Inspection on 09/02/06 for High Peak Nursing Home

This inspection was carried out on 9th February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

High Peak Nursing Home 09/05/07

High Peak Nursing Home 01/09/06

High Peak Nursing Home 22/08/05

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 High Peak Nursing Home Main Lane Kenyon Warrington Cheshire WA3 4AZ Lead Inspector Wendy Smith Unannounced Inspection 9th February 2006 11:30 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 High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service High Peak Nursing Home Address High Peak Nursing Home Main Lane Kenyon Warrington Cheshire WA3 4AZ 01925 764081 01925 768888 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) European Care (UK) Limited Lisa Marie Astley Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 41 service users to include: * Up to 41 service users in the category of 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. 22nd August 2005 2. 3. Date of last inspection Brief Description of the Service: High Peak is a nursing home for older people set in a rural area towns of Warrington and Leigh. It belongs to a small group of home is currently registered for 41 people, however a maximum are now provided, all in single rooms, most of which have en-suite between the homes. The of 35 places 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 DS0000005170.V276672.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on February 9th and 17th 2006. Since the last inspection the home has a new manager and the deputy manager had recently returned from maternity leave. At the time of the inspection 31 residents were living at the home, all of whom were receiving nursing care. A tour of the building, including communal areas and some bedrooms, was completed. A sample of staff records, health and safety records, and management records was inspected. National Minimum Standards that were found to be met in full at the inspection carried out on 22nd August 2005 were not assessed at this visit. What the service does well: What has improved since the last inspection? The laundry door has been made good. The medicine room window has been made more secure. The lock on the second floor bathroom has been repaired. The home has a new manager. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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 DS0000005170.V276672.R01.S.doc Version 5.1 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 High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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): Not inspected on this visit. EVIDENCE: Standards 3 and 5 were found to be met in full at the last inspection. High Peak does not provide intermediate care. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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): 9 and 10 Recommendations made regarding medicines have been acted on. The privacy and dignity of residents are respected. EVIDENCE: The window in the medicine room has been made secure. A contract in place for the collection and disposal of unused medicines. The deputy manager informed the inspector that the home is changing to a new pharmacy next week. European Care provides policies and procedures regarding the privacy and dignity of residents. Staff receive induction training during which they are instructed how personal care should be provided to residents in a way that protects their privacy and dignity. The lock on the second floor bathroom has been repaired. Staff were observed to have a pleasant and polite attitude towards residents. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 10 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): 13, and 14 Residents are able to maintain contact with their friends and relatives. Residents are able to exercise choice in daily living. EVIDENCE: The home has been without an activities organiser for the last few weeks, however a new activities organiser has now been recruited. The home has an open visiting policy and residents may receive visitors in communal areas or in their own room. A church group visits monthly and holds a religious service. A Roman Catholic priest visits weekly. The home receives a service from a mobile library. The home manager said that a minibus has been purchased for the home and should be received at the home in the near future. During the inspection most residents were having lunch in the dining room, which is pleasant and spacious and looks out onto the garden. One resident had chosen to have her meal in her bedroom. Residents needing assistance from staff with their meal were sitting around a large dining table with staff sitting with them to assist. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 11 Most residents sit in the main lounge during the day but a few choose to spend their time in their own room. Residents are encouraged to bring in personal belongings to personalise their own rooms. Residents are able to choose their time of rising and retiring and a daily record of this is maintained. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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 and 18 Complaints are handled appropriately. Residents are protected from abuse. EVIDENCE: The home has a complaints procedure that meets the required standard. The complaints procedure is displayed in the entrance area near to the manager’s office, however the main entrance for visitors has now been relocated and the complaints procedure needs to be moved so that it is easily accessible for visitors. The complaints procedure is also included in the service user guide. Records of complaints received were available for inspection. The last complaint recorded was in March 2005. Staff training records showed that the home’s staff have attended Warrington Borough Council’s adult protection training. European Care provides policies and procedures, including Whistleblowing, for the protection of residents. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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 and 26 Most parts of the home were found to be well-maintained, however some windows are in poor condition. Two bathrooms require attention. All areas inspected were clean and tidy. EVIDENCE: The exterior of the building needs some attention. A number of windows need re-painting and some are in need of repair or replacement as the wood is starting to rot. See requirement. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 14 Communal areas are light, bright and well furnished. There is a spacious lounge on the 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 home has lovely gardens and a furnished outdoor sitting area for residents. There is a large bathroom on the ground floor with a Parker bath. 