Inspection on 14/11/06 for Hythe Nursing Home

This inspection was carried out on 14th 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.

Other inspections for this house

Hythe Nursing Home 29/09/08

Hythe Nursing Home 28/02/06

Hythe Nursing Home 24/08/05

Hythe Nursing Home 19/10/04

Hythe Nursing Home 22/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Hythe Nursing Home 91 North Road Hythe Kent CT21 5ET Lead Inspector Lisbeth Scoones Unannounced Inspection 14th November 2006 09:45 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 Hythe Nursing Home DS0000026101.V303612.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. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hythe Nursing Home Address 91 North Road Hythe Kent CT21 5ET 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) 01303 265441 01303 230329 Premium Healthcare Limited Mrs Linda Barbara Hazrati Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users with pallative care needs to be restricted to three (3) at any one time. Service users under the age of 65 years old are restricted to two (2) whose DOB is 08/05/1943 & 17/08/1942. Service users admitted for intermediate care can be aged 55 years old and over and are restricted to two (2) in number. 28th February 2006 Date of last inspection Brief Description of the Service: Hythe Nursing Home is a large converted detached two-storey house situated on the outskirts of the town of Hythe. Rooms at the rear of the home have panoramic views of the town and the English Channel. There is a bus stop nearby and the railway station is ¾ mile away. There is a large patio area, which overlooks the sloping rear garden, and most residents would need supervision when accessing this area. There are parking spaces in front of the home as well as opportunities for off street parking. Mrs Linda Hazrati has been the manager since July 2002 and continues to show a commitment to the development of her staff in order to provide the residents with a quality service. The home’s email address is: premiumhythe@btconnect.com. The inspection report is freely available. Weekly fees are in the range of £600 to £650 with additional charges for newspapers, chiropody and hairdressing. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours and comprised discussions with the Directors, the manager, deputy manager, newly appointed nurse and care worker, the chef and other staff, several residents and two visiting relatives. A tour of the building was undertaken and care and other records examined. Prior to the inspection, the manager completed a pre-inspection questionnaire. At the inspection, a number of comment cards were handed out to residents or their relatives to complete. A comment card was also completed by the GP who regularly attends to the residents’ medical needs. Two care managers were contacted for their views on the service. All this information informed the inspection process. All comments returned were very positive. What the service does well: The home provides a clean, pleasant and tranquil environment and the staff interacted with the residents and each other in a harmonious manner. Residents spoken to praised the manager, the staff and the service provided. Comments made on the day: “ This is a lovely place”. “ Staff are amazing”. “My relative is well looked after.” Residents said that the meals are good, balanced and varied. what I ask for.” “They give me Residents are protected from abuse through staff training and supervision and a sound recruitment process. An adult protection policy is in place and staff training provided. The location and layout of the home are suitable for the service user group. A rolling decorating programme is in place. A relative said, “I like the view and the sense of space”. Staffing levels continue to be stable and NVQ training is encouraged. The home’s manager is an experienced nurse and is supported by a deputy and other trained staff. The directors of the company visit daily and praised the manager’s continued commitment and leadership. Excellent quality assurance systems are in place based on residents’ views. What has improved since the last inspection? All complaints are logged, investigated and acted upon. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 6 The home is well decorated and in a good state of repair. The manager has tried hard to achieve that 50 of the care staff are NVQ trained. Staff are provided with good training opportunities. A new bedpan washer has been provided in one of the sluices and wall-mounted liquid soap dispensers have now been supplied in all residents’ bedrooms. 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. Hythe Nursing Home DS0000026101.V303612.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 Hythe Nursing Home DS0000026101.V303612.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, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents are provided with and have access to the Service User Guide and the inspection report. Each resident is provided with a written contract/statement of terms and conditions. Residents are only admitted to the home following a comprehensive assessment of need. Residents and their relatives are offered opportunities to visit the home before they make a decision whether the home can meet their needs. Residents assessed as needing intermediate care are provided with a programme to maximise their independence. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 9 EVIDENCE: The directors keep the service user guide and statement of purpose under regular review. Prospective residents are provided with an information pack, which refers to the service user guide and the recent inspection reports being available at reception. All residents are provided with a written contract/statement of terms and conditions. One such contract was seen. It was signed but not dated. From discussions with residents’ relatives and staff and documentation seen, it is ascertained that a pre-admission assessment is undertaken prior to the decision being made that the home can meet the resident’s needs. From discussions with staff and training records seen, it is ascertained that staff individually and collectively have the skills and experience to deliver the planned care. It is the home’s philosophy, as confirmed by visiting relatives, that visitors are welcomed at any time. The home is registered to care for two residents with intermediate care needs over the age of 55. The manager and a resident visited said that the service is working well. Dedicated accommodation has been provided and staff are supported by the rehabilitation team. Hythe Nursing Home DS0000026101.V303612.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system is good but would benefit from more detail pertaining to certain personal care needs. Residents’ health care needs are fully met. The systems for medication administration are good and records well maintained. Residents are treated with dignity and respect for their privacy. EVIDENCE: The manager and her trained staff regularly review the care plans. A sample of these was examined and this contained information about a range of assessed care needs and planned nursing intervention including safety, Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 11 personal hygiene, mobilisation, communication and activities. However, in respect of continence management, it was agreed that this should be more clearly recorded thus providing staff with up to date information to deliver the care. Good clinical risk assessments are used to inform the care plan. These include assessments to determine risks of developing pressure ulcers. District nurses would be consulted to provide wound care advice. The home has a range of pressure relieving equipment, and specialist chairs. The staff are particularly vigilant in respect of nutritional assessments and weight recording. Residents have access to hearing and sight tests, chiropody, speech therapy and dental care. The services of a continence advisor are sought when necessary and there was evidence of regular visits by GP’s, other health professionals and psychiatric referral. The inspector met with the GP who visits the home weekly. The home is served by two GP surgeries and the manager said this was a good arrangement. The deputy manager showed the inspector the clinical room, which was tidy and clean. Medication records were well maintained. The system for the disposal of unwanted and out of date medication would benefit from a review. It was observed that staff communicate with the residents in a dignified and respectful manner. Residents are well dressed in clothes of their choice. Hythe Nursing Home DS0000026101.V303612.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. Residents’ social and recreational needs are met and contact with family/friends and the local community is encouraged. Residents are helped to exercise choice and control over their lives. Residents receive a varied, wholesome and balanced diet. EVIDENCE: Currently staff who work in the afternoons are responsible for providing inhouse activities for the residents. Recently a care worker, who knows the residents well, has been employed for 18 hours a week to take over that role. The home provides the following activities: Flexi fit, library books, board games, singers, flower arranging and Bingo. A resident said he likes watching his favourite film on DVD in his room. Other residents were reading the newspaper and watching television programmes of their choice. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 13 It was noted that staff enable residents to make choices in respect of what they would like to wear, where and what they would like to eat and what they would like to do. Relatives are encouraged to visit and are made welcome at any time. The inspector met with the chef in a clean and tidy kitchen. She has a good knowledge of the residents’ individual nutritional needs, preferences, likes and dislikes and speaks to them on a regular basis to ascertain their views. Residents said that the food was good and varied. Meals, including soft foods are well presented and diets catered for. It was observed that a choice of meals is available. Cakes and scones are made every day. Home made quiches, fresh fruit, local vegetables and fresh fish are provided. Evening meals are varied and include sandwiches, soup and jacket potatoes with various fillings. Residents either have their lunch in the dining room or in their bedrooms if they prefer. The chef said that the replacement of the kitchen units is part of the home’s development plan. The Environmental Health Officer recently inspected the kitchen. Hythe Nursing Home DS0000026101.V303612.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. Residents are confident that their complaints and concerns are taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: It is evident from talking to the residents that they are encouraged to air their views and express any concerns to the manager and staff. Complaints were well recorded in the complaints book, including the action taken thus providing evidence that the issues had been satisfactorily dealt with. The complaints procedure is included in the Service User Guide. The Home has an adult protection policy and staff demonstrated their awareness of the action to take if this was ever witnessed or suspected. They are first introduced to adult protection issues at induction and during NVQ training. The manager is the adult protection trainer. Recent training has been carried out. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 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. 