Inspection on 21/02/07 for Hornchurch Nursing Centre

This inspection was carried out on 21st February 2007.

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

Hornchurch Nursing Centre 03/09/07

Hornchurch Nursing Centre 16/02/06

Hornchurch Nursing Centre 04/11/05

Hornchurch Nursing Centre 11/03/05

Hornchurch Nursing Centre 01/07/04

Hornchurch Nursing Centre 03/12/03

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Hornchurch Nursing Centre 2a Suttons Lane Hornchurch Essex RM12 6RJ Lead Inspector Joanna Moore Unannounced Inspection 21st February 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hornchurch Nursing Centre Address 2a Suttons Lane Hornchurch Essex RM12 6RJ 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) 01708 454 422 01708 445 456 ANS Homes Limited Ms Carol Baldock Care Home 55 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (38), of places Physical disability (5) Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: Hornchurch nursing home is a purpose built fifty-five bed home, which is owned and operated by ANS Homes Ltd a company which operates similar homes throughout the country. ANS Homes Ltd has recently been bought by BUPA but remains a wholly owned subsidiary company. The home caters for three categories of service user: up to 16 people over the age of 65 with a diagnosis of dementia, up to 34 people over the age of 65 who have age related physical illnesses/ disabilities and up to 5 people between the ages of 18-65 who have physical disabilities / complex needs. The home is managed and staffed by registered nurses, care assistants and support staff. The home offers administrative, catering and laundry facilities on the ground floor and care accommodation on the further three floors. Each floor operates as a separate unit with staff allocated to each floor with bedrooms, lounge/ dining room, small kitchen area, bathrooms and toilets situated on each floor. The Home itself is situated within two minutes walk of the railway station and is easily accessed by car from the A13, A127 and M25. Hornchurch shopping centre is approximately twenty minutes walk or a short bus ride away. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out as part of the annual inspection program. The home was visited on two days so that the staff files could be viewed as these were not accessible on the first visit. The inspector-spent time talking with service users, their relatives, nurses, the administrator, the handyman and the manager. What the service does well: What has improved since the last inspection? The home has worked hard to improve the standards of record keeping particularly in relation to care plans and daily care records. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 & 5.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families have information about the home before moving in. The home and the service user are confident that the individuals needs can be met through a comprehensive assessment process prior to moving in. EVIDENCE: The home provides an informative service users guide which is displayed in the hallway for visitors to peruse. Each service user has a contract for care in place whether self funding or funded by the local authority. A system of assessment is in place whereby the home obtains a copy of the central care management assessment and this is supplemented by a visit to the service user to fully ascertain whether the home can meet their needs. A review of care is then undertaken after they move in, to review how the home has been able to support them and to allow them to “test drive” the home. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 9 Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 &11. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a good standard of care and from staff who are genuine in their commitment to high standards. The home is clearly committed to supporting the rights and wishes of service users who are terminally ill and caring for them in line with their wishes at the point of death. EVIDENCE: • Three service users care files were viewed and the medication checked. The medications were stored, recorded and dispensed appropriately. Only qualified nurses administer medication. The care plans detailed the care to be given and these were reviewed regularly. Where the care plan stated things were to be done regularly it could be evidenced from the daily records of care that this did indeed happen. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 11 • Risk assessments for falls and pressure areas were carried out and updated. Risk assessments for other matters were included in the care plan as required. Care records and discussions with staff and relatives evidenced that health professionals such as the chiropodist, dentist, optician, tissue viability, McMillan and Diabetic nurses were involved in supporting the residents. The G.P visited the home during the inspection and the manager advised the inspector that the home benefits from a very supportive relationship with their G.P. Feedback from those relatives met with during the inspection was that they were very happy with the health care support that the service users received. One relative told the inspector that they visited every day and have done since their mum came into the home. The staff she said let her do everything she wants for her mum but are there to offer help and are very friendly. She said that she stayed when the staff provided personal care and the fact that this was allowed, gave her confidence in the carers and first hand observation of the way that personal care was carried out. The home has implemented the Liverpool care pathway and is involved in the end of life scheme, which is soon to be implemented. This is a scheme whereby the home signs up to agreed practices to support people when they are terminally ill or who are at the end of their life. The main premise of this work is to involve the service users and find out what they want, this may mean that the home will see an increase in deaths recorded at the home as a direct result Of people choosing to die at home. The home is to be commended for implementing these programmes. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 &15.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from comprehensive activity opportunities, which are well publicised and attended. Service users benefit from a variety of nutritious wholesome home cooked food. Service users and their families enjoy a program of a wide variety of activities designed to reflect the needs of all service users in the home. Families felt involved in and supported by the home. EVIDENCE: Food sampled during the inspection was tasty, the menu showed a rotational menu which offered a varied and nutritious diet. The majority of food is home cooked on the premises by the chef who when interviewed in previous inspections has shown awareness of individual service users nutritional needs and preferences. Menu cards were in the dining rooms. The tea provided was mostly sandwiches and light tea, which service users and their relatives said was what they wanted, some service users however chose the daily available hot option. Relatives commented positively on the standard of food available, as did residents. The home has a comprehensive activities program, which Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 13 meets the needs of the vast majority of people living in the home. An activity organiser is responsible for ensuring that the social and recreational needs of service users are met. Information about activities is provided on notice boards and a notice board at the entrance to the home states what is planned for the day. Service users were given the choice whether to attend activities or not. The activities co-ordinator operates a daily shop, which is also used as informal chatting time with service users. Service users with dementia are encouraged to attend both the main activities and also receive one to one time. For the service users who were bed bound and uncommunicative the activities coordinator previously advised the inspector that they spent time every couple of days chatting and spending time doing hand massages, relatives said that they had seen this happen. A variety of activities had been held by the home in the previous few months and the inspector was advised that a full program had taken place at Christmas. The home was decorated to celebrate Valentines Day at the time of the visit. The inspector was advised that the Activities Organiser was awarded a certificate as ‘BUPA Champion’ in recognition of quality of work (and all she does) and is attending NAPA training for implementing further activities with elderly frail and dementia care residents. Relatives said they were always made to feel welcome when visiting and were kept informed of events within the service users life, relatives were made especially welcome to join in with activities planned in the home. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families were confident that any issues of concern would be listened to and acted upon effectively. Systems are in place to protect service users from abuse and carers are aware of the issues. EVIDENCE: The complaints record recorded no complaints as received by the home, which was confirmed by the manager. One issue re the provision of a wheelchair had been raised but this related to the Primary Care trust. Relatives’ comments throughout the report support the view that complaints are few and far between. Complaints procedures were in place and had not changed since the previous inspection. Relatives said they felt able to approach the manager about any issues of concern and were confident that the issues would be investigated and addressed. The home has clear policies in place in relation to adult protection and the manager through previous discussions has shown clear awareness as to the procedures to be followed should such an allegation be made. Carers have also shown awareness of the issues. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 15 Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families benefit from safe and suitable accommodation, which meets their needs and the national minimum standards. The home is clean and odour free. The home is well maintained. EVIDENCE: The home is divided into three units on three floors. Each unit operates independently and has its own staffing team for the shift. Sufficient and appropriate toilets, bathrooms, bedrooms and communal lounges with kitchenette are provided in each unit. All service users have their own private rooms, which are furnished and decorated according to their choice. The building was maintained to a safe standard. Those areas visited were clean and hygienic with no noticeable odours. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 17 The food is supplied from the kitchen situated on the ground floor. The kitchen was not inspected as part of this inspection. The vast majority of service user within the home require physical assistance and by definition of residing at the home require nursing care and have high care needs. However a large proportion of the beds within the home are of standard type rather than adjustable beds, which are most suitable for nursing care. This has been raised at numerous inspections and the programme of replacing the beds has been slow. It is a requirement that within 12 months all service users are provided with an adjustable bed. This will reduce the likelihood of back injuries for staff assisting people in and out of bed and easier for the service user. The home has undergone much decorative improvement and new carpets over the last two years. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from caring competent staff that show a genuine interest in the welfare of the residents. Staffing levels remain at those set at the point of registration. Service users benefit from well-trained and competent staff. EVIDENCE: The home has a qualified nurse on each floor between the hours of 8am and 8pm. Staffing levels were satisfactory. Most of the staff at Hornchurch nursing centre have worked at the home for a number of years. Staff turnover has been little and service users enjoy staff who are regular and who are familiar with their needs. Relatives and service users interviewed spoke very positively about the staff. Three staff recruitment files were checked to sample staff recruitment processes. All these files were in line with regulatory requirements and included two written references, an employment history, a medical declaration, a Criminal Records Bureau check, evidence of identity and a current photograph. Files also held copies of job descriptions. A clear system was in place to check the status of qualified nurses at the point of recruitment and also to monitor their ongoing registration. Evidence was held on staff legal Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 19 working status within the UK. Staff sign to say that they have read all key policies and procedures. All staff are progressing through the newly introduced BUPA induction workbook. Staff training records evidence that staff have received updated fire training, moving and handling, adult protection, first aid, skin and pressure area care, optical awareness, food hygiene and dementia awareness training. Two RGNs have undertaken a degree in tissue viability, Two RGS have attained the Certificate for introduction to Quality Dementia Care, and Five RGN’s are trained to carry out phlebotomy. One nurse is a manual-handling trainer. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 &38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home benefits from an approachable and competent manager who ensures the home is run in the best interests of service users. Financial systems are in place for the protection of service users. Service users benefit from a home, which is maintained to a safe standard. Staff benefit from an open door policy and are supported by regular meetings and supervision. EVIDENCE: Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 21 The registered manager is a registered nurse with experience of managing services for this client group who has undertaken a certificate in management studies and is currently studying for a degree in business management. Through discussion and observation it was evident that the manager has the qualities and experience necessary to manage the home. The registered persons representative undertakes monthly visits of the home in line with regulation 26 and forwards copies of the reports to CSCI. The majority of service users families or representatives manage their finances. A petty cash float is held and a clear recording system was shown to the inspector which recorded all monies received and spent on the service users behalf and how that money had been spent. Expenditure could be traced to a receipt. The home operated clears systems to monitor health and safety. The water supply was checked in line with guidance for the risk of legionnaires disease. Staff were provided with appropriate equipment for their job such as disposable gloves and aprons, sharps box and yellow bags for the disposal of ‘medical waste’. A contract was in place for pest control. A valid electrical certificate was in place (2003). Water temperatures within the home were checked monthly to prevent the risk of scalding. Fire appliances were checked and serviced regularly by a contractor. Fire doors, emergency lighting, alarm and extinguishers were checked in line with current fire prevention guidance. Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 2 3 3 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 3 3 3 3 3 3 3 3 Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 23 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 OP22 Regulation 16 Timescale for action It is a requirement that within 12 01/04/08 months all service users are provided with an adjustable bed Requirement 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 Hornchurch Nursing Centre DS0000015596.V333362.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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