CARE HOMES FOR OLDER PEOPLE
Hinckley Park Nursing Home 67 London Road Hinckley Leicestershire LE10 1HH
Lead Inspector Mrs C A Burgess Unannounced 5th April 2005 09:30 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. Hinckley Park Nursing Home Version 1.10 Page 3 SERVICE INFORMATION
Name of service Hinckley Park Nursing Home Address 67 London Road Hinckley Leicestershire LE10 1HH 01455 615252 01455 612956 www.highfieldcare.co.uk Highfield Care Centres Limited 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) Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (3), Physical disability of places over 65 years of age (40), Terminally ill (1), Terminally ill over 65 years of age (1) Hinckley Park Nursing Home Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: No persons falling within category PD may be admitted into the home where there are 3 persons of category PD already accommodated in the home. No persons under 55 years of age who falls within category PD or TI may be admitted into the home. No one falling within category TI or TI (E) maybe admitted into the home where there is one person of TI or TI(E) already accommodated in the home. To be able to admit the person of category TI named in the variation application number 49858 dated 26th June 2003 Date of last inspection 29th October 2004 Brief Description of the Service: Hinckley Park Nursing Home is a care home with nursing facilities providing personal care and accommodation for forty older persons. Highfield Care Limited owns the home and is the owner of a number of care facilities throughout the Midlands region. The home is located close to the town centre of Hinckley where service users have access to shops, the library, the post office and other local amenities. The home is easily accessible by private or public transport. There is adequate parking. It is a purpose built, three storey property with level entry access. It has two floors for service users’ use. Access to both floors is by use of the passenger lift or stairs. There is a third floor which accommodates the kitchen, laundry and staff room. The home has thirty single bedrooms, seven with en suite facilities, and five double bedrooms, all with en suite facilities. There are two communal areas with television, two dining rooms and a conservatory. The home has a garden to the rear of the building, which is currently being improved. Hinckley Park Nursing Home Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over one day. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff and residents. Many of the residents were seen during the inspection and six of the residents spoken to gave the inspector their impressions of the home. What the service does well: What has improved since the last inspection?
Improvements have been made in the standard of care planning records. Residents care plans and risk assessments are of a good standard. A carer now acts as activities officer and has activities planned throughout the week. A new hoist has been provided, and general repairs and maintenance work, required during the last inspection, have been completed. In addition, the garden has been cleared and is being improved. Hinckley Park Nursing Home Version 1.10 Page 6 Residents were particularly enthusiastic about the improvements in the quality of food and are also looking forward to using the improved garden area in the summer. The new acting manager (Matron) has worked hard to effect changes and to improve the quality of care for the residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hinckley Park Nursing Home Version 1.10 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 Hinckley Park Nursing Home Version 1.10 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) 1, 2, 3, 4 & 6 The admission process is well managed and residents are given clear and detailed information regarding the service; thereby ensuring that the residents’ health and welfare needs are being met. EVIDENCE: There is a comprehensive Statement of Purpose & Service Users’ Guide. The pre-assessment process is robust. One care plan did not have a risk assessment completed in regard to the possibility of falls. This had been identified by the home’s own audit system. A new resident said that he had received a warm welcome from the staff and other residents and had received information about the home both before and after his arrival and continued to feel well supported. Five other residents said that they were well looked after. Hinckley Park Nursing Home Version 1.10 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, & 10, Residents are, generally, looked after well in respect of their health and personal care needs but should be encouraged to be involved in drawing up their care plans. Particular attention is required in recording medication. The result of poor practice may, potentially, have a detrimental affect the healthcare needs of the residents. EVIDENCE: Care plans reflected residents’ specific needs and contact with other healthcare professional is well documented. However, further attention needs to be given to involving residents and/or their relatives in the care planning process. Medication policies and procedures are generally sound. However, on the day of inspection two gaps were noted in the medication sheets, although staff said that the medication had been given. The controlled drugs book was incorrectly filled in – the resident’s name had been entered where the name of the drug should be. Gaps in the residents’ medication sheets had been noted at a previous inspection. Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity. They were seen to knock on
Hinckley Park Nursing Home Version 1.10 Page 10 doors and wait for a response before entering and spoke to residents in a respectful, friendly and supportive way. Residents spoken to said that staff are respectful and very caring. Hinckley Park Nursing Home Version 1.10 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, & 15 Residents experience a homely life style and visitors are encouraged. Various formal and informal activities are made available and meals are well presented and nutritious. EVIDENCE: The home has an activities officer who arranges activities on Monday, Wednesday and Friday. Residents enjoyed singing and listening to the organ – played by the activities office- on the day of the inspection. Residents said that they enjoyed bingo, singing and movement to music, and are encouraged to participate if they are able; although this was more evident in the ground floor sitting room. Residents said that family and friend visit them regularly – a number of residents had visitors during the inspection. Residents also said that they had made particular friends since moving to the home. Menus are balanced and appealing, and are flexible enough to accommodate individual preferences. They are freshly prepared and are of a good standard – the cook provides home made cakes daily - and the residents said that they enjoyed their meals and are able to choose when and where they take them.