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. Residents live in a safe, well maintained, well equipped, clean and pleasant environment. EVIDENCE: The Home is located in a quiet, residential area in Hythe. It occupies high ground with some rooms having an attractive view of the sea. It provides a pleasant and well-maintained environment. There was evidence of a continued maintenance and renewal programme and bedrooms are redecorated and refurbished when they are vacated. The company employs a full time maintenance person and a gardener. A patio area is accessible to residents and their visitors, although they would need to be accompanied by staff when going into the garden. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 16 The standard of cleanliness is good and staff are trained in infection control issues. All residents’ rooms and communal hand washing areas have been provided with liquid soap and paper towel dispensers. Since the previous inspection, a new sluice disinfector machine has been purchased. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 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. 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. Residents’ needs are met by the number and skill mix of the staff who are well trained. The home’s recruitment process is sound. EVIDENCE: As confirmed on the duty rota, in addition to the manager and the deputy, there was a trained nurse and 5 care staff on duty. Two trained staff are on duty most mornings with 5 carers. In addition to the care staff, the home employs domestic, catering and maintenance staff as well as two administrative staff who deal with contracts, recruitment and all financial issues. The home operates a key worker system. Staffing levels are stable and roles and responsibilities well defined. A sample of staff records was examined and this demonstrated that the recruitment procedures are sound. A recently employed nurse described the Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 18 details of her recent recruitment. From this discussion and documentation seen, it is ascertained that the home’s recruitment process is sound. Two written references, POVA and enhanced CRB checks are undertaken prior to offering employment. Statutory and NVQ training is provided. The manager and deputy share the responsibility for staff training. The deputy manager said she is enjoying taking. A number of staff are undertaking NVQ training thus working towards the target of 50 . It was evident from the training calendar seen in the manager’s office and from discussions with staff that the home provides many training opportunities. In addition to NVQ and statutory training, recent training includes: Dementia care, Intermediate care, Parkinson’s disease, wound care and COSHH. All staff are provided with individual staff training files. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 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. Residents live in a home, which is well managed by a manager who leads by example and creates an open and inclusive atmosphere. Excellent monitoring systems are in place, which includes residents’ views on the service provided. Good systems are in place to safeguard residents’ monies. Staff are appropriately supervised and a formal system has been introduced. Residents’ health, safety and welfare are promoted and protected. EVIDENCE: Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 20 Mrs L Hazrati, has been the home manager for a number of years, is a first level nurse and has many years of experience in managing care homes. Her management approach is one that encourages an open atmosphere in which staff and residents can raise issues and express their views. She has nearly completed the NVQ level 4 in management. The Directors Mr A Barnes and Mr P Barker support Mrs Hazrati and they praised her for her many achievements. She is further supported by a deputy further supports her and other trained staff and said that all staff work as a team. Residents’/relatives’ views are sought on a daily basis and through six monthly quality questionnaires. The Directors visit the home very regularly and an annual heath and safety audit is carried out. The administrator looks after the personal allowance monies of one resident. Good records of financial transactions made on behalf of the resident were seen including receipts and audit. Staff confirmed that they receive formal recorded supervision. A newly appointed RN said she was well supported and supervised during the induction period. Staff spoken to confirmed that they had received statutory training, including moving and handling. A member of staff in the company’s other home is the moving and handling trainer. The maintenance man undertakes environmental risk assessments and checks the fire alarms and fire fighting equipment. In-house fire safety awareness training takes place twice a year. A recent fire risk assessment has been carried out. The manager demonstrated that residents’ health and safety and practices in the home are protected through training, appropriate policies and risk assessments. Accident records were well maintained. The manager advises the CSCI of any event reportable under Regulation 37. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 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 3 3 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 4 x 3 3 x 3 Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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. 1. Refer to Standard OP7 Good Practice Recommendations That care plans provide more clarity to staff in respect of continence management. Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hythe Nursing Home DS0000026101.V303612.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!