all in single rooms, most of which have en-suite facilities. The building combines an adapted three storey country house with a two storey, purpose built extension. The building is spacious and is set in its own grounds. Bedrooms are on all three floors, with access to the upper storeys by staircases, passenger lift and stair lift. Staff areas, including the kitchen and laundry, are on the ground floor. The dining room and the main lounge are on the ground floor and there is also a sitting area on the first floor. The home provides good car parking space but is not accessible by public transport. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on August 22nd 2005 over a period of four and a quarter hours. The home was without a manager at the time and the deputy manager was on maternity leave. The two registered nurses on duty, and other staff spoken with, were very helpful and informative. The inspection was carried out using a process of cross referencing the documentation of identified residents following discussion with them, and following the delivery of care and support to them. A tour of the building, including all communal areas and most bedrooms, was completed, and a sample of records was inspected. Due to the absence of a manager or acting manager, management systems within the home were not inspected during this visit. On the day of the inspection 32 residents were living at the home, all of whom were receiving nursing care. Three bedrooms on the second floor were vacant. Five residents and most of the staff on duty were spoken with. Comments cards were left at the home for completion by relatives/visitors and residents. What the service does well: What has improved since the last inspection? The fire alarm is tested weekly to meet with a requirement made at the last inspection. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 6 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. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 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 High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 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 and 5. Standard 6 is not applicable. Prospective residents are assessed prior to admission being agreed to ensure the home will be able to meet their needs. Prospective residents and/or their families are able to visit the home before making a decision. EVIDENCE: A sample of care plans was examined and provided evidence that a senior member of staff from the home had completed a pre-admission assessment for each individual prior to them being admitted to the home. Two residents spoken with informed the inspector that a family member had visited High Peak and had chosen this home for them. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 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, 8, and 9. Each resident has a care plan which details their needs. Residents’ health care needs are met. Medicines were generally well managed but all unused medicines need to be disposed of. EVIDENCE: Each resident has a care plan and these are kept securely in the nurses’ office. A sample of care plans was examined. All of the care plans looked at contained a detailed assessment of the resident’s needs and instructions for how their needs should be met. Care plans had been reviewed monthly. On the day of the inspection two frail residents were being cared for in bed. Repositioning charts and fluid charts recorded care given. There were oral hygiene packs in their rooms and pressure relieving mattresses on their beds. One of the nurses informed the inspector that two residents had pressure ulcers that were very small in size and healing satisfactorily. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 10 A handover sheet from night to day staff recorded any changes in residents’ condition. A number of different hoists are available and these had been serviced in February 2005. Supporting chairs are for provided for frail residents. The home deals with three different GP surgeries. A GP visits by request only. Care plans provided evidence of visits by the continence advisor, dentist and chiropodist. The medicine room was tidy and orderly. There is a large unprotected window in medicine room. See recommendation. One of the registered nurses described the procedure for ordering and checking in medicines, and records examined showed that this was taking place in a safe manner. A monitored dosage system is in use. There were some old stocks of medicines in the controlled drug cupboard (not controlled drugs) that need to be disposed of, and a box of unused medicines was awaiting disposal. The nurse explained that they were waiting for the appropriate disposal containers to be delivered by a waste disposal company. See recommendation. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 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 and 15. The social needs of residents are met. A good standard of catering is provided. EVIDENCE: Most residents sit in the main lounge during the day but a few choose to spend their time in their own room. One resident spoken with was reading the newspaper which he has delivered daily. He said that he likes to joins in activities and enjoys watching sport on TV in his room. He had gone out with his son the day before. A second resident spoken with has a computer in his room and keeps in touch with his family by email. He said that he enjoys some of the activities and also goes out with his family. Another resident goes home several days a week with a private carer. A hairdresser visits the home twice a week and this service is included in the fee paid. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 12 There is a payphone in a fairly quiet area of the home but at the time of the inspection there was no chair for a resident to sit on whilst using the phone. An activities notice-board showed that there are regular religious services and holy communion in the home. There was a programme of daily activities and details of forthcoming events ie a story-telling morning, a clothes sale and a reminiscence session provided by a local museum. The home employs an activities organiser for 16 hours each week and three other staff arrange fundraising events with support from some of the residents’ families. Residents spoken with said that the food served was very good and that a good choice was available. The lunch served on the day of the inspection was very nicely presented. Most residents had their meal in the dining room, which is pleasant and spacious and looks out onto the garden. A separate area of the dining room is available for residents who need extra support from staff with their meal. Staff who were on duty for the whole day had the same meal as the residents. One resident commented that, if he went out during the day, a meal was saved for him to have later. The kitchen was clean and tidy and the cook said that a recommendation made by the environmental health officer had been actioned. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 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) EVIDENCE: High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 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, 20, 21, 23, 24 and 26. Most parts of the home were found to be well-maintained, however a few areas have been identified as being in need of attention. The home has spacious and well-furnished communal areas. Two bathrooms require attention. All residents have single rooms, most of which have en-suite facilities, but some bedrooms would benefit from a new carpet and one needs redecorating. All areas inspected were clean. EVIDENCE: The exterior of the building needs some attention. A number of windows need re-painting; some gutters are overgrown with weeds; there is a lot of moss growing on the flat roof; some windows and window ledges are covered with bird droppings. See recommendations. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 15 The home has lovely gardens and a furnished outdoor sitting area for residents. Communal areas are light, bright and well furnished There is a spacious lounge on ground floor with a separate area for activities. The dining room has enough space for all residents to have their meals. There is an additional sitting area on the first floor. The corridor on the first floor is knocked and marked in places. There is a large bathroom on ground floor with a Parker bath that was serviced in February 2005. The other ground floor bath was out of use awaiting repair and the room was being used for storage. An assisted bath on the first floor was also out of use. The other bathroom on this floor has a bath seat but is not suitable for all residents. Staff said that there was no bath that could be used for residents who need a hoist. See requirement. There were water thermometers in the bathrooms and a sample of hot water tested at 40 degrees. The lock on the second floor bathroom/toilet is broken and needs to be replaced. See recommendation. Bedrooms were clean and tidy. Bedrooms are of different shapes and sizes, most have en-suite facilities and are light and bright but some are a little dark. The carpets in some of the first floor bedrooms are ready for replacement. See recommendation. A bedroom on the second floor has wallpaper peeling off the ceiling. This needs to be redecorated and investigated to ascertain whether there is a damp problem. See recommendation. All areas of the home were clean. There is a sluice on each floor and a laundry on the ground floor. A panel at the bottom of the external laundry door has been replaced with mesh. The staff member working in the laundry said that this had been done to provide ventilation. This made the room cold and draughty to work in although this inspection was in August, and an alternative means of ventilation should be found before the winter. See recommendation. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 16 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. The home provides sufficient staff to meet the needs of residents. EVIDENCE: Staff rotas were inspected. The home employs nine nurses and 25 care staff, with one overseas nurse doing adaptation training. In the morning there are two nurses and six or seven carers on duty, in the afternoon one nurse and five carers, and at night one nurse and three carers. The rotas showed that no staff were working excessive hours, and most work part-time. A small number of staff were working 42 hours in a week to cover for holidays. The home also employs a maintenance person, an activities organiser and an administrator. Each day there are two or three cleaners and a laundry assistant, and in the kitchen two staff in a morning and one in an afternoon. There is little use of agency staff. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 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 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) 31 and 35. A new manager must be appointed as soon as possible. Residents’ finances are handled appropriately. EVIDENCE: The manager has left the home and the deputy manager is on maternity leave. The smooth running of the home is being maintained from day to day by the nurses and other staff, with support provided by a regional manager and a ‘sister’ home in Leigh. A new manager needs to be appointed as soon as possible. See requirement. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 18 An administrator deals with the day to day financial affairs of the home. She holds money on behalf of two residents. One of these residents controls his own finances and writes a cheque when he needs spending money from the bank. The other resident’s finances are looked after by social services and the administrator requests personal money for this person as required. Cash held on behalf of these residents is kept securely and records and receipts are kept for all transactions. These are audited from time to time by the regional manager. Balances were checked and found to be correct. High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 2 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 1 x x x 3 x x x High Peak Nursing Home F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 20 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. 2. Standard OP21 OP31 Regulation 23 8 Requirement Bathing facilities must be provided to meet the needs of residents. A new manager must be appointed as soon as possible. Timescale for action 30/11/05 30/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. Refer to Standard OP9 OP9 OP19 OP19 OP19 OP21 OP24 OP24 OP26 Good Practice Recommendations The window in the medicines room should be made secure from intruders. Unused medicines should be disposed of without delay. Some windows need to be re-painted. Gutterings need clearing of weeds, and moss should be removed from the flat roof. Windows should be cleared of bird droppings. The lock on the second floor bathroom/toilet should be replaced. Bedroom carpets that have become shabby should be replaced. The ceiling in a bedroom on the second floor needs attention. A more satisfactory method of ventilation should be provided in the laundry. F51 F01 S5170 High Peak V237858 190705 Stage 4.doc Version 1.40 Page 21 High Peak Nursing Home Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, CW9 7LT 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. 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