Inspection on 24/08/05 for Hythe Nursing Home

This inspection was carried out on 24th August 2005.

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 14/11/06

Hythe Nursing Home 28/02/06

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 24 August 2005 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hythe Nursing Home Address 91 North Road, Hythe, Kent, CT21 5ET Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 265441 01303 230329 Premium Healthcare Limited Linda Barbara Hazrati Care home with nursing 27 Category(ies) of Older People x 27 registration, with number of places Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/10/04 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. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours and comprised discussions with the Directors, the manager, recently appointed RGN, the cook and other staff, several residents and a visiting relative. A partial tour of the building was undertaken and care and other records examined. What the service does well: What has improved since the last inspection? A previous requirement and recommendation have been acted upon. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 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. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standard were not inspected on this occasion. EVIDENCE: Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 7 The care planning system is clear but does not provide adequate evidence of review. Not all daily records evidence that the planned intervention has been carried out. 8 Residents’ health care needs are fully met. 9 The systems for medication administration are good and records well maintained. 10 Residents are treated with dignity and respect for their privacy. EVIDENCE: Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 10 7 It is evident that the manager and her trained staff work hard to update and 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, personal hygiene, mobilisation, communication and activities. Good clinical risk assessments are used to inform the care plan. However, further detail is needed evidencing care reviews, and the daily records should reflect the care provided. See also standard 12. The manager acknowledged the deficits identified and said that due to the staffing issues already referred to, there have been few opportunities for an audit of care records. 8 Assessments to determine risks of developing pressure ulcers are undertaken and acted upon. The home has range of pressure relieving equipment, and specialist chairs. Nutritional assessments are undertaken and residents weighed regularly. Residents have access to hearing and sight tests, chiropody, speech therapy and dental care. See also standard 30 in respect of staff training. The services of a continence advisor are sought when necessary and there was evidence of regular visits by GP’s and other health professionals. District nurses have been consulted to provide wound care advice. 9 A nurse showed the inspector the medication charts, which had been well maintained. The member of staff demonstrated an excellent awareness of residents’ medication needs and review. The home is served by two GP surgeries. A GP visits the home weekly. 10 It was observed that staff communicate with the residents in a dignified and respectful manner. Residents are well dressed in clothes of their choice. A relative said that he is always made welcome by staff. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 12 and 13 Residents’ social and recreational needs are met and contact with family/friends and the local community is encouraged. 15 Residents receive a varied, healthy and balanced diet. EVIDENCE: Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 12 12 and 13 Staff entertain the residents as part of their caring role. Professional singers visit monthly. It was said that these sessions are much enjoyed. Residents’ preference not to take part in organised activities is respected. Recently a special coach with wheel chair provision was hired for a day out for 10 residents. The day was much enjoyed by residents and staff. The lounge has French doors to a patio area, which looks out onto the garden. In good weather residents may sit out and enjoy the view and fresh air. Some residents are very dependent and are either nursed in bed or stay in their room. For those residents, it was recommended that the need for social interaction be recorded in their care olan and evidenced in the daily record. See also standard 7. A discussion ensued about the need for staff to consult with the resident as to whether they wish the television to be on or off and the type of programme they like to watch. Relatives are encouraged to visit and are made welcome at any time. Visits to Age Concern and Umbrella club are enabled. 15 Residents and the visiting relative said that the food was good and varied. The chef has cooked the breakfasts and lunches for the residents for a number of years. A supper cook provides the evening meal. The chef has a good knowledge of the residents’ nutritional needs, preferences, likes and dislikes and speaks to them on a regular basis to ascertain their views. 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. Fresh fruit, local vegetables and fresh fish are provided. Cooked breakfasts are available on request and every Friday. Evening meals are varied and include sandwiches, soup and jacket potatoes with various fillings. Roast lamb was on the menu. It was said that roast dinners are provided twice a week. Eight people were having lunch in the dining room. Other residents preferred their meals served in their bedroom. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 16 Residents are confident that their complaints and concerns are taken seriously and acted upon. 18 Residents are protected from abuse. EVIDENCE: 16 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. The complaints procedure is included in the Service User Guide. 18 The Home has an adult protection policy and staff demonstrated their awareness of the action to take if this was ever witnessed or suspected. Staff are first introduced to adult protection issues at induction and during NVQ training. The manager is the adult protection trainer and provides in-house training to all staff. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 19 and 26 Residents live in a safe well-maintained, clean and pleasant environment. EVIDENCE: 19 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 is a planned 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. The area had colourful plants and flowers and a bird feeder. 26 The standard of cleanliness is good and staff are trained in infection control issues. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 30 27, 28, 30 Residents’ needs are met by the number and skill mix of the staff who are well trained. EVIDENCE: Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 16 27 As confirmed on the duty rota, in addition to the manager, there was a trained nurse and 5 care staff on duty. Two trained staff are on duty most mornings with 5 carers. The manager has not had as many supernumerary hours as before and due to staff changes and the absence of a deputy manager, she has been working “on the “floor”. See also standard 31. This situation may soon change as a fulltime RGN has recently been employed. It was said that only very occasionally, agency care staff are employed. To date, existing staff have picked up extra shrifts. There is a vacancy for a night carer. As identified in standard 26, domestic staff are employed in sufficient numbers to ensure the home is maintained in a clean and hygienic state at all times. The home employs two administrative staff who deal with contracts, recruitment and all financial issues. 28 and 30 Statutory, TOPSS compliant induction and NVQ training is provided. It was evident from information seen in the manager’s office and from discussions with staff that the home provides many training opportunities. A nurse said she had enjoyed the training sessions in optical awareness and wound care and would be interested in attending Dementia acre training. At the previous inspection, the need for a formal training system and devising of individual staff training files was discussed. This subject will be looked at in detail at the next inspection; the manager said that she keeps a training matrix in her office. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 38 31 and 32 Residents live in a home, which is well managed by a manager who leads by example and creates an open and inclusive atmosphere. 33 Good monitoring systems are in place, which includes residents’ views on the service provided. 36 Staff are appropriately supervised but a formal system has yet to be introduced. 38 Residents’ health, safety and welfare are promoted and protected. EVIDENCE: Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 18 31 and 32 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. There are frequent informal and regular formal staff meetings. She hopes to complete the NVQ level 4 in management in November 2005. The Directors Mr A Barnes and Mr P Barker support Mrs Hazrati and they praised her for her many achievements. “Officially”, Mrs Hazrati has 50 supernumerary hours. See also standard 27. She attends management meetings. 33 Residents’/relatives’ views are sought on a daily basis and through six monthly quality questionnaires. The Directors visit the home very regularly and a monthly report in accordance with Regulation 26 is written and a copy sent to the CSCI. 36 Due to the staffing issues referred to in standard 27, the formal process of staff supervision has been delayed. It is the manager’s intention to share supervision with other senior staff. As already acknowledged, the manager and senior staff supervise all staff informally on a daily basis. A newly appointed nurse said she was well supported and supervised by the manager and senior staff during the induction period and thereafter as needed. 38 The member of staff interviewed confirmed that she 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. The manager demonstrated that residents’ health and safety and practices in the home are protected through training, appropriate policies and risk assessments. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x 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 x 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 2 x 3 Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 2. 3. Refer to Standard 7 27 and 31 36 Good Practice Recommendations That care plans include all care needs and that reviews are more comprehenisve That the manager has adequate time available to carry out her duties That staff receive formal supervision. Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Hythe Nursing Home H56-H05 S26101 Hythe Nursing Home V241944 240805 Stage 4.doc Version 1.40 Page 22 - 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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