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Inspection on 08/11/06 for Hunters Creek Nursing Home

Also see our care home review for Hunters Creek Nursing Home for more information

This inspection was carried out on 8th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff ensure that they get to know each resident and a relative commented that they find creative ways of increasing the residents independence. The activities co-ordinator makes sure that the residents contribute ideas about activities and that they continue their interests both inside and outside the home. The residents benefit from a manager who leads an effective team, they are recruited and trained and they feel they are well supported to do their jobs. The residents commented positively about the staff care, these included; `The staff do everything they can to help.` `The staff are kind, they take me out when I want to.` The manager assesses new residents prior to them moving into the home to ensure that the home is able to meet their needs and each resident has a comprehensive assessment and a plan of care. The manager has ensured that they change the way things are done in the home to improve the service and to comply with requirements made by the commission.

What has improved since the last inspection?

The manager continues to work with the providers to improve the service.

What the care home could do better:

The manager has agreed that they will monitor the time it takes to answer the call bells after one resident leaves the home. This follows two comments in the `Have Your Say `comment cards, and a discussion during the site visit.

CARE HOMES FOR OLDER PEOPLE Hunters Creek Nursing Home 130 London Road Boston Lincolnshire PE21 7HB Lead Inspector Kima Sutherland-Dee Unannounced Inspection 8th November 2006 10.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hunters Creek Nursing Home DS0000002540.V318746.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. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hunters Creek Nursing Home Address 130 London Road Boston Lincolnshire PE21 7HB 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) 01205 358034 01205 361398 www.tanglewoodcarehomes.co.uk Tanglewood (Lincolnshire) Limited Caroline Greaves Care Home 83 Category(ies) of Old age, not falling within any other category registration, with number (83), Physical disability (16) of places Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care with nursing for service users of both sexes. The maximum number of service users to be accommodated is 83(OP) not falling within any other category and up to 15 service users under the category PD. Rooms 64-79 (inclusive of the Garden Wing) cannot be used to accommodate residents requiring nursing care. Up to 15 service users within the category (PD) will be aged between 50 and 64 and up to 3 may be aged between 24 years and 64 years with a maximum within the category (PD) of 15 Up to fifteen of the following rooms may be used to accommodate people within the category PD: numbers 12, 14, 15, 16, 17, 18, 26, 27 48, 49, 50, 51, 52 & 54 and 59. When used by service users within the category PD, these rooms will be used on the basis of single occupancy and, where they are otherwise used by Older People as double rooms, the overall occupancy will be reduced proportionately. Rooms 16, 17, 18, 51, 52 and 54 may not be used for people who are wheelchair users and and all rooms must only be used by people within the category PD if the useable floor space is sufficient to meet their needs) including any necessary equipment). One named service user under the age of 20 years within the category PD can be accommodated. The one PD bed for the service user under the age of 20 is as named on the Notice of Proposal dated 17 August 2005. 13th December 2005 2. 3. 4. 5. 6. 7. Date of last inspection Brief Description of the Service: Hunters Creek is a modern, two storey, purpose built home which is situated in a residential area on the edge of the market town of Boston. The home is within close proximity of the town centre and is on a bus route. The home is registered to accommodate eighty three service users. There are a number of small lounge and conservatory areas on the first and ground floor. Within the grounds, there are two single storey bungalows occupied by service users needing personal care only. The home provides nursing and personal care for people of over sixty five years, and also provides accommodation for up to Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 5 twelve people under the age of sixty five. There is a car park to the side of the building. The gardens are landscaped, and well maintained. Service users have access to the garden, which, in the summer offers seating. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection used all of the information about Hunters Creek that had been supplied to the commission. This included a pre inspection questionnaire, ‘Have Your Say’ comment cards and any notifications that had been sent to the commission since the last inspection. Evidence was also sought through this site visit. This included the inspector ‘case tracking’ or following through, the care of a sample of the residents, speaking to the residents, the staff and the manager and sampling documents. This site visit included a thematic enquiry. This consisted of asking a number of standardised questions to a sample of the residents. This was part of a national pilot scheme. We informed the registered person and sought the agreement of the residents in advance of asking the questions about the care they receive. What the service does well: The staff ensure that they get to know each resident and a relative commented that they find creative ways of increasing the residents independence. The activities co-ordinator makes sure that the residents contribute ideas about activities and that they continue their interests both inside and outside the home. The residents benefit from a manager who leads an effective team, they are recruited and trained and they feel they are well supported to do their jobs. The residents commented positively about the staff care, these included; ‘The staff do everything they can to help.’ ‘The staff are kind, they take me out when I want to.’ The manager assesses new residents prior to them moving into the home to ensure that the home is able to meet their needs and each resident has a comprehensive assessment and a plan of care. The manager has ensured that they change the way things are done in the home to improve the service and to comply with requirements made by the commission. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 8 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 Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 9 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have the information they need to make an informed choice, their needs are always assessed, and each person has a signed contract. EVIDENCE: Each resident has a comprehensive assessment of their needs before they move to the home. The manager then assures them that their needs can be met. This assessment then forms the basis of a detailed care plan. Thematic probe evidence. 3 residents were asked the standard questions. • • • Do you have an up to date Service user guide? Two residents said yes, one said no but they came as an emergency. Have you had information about changes to the costs of your care? Three said yes and they were informed by letter. DS0000002540.V318746.R01.S.doc Version 5.2 Page 10 Hunters Creek Nursing Home • • • • • • • • Do you have a written contract or terms and conditions? Two residents said yes and one said no. (They were not aware of this.) Has the contract changed since you came to live here? One resident said yes, and one resident said no and one resident didn’t know. The inspector saw a sample of 3 contracts that were signed, and kept confidentially in the resident’s files. Before you came to live here, did anyone talk to you to find out what your care needs were? One resident said no not at the beginning, I can’t remember. One resident said yes, one resident said yes and one said they came to the home as an emergency. The needs assessments were available in the files, they were comprehensive. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported to maintain their health and the staff offer care whilst maintaining each persons privacy and dignity. EVIDENCE: The senior staff develop really detailed care plans, they use the information from the initial assessment and the then this increases as they get to know each resident. These plans inform the care. Information about each persons care is passed on during ‘handover’ when staff shifts change. The staff had a good understanding of the care that each person needed. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 12 The residents talked about their health care and that they see the doctor and nurses when they need to. One resident said that the staff were good about contacting the G.P. Other specialists are available and the speech therapist or physiotherapist assess the residents. Medication was administered and recorded correctly and the staff who administer are trained. The residents were very positive about the care the staff give. The staff are maintaining peoples privacy and dignity during personal care. A small minority of negative comments were discussed with the manager, they are aware of the issues and they continue to support all of the residents. The time it took some staff to answer call bells was raised in the comment cards. This was discussed with the manager, who understands that there has been an issue due to the care required by one resident. This resident was leaving the home and the manager will then monitor the call bell response time. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 13 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents can follow their preferred routines and the staff support people to enable them to make choices and decisions. Activities are planned according to individual and group needs, and events often include families and friends. The residents are offered a varied and balanced menu. EVIDENCE: The activities co-ordinator speaks to all the residents about their preferences and then they try to engage the residents in suitable activities both inside and outside the home. Residents said they enjoy the activities and the entertainment in the home. The Co-ordinator also said they try to speak to those residents that can’t leave their rooms and spend some talking to them. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 14 The residents said they could go out with the staff into the town. One resident goes to college and uses a computer in their room, they said how much they value this. A group of residents were encouraged to take part in a dominoes match after lunch. They enjoyed the social interaction and the activities. Relatives said how they appreciated the care of the staff for their relatives. One person commented that the staff do everything they can to make the residents life better. One resident has English as a second language. They said they get opportunity to speak their first language with their family and friends. They also said they have learnt a lot of English and the staff understand them. The residents said they enjoy the food and they can make choices. Different meals were served and they were well presented. The staff make sure that the meals are the right consistency for each resident, and trained staff support the catering staff to ensure each person gets the right meal. Some residents commented that the drinks on the trolley could be hotter. This was discussed with the catering staff who made suggestions about how this could be improved. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 15 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. The residents are confident that their concerns or complaints will be listened to acted upon. The staff and the manager have received training and they competently deal with any suspicions of abuse. EVIDENCE: Thematic Probe evidence. • • • • Have you received any written information, which tells you how to make a complaint? Three residents said that they did have the information or they could look at the information around the home. Do you have all the information you need to need to raise any concerns you have about your care? Three residents said yes, one added that they had raised a concern that morning and it was dealt with. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 16 Previous inspections demonstrate that the staff are trained to deal with suspicions of abuse. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 17 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a suitable and comfortable environment that meets their needs. The manager ensures that the home remains as odour free as possible, for the comfort of all the residents. EVIDENCE: The manager ensures the home is well maintained and clean. The residents said they like their home and feel comfortable in the lounges and their bedrooms. The residents said they use the garden in the warmer weather and they can access all the areas of the home. The housekeeping staff keep the home clean and there are procedures for dealing with any spillages or odours. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 18 When odours do occur they are temporary. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 19 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. The manager recruits and trains an effective staff team. EVIDENCE: All the residents were satisfied with their care. The staff said they can usually do their job without having to rush, and they had time to talk to the residents. The residents gave feedback about the teas at the home, and due to this extra staff hours were used to increase the amount of fresh , homemade items that were offered. Staff are put forward for N.V.Q training and other relevant courses. New staff take part in an induction where they get to know the residents and work with more experienced staff. Information about staff training was included in the pre inspection information. The manager follows the organisations recruitment policy. This ensures that staff are recruited safely, and the files contain the required information. Hunters Creek Nursing Home DS0000002540.V318746.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): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is effectively and safely managing the home, in the interests of the residents. EVIDENCE: The staff said they appreciate the support from the manager. They said they could raise any issues and feel confident that their ideas will be listened to. The manager was able to give detailed examples of how they manage the home and the care that individuals need. Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 21 The heads of each department supervise their staff and the manager monitors this system. Regular quality reviews take place and there is evidence that changes are made as a result of this feedback from the residents and their relatives. The relatives said they could speak to any of the staff or the manager about any aspect of their relatives care. The pre inspection information demonstrates that the equipment in the home is regularly serviced. This ensures the safety of both the residents and staff. Hunters Creek Nursing Home DS0000002540.V318746.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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X X X X X X 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 X 3 X 3 3 X 3 Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. Extracts may not be used or reproduced without the express permission of CSCI Hunters Creek Nursing Home DS0000002540.V318746.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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