Inspection on 17/02/06 for Hurstead House Nursing Home

This inspection was carried out on 17th 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

Hurstead House Nursing Home 28/06/06

Hurstead House Nursing Home 23/11/05

Hurstead House Nursing Home 08/02/05

Hurstead House Nursing Home 03/09/04

Hurstead House Nursing Home 23/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Hurstead House Nursing Home Hurstead House 631 Halifax Road Rochdale Lancashire OL12 9QU Lead Inspector Bernard Tracey Unannounced Inspection 17th February 2006 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 Hurstead House Nursing Home DS0000017330.V283383.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. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hurstead House Nursing Home Address Hurstead House 631 Halifax Road Rochdale Lancashire OL12 9QU 01706 379511 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) Mr Nicholas John Frost Linda Eastwood Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (28), Terminally ill (2) of places Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That the service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Within the total number of 30 places there can be up to a maximum of:- 30 General Nursing including 2 Terminally Ill, Male and Female 65 years of age and over. 23rd November 2005 Date of last inspection Brief Description of the Service: Hurstead House is a large stone property, which has been adapted and extended to accommodate 30 older people, providing personal care for all and nursing care for up to 30 service users. Hurstead House is situated in a residential area off Halifax Road, Rochdale, approximately two miles from Rochdale town centre. Local amenities include a Post Office, newsagents and pub all of which are within short walking distance. A regular bus service passes the home to/from Rochdale and Littleborough. Parking is provided to the front of the home. Ramped access is available to the front door and a passenger lift and stair lift enables service users access to the first floor accommodation. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not told that this inspection was to take place. This was an unannounced inspection. The Inspector spent 4 5 hours in the home and during the inspection made a tour of the home as he had not visited the home previously. During this inspection he looked at care and medicine records to ensure that the health and care needs of the residents were being met. The Inspector then visited many of the residents in their own bedrooms and in the lounges to find out about the care that was being provided for them. In order to get some information about the home the Inspector also spent time speaking to 4 residents, 3 care assistants, and the owner who was also the nurse in charge of the home on the day of the inspection. Not all the National Minimum Standards were looked at on this visit but the inspector did look at those standards that were not assessed on the last inspection and that are considered to be important for residents safety and well-being. These are the Standards that have to be inspected at least once a year. What the service does well: The home has an experienced and enthusiastic team of staff who work well together. The staff are motivated and keen to ensure that residents receive high standards of care. Residents were complimentary about the owner, manager and the staff. One resident said “ nothing is too much trouble for the carers”. Two other people living at the home said “ the manager is caring, she visits us every day and listens to any problems we may have and takes action if needed”. Many of the staff had worked at the home for a long time and the residents said that they liked the staff and felt safe in the home. Comments such as “they are lovely girls”, “I am very happy here” “I am glad I moved here” were made to the inspector. Meals are well presented and offer people at the home a choice and variety of Different home cooked foods. One resident said that “staff are very helpful, they will get you a drink whenever you need one and always ask what you want to eat at each meal time”. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The Manager of the home is also a nurse, and spends a great deal of her time being the only nurse on duty, and thus undertaking nursing tasks. As she is also the Manager she must have time away from nursing duties to develop her role as the Manager and ensure that all management task such as monitoring and developing staff are undertaken. Following the last inspection time was set aside for management duties but more time needs to be given. Staff must keep a record of medicines and tablets that are delivered to the home. Some activities are provided, but not enough. A programme to replace carpets that are worn and dirty needs to start without further delay. The owner should also make plans for decoration and replacing fabrics such as curtains and bedding. Where bedside rails were used, proper bumpers must be in place to keep residents safe. The home must carry on providing all the necessary training for staff so they know how best to do their jobs and keep residents safe from harm. The manager must make sure that staff do not start work at the home until they have had satisfactory checks to make sure they are safe to work with older people. Please contact the provider for advice of actions taken in response to this Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 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 Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standard was examined at the last inspection. The arrangements in place for ensuring that assessments are undertaken and received at the home prior to a new resident being admitted, ensure that the staff have the knowledge and skills to meet the needs identified. EVIDENCE: The key standard was examined at the last inspection on the 23rd November 2005 and was met. The home does not provide Intermediate Care. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 The care plans reflected the support needs of the residents. Care practices ensured that the residents health care needs were met, that they were treated with respect and their dignity was upheld. Although some improvements could be made, the medication system in place ensured that the residents received their medicines safely. EVIDENCE: Individual care plans are in place for all residents that clearly set out the health, personal and social care needs identified for each person. Four of the plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. The care plans are well written and included detailed information about the needs and expectations of the residents and the care being given on a daily basis. It is recommended that daily progress reports are timed as well as dated. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure sores, the use of bed rails and falls. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 11 One resident who was being nursed in bed had been assessed as requiring bedside rails, which were in situ, but did not have safety bumpers attached thereby placing the resident at risk of harm. A discussion with the residents identified that they had access to other health care services including hearing, sight tests and a visiting chiropodist. Evidence of these visits was kept in the residents’ individual files. Equipment necessary for the prevention and treatment of pressure sores was Available. Continence aids were in use and the staff were aware of how to contact the continence advisor if deemed necessary. Following the previous inspection an additional inspection was carried by the Pharmacist Inspector, the outcome of which was that several requirements and recommendations were made. As part of this current inspection the Inspector was able to evidence that whilst the majority of these matter had been dealt with, there were still some that required attention to ensure that the policies and procedures for the receiving of medication were being complied with. The home has now contracted with Boots chemist and has incorporated the monitored dosage system as the preferred method of administration. The owner of the home said that this change has resulted in a better service to the home and a more organised method of receipt storage and administration, but the home must record all medicines received into the home on the Medicine Administration sheet. A discussion with the residents identified that they feel their privacy is respected and that they are treated with great kindness. One resident said that “ the staff are wonderful particularly the night staff who are absolutely marvelous – if you want a drink or anything else they are so obliging.” Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 The social activities in the home, although limited, provide the residents with enjoyment and interest and is planned to meet individual preference. The dietary needs of the residents are well catered for with a balanced and varied selection of food available that meets the residents’ tastes and choices. EVIDENCE: No formal activities programme is in place with activities arranged more on an ad hoc type basis. A number of regular activities take place once a month such as: a “film show”, and the owner plays the piano in the main lounge. Local clergy also holds a church service once a month. Other than these activities, nothing else is particularly arranged and no formal activities programme is planned. A record of the activities undertaken is generally kept in the diary, seen by the inspector. An aroma therapist also visits and does hand massages for individual residents. Residents spoken with said they had a choice “whether to join in activities or not” Another said that she enjoyed going out for a walk with the staff. The owner said that should a resident express a particular interest in an activity, the home would provide the means to ensure the activity was available. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 13 All residents spoken to were full of praise for the quality and quantity of the meals provided at the home. One resident said “the staff always ask us what we want to eat and we have a good choice of food at every mealtime.” The menu for the home has been revised and follows a four weekly cycle, which will be seasonally adjusted. On the day of the inspection the lunchtime meal and its alternative corresponded with the printed menu. The cook does lots of home baking and does make additional ‘treats’, not necessarily always detailed on the menu. The inspector sat with three gentlemen during the lunchtime meal, which was fish in parsley sauce potatoes and vegetables with meat pie as the main alternative. Apple crumble and custard was served as the pudding. All of the residents said the generally enjoyed the food served. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were examined at the last inspection Training provided has ensured that staff have knowledge and understanding about Adult Protection issues, which protects residents from abuse. EVIDENCE: The key standards were examined at the last inspection on the 23rd November 2005. All of the key standards were met Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 15 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 26 Generally, the home provides accommodation of a good standard. It is a safe, clean and comfortable environment, for the residents. EVIDENCE: The home has had a number of bedrooms and communal areas redecorated since the last inspection and all areas seen were homely, clean and odour free. The Registered Provider has an ongoing programme of maintenance and renewal and the new carpets planned for four bedrooms Nos. 4 7 8 12 indicated this. The inspector identified a further five bedrooms that required new carpets and these were 2 6 10 32 36. Although all of the bedrooms seen were highly personalized the Registered Individual needs to provide the Commission with a detailed planned decoration and refurbishment of all the areas in the home that have not been addressed: communal areas, corridors, toilets, bathrooms and bedrooms. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 16 Several residents spoken to were very pleased with their individual rooms and said that they had ‘brought in a number of personal possessions to make them feel more homely’. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 17 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 30 The standards of recruitment, and training of staff are unsatisfactory with appropriate checks not being carried out to ensure that residents are protected from risk. Staff have not received appropriate training to enable them to fully meet the needs of the residents. EVIDENCE: Examination of the duty rota and a discussion with staff and residents indicated that there was sufficient staff on duty to meet the care needs of the residents. Feedback from staff and residents supported the view that generally there were enough staff on duty each shift to meet residents’ needs. Five care staff had completed NVQ level 2 training and one had completed level 3. Four had begun NVQ level 2 and a further four were to be enrolled once funding arrangements were in place. A matrix of training given and a future training and development programme must be provided to Commission for Social Care Inspection. Inspection of three staff files showed that the most recently recruited staff members had taken up employment prior to a Criminal Records Bureau (CRB) or Protection of Vulnerable Adults (POVA) check having been received. Only Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 18 one written reference was in place. Recent photographs of staff and documentary evidence of completed training were not held on all files. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 19 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 35 36 38 The management arrangements in place need to be strengthened to ensure that the management tasks such as supervision of the staff are undertaken thereby ensuring that staff fully understand their roles and responsibilities in meeting the needs of residents. EVIDENCE: The manager of the home is a qualified nurse and she has recently completed her Registered Manager’s Award. At the last inspection, the Commission required the manager’s supernumerary hours to be more clearly shown on the rota. This has been done and it was evident which of the manager’s hours spent at the home were supernumerary. However a discussion with the Registered Person identified that the amount of time allocated to the manager specifically to undertake her management duties, on average 6 hours a week, is insufficient and will be reviewed with a view to increasing the allocation. The Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 20 manager has a job description and an up to date copy of a Contract of Employment in relation to her position as the manager. A formal supervision programme has started, but as yet, is not fully operational. An accountant audits the home annually and these records would be made available to the Commission of Social Care Inspection on request. Adequate public and employers liability insurance was seen to be place. Evidence was seen that indicated that fire extinguishers, alarms, lifts and hoists are all serviced and maintained as required. The 5 yearly periodic Electrical check and annual gas safety checks have been completed. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 21 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 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 3 Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 22 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 OP8 Regulation 12 Requirement The Registered person must ensure that bedside rails are fitted with bumpers to minimise risk of the resident becoming trapped The provider must ensure that a record of all medication received into the home is maintained An activities programme must be drawn up after consultation with the residents. A programme of renewal of the fabrics and decoration, with timescales is to be provided to the Commission. As well as the bedroom carpets already identified by the provider for replacement ( 4 7 8 12): rooms 2 6 10 32 36 also require new carpets The manager must have sufficient supernumerary hours, to fulfil her role as manager Timescale for action 30/03/06 2. OP9 13 30/03/06 3. OP12 16 30/03/06 4. OP19 23 15/04/06 5. OP19 23 01/07/06 6. OP31 18 30/03/06 Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 23 7. OP18OP29 19 8. OP30 18 Two satisfactory written references, POVA and CRB checks must be in place prior to staff beginning work at the home. Staff must receive training appropriate to the assessed needs of the residents. A training matrix is to be sent to the Commission for Social Care Inspection within the timescale. 30/03/06 15/04/06 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 OP7 Good Practice Recommendations Daily progress report entries should be timed as well as dated. Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Hurstead House Nursing Home DS0000017330.V283383.R01.S.doc Version 5.1 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. 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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