Hinckley Park Nursing Home Version 1.10 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 standard(s) 16 &18 Arrangements for receiving and responding to complaints are sound, resulting in satisfactory protection of residents’ rights. EVIDENCE: Residents and staff comments showed that people feel at ease discussing any concerns with Matron or the staff. The CSCI has received 1 complaint regarding an unpleasant odour on the first floor. It was referred to the home’s complaints policy, and was dealt with appropriately. The home’s complaints process reflects the government’s adult protection guidelines, set out in the No Secrets’ publication but Matron has ordered a new copy of the guidelines as the current copy has not been updated since 2001. Complaints and concerns made to the home are dealt with appropriately. Hinckley Park Nursing Home Version 1.10 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 standard(s) 19, 20, 21, 22, 23, 24, 25 & 26. A comfortable and safe standard of accommodation is provided for the residents but the garden is currently unsafe as it is being cleared and refurbished. EVIDENCE: In general, the home is well maintained and suited to residents’ needs. It is decorated and furnished to a standard that creates a comfortable and homely environment and there is a system of maintenance and refurbishment. The garden is being upgraded to further improve the environment. Residents’ rooms are clean, well decorated and residents are able to bring items of their own furniture and possessions with them to personalise their rooms. Many of the rooms have en suite facilities and there are sufficient toilet bathing and assisted bathing facilities. Staff were observed to answer the call bells promptly. There is a spacious sitting room and dining room on the ground and on the first floor, with
Hinckley Park Nursing Home Version 1.10 Page 14 a conservatory on the ground floor- used as a smoking room- overlooking the garden, offering a range of communal accommodation. Currently the garden is unsafe and the residents are unable to use it. General risks are addressed such as, windows are fitted with safety restrictors and there is under floor heating, eliminating the risk of burns from radiators. Residents said that the home always felt warm and comfortable. Hot water and boiler temperatures are checked to ensure they comply with Health and Safety legislation and were satisfactory when checked during the inspection. All areas of the home smelled pleasant and were cleaned to a good standard. Hinckley Park Nursing Home Version 1.10 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Staff at the home are well trained and supported, and employed in sufficient numbers to meet the residents needs, although additional, regular checks on nurses’ registration status would further protect the residents. EVIDENCE: Staffing levels were sufficient to meet the residents needs at the point of inspection and residents said that they felt the staff were capable and caring, and that there were sufficient staff on duty. There are 6 registered nurses and 16 carers (some of whom are part time). Three of the care staff hold National Vocational Qualification (NVQ) in Care, Level 2 and a number of others are undertaking NVQ Level 3. Training is well planned and supports staff in providing for the varied needs of the residents. A training matrix provides a clear indication of staff training for the year. The three staff files checked during the inspection showed that a satisfactory recruitment process is undertaken, although checks on nurses’ registration is not rechecked after the initial recruitment process (registered nurses must demonstrate competence every three years to remain on the nursing register). Hinckley Park Nursing Home Version 1.10 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37 & 38. The home is managed efficiently by the acting manager (Matron) but the position of Registered Manager must be filled as soon as possible to demonstrate a commitment to managerial stability within the home. Effective supervision of staff would further ensure that the quality of care is maintained. Hinckley Park Nursing Home Version 1.10 Page 17 EVIDENCE: There is no manager registered at present but an acting manager (Matron) has been in post since October 2004. She is a registered nurse with many years of experience in care. An application for a registered manager has not been received by CSCI and a requirement to do so has been made in this respect. The acting manager (Matron) should ensure that an up-to-date insurance policy is displayed. There were no records of staff receiving regular supervision and/or appraisals to ensure that they are maintaining the standards of care that are required. Nevertheless, residents said that they felt that the home was well managed and they had no complaints and were happy with the care they received. The records of tests to the fire safety equipment were in good order and health and safety issues were well documented and managed. Hinckley Park Nursing Home Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 2 3 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 3 3 3 2 3 2 Hinckley Park Nursing Home Version 1.10 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 3 Regulation 15(1) Requirement The Registered Person is required to demonstrate, unless it is impracticable to do so, that residents and/or their relatives/representatives are consulted in the preperation of a care plans to meet residents health and welfare needs. The Registered Person is required to ensure that all residents have current risk assessment regarding falls. The Registered Person is required to ensure that the administration of residents medication is accurately recorded. (Timescale of 29/10/04 not met). The Registered Person is required to appoint a Registered Manager. The Registered Person is required ensure that staff working in the home are appropriatly supervised. The Registered Person is required to ensure that external grounds (the garden) are suitable and safe for use. Timescale for action 05/05/05 2. 3 14(2) 05/05/05 3. 9 13(2) 05/05/05 4. 5. 31 36 8 18 (2) 05/06/05 05/06/05 6. 38 23(o) 05/06/05 Hinckley Park Nursing Home Version 1.10 Page 20 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. Refer to Standard 29.3 34.3 Good Practice Recommendations Registered Nurses have their Nursing & Midwifery Council (NMC) Registration checked every three years. Up-to-date insurance cover should be displayed in the home. Hinckley Park Nursing Home Version 1.10 Page 21 Commission for Social Care Inspection 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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