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, and there is no shower except over a bath. It is sometimes necessary for a resident to be taken to another floor for bathing. See requirement. The deputy manager said that the home was due to have a visit from a property manager of European Care. All areas of the home were clean and there were no unpleasant odours. There is a sluice on each floor and a laundry on the ground floor. The panel at the bottom of the external laundry door has now been replaced. A good report had been received from the environmental health officer. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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): 27, 28, 29 and 30 Staffing levels are maintained during the day but had been reduced at night due to the home having some vacant rooms. Over 50 of care staff have, or are working towards, an NVQ qualification in care. Good recruitment policies are followed. A range of training has been provided for staff, but arrangements for moving and handling instruction need to be improved. EVIDENCE: The home was fully staffed during the day, but there were vacancies for night carers. On some nights there were two carers and a registered nurse on duty. The agreed staffing level is one nurse and three care assistants, however the home was not fully occupied. The manager has carried out a risk assessment and considered that the safety of residents had not been compromised, however it was her intention to have three carers at night as soon as new staff were in post. Staffing levels at night need to be kept under review to ensure that residents are not put at risk when numbers are reduced. No agency staff had been used recently. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 16 19 care staff are employed and of these, five have an NVQ level 3, and four have an NVQ level 2. In addition to this, four staff are working towards NVQ level 2 and three are waiting to start their training. A selection of staff personnel files was inspected. The records were well maintained and contained all of the required information including references, Criminal Records Bureau enhanced disclosures, and a health declaration. The home’s senior carers have designated responsibilities. One is responsible for ‘buddying’ new staff, and on 9th February a new carer was undertaking induction training with this senior carer. The home has a four week induction training programme that is based on TOPSS. Training records are maintained for each staff group. The records provided evidence that the following training opportunities had been provided during the last year: Falls, Wound Care, Abuse, Fire Safety, Food Hygiene, Moving and Handling, Continence. The home manager is currently reviewing training records to identify which staff are due for updates of statutory training. This will inform the training programme for the forthcoming year. The home does not currently have an in-house moving and handling trainer, and there have been some difficulties in accessing appropriate training as and when required. The manager said that new staff receive moving and handling instruction from nurses and experienced carers ‘the best they can’. This is not acceptable. See requirement High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 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, 33 and 38 The home has a new manager. Quality assurance processes ensure that the home is run in the best interests of residents. The health and safety of residents and staff are protected. EVIDENCE: A new manager was appointed in September 2005. She is a registered nurse with some previous management experience. The manager said that she plans to start working towards an NVQ level 4 in management in March or April 2006. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 18 The home manager is supernumerary and the deputy manager also has some management time to carry out auditing. A sample of six care plans is audited each week and there was also evidence of regular medicines audits and food hygiene audits. A full audit of the home was carried out by the regional manager in October 2005. A residents and relatives meeting was held the week before this inspection. It was held at 6.30 pm to try and accommodate relatives who are at work during the day. The deputy manager said that different times have been tried, but the meetings are generally poorly attended. The main points of discussion were activities and outings. Regular staff meetings are held. A trained staff meeting was held the week before this inspection and a carers meeting the week before that. Meetings are minuted. A system of staff supervision is in place. Satisfaction surveys were sent out in October 2005 and January 2006. Only one response was received. A full health and safety audit of the home was carried out in December 2005. This highlighted windows in need of attention and causing draughts. Health and safety records were inspected and showed that: Water systems were chlorinated in November 2005. The gas safety certificate was renewed in July 2005. A contract is in place for the disposal of waste. Fire extinguishers were checked in January 2006. The fire alarm system was services in November 2005. The electrical installation certificate was renewed in November 2002. Portable appliance testing was done in September 2005. The passenger lift was serviced in February 2006. The stair lift was serviced in June 2005. Hoists were serviced in November 2005. The fire log book showed that weekly alarm tests and emergency lighting tests are carried out by the home’s maintenance person. Fire drills were recorded in July and October 2005 and on 1st February 2006, however the time of the drill is not recorded and the names of staff participating are not recorded. This was discussed with the home manager, and it was agreed that fire drills should include staff working both days and nights, and a record should be maintained. See recommendation High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 19 Door guards have been fitted to bedroom doors for those residents who like to have their door open, and the deputy manager said that more have been ordered. Accident records were inspected and it was noted that these are audited monthly. A list of emergency contact numbers was available for staff. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 20 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 2 High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP19 OP21 Regulation 23 Requirement Bathing facilities must be provided to meet the needs of residents. (Timescale of 30/11/05 not met) Some windows need to be repainted and repaired. Moving and handling instruction must be provided for staff by a suitably qualified person. Timescale for action 30/04/06 2. 3 OP19 OP38OP30 23 13 30/04/06 30/04/06 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 OP38 Good Practice Recommendations A record of staff attending fire drills should be maintained. High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich 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. Extracts may not be used or reproduced without the express permission of CSCI High Peak Nursing Home DS0000005170.V276672.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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