Inspection on 25/09/06 for Inglewood Nursing Home

This inspection was carried out on 25th September 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

Inglewood Nursing Home 17/11/05

Inglewood Nursing Home 23/05/05

Inglewood Nursing Home 02/11/04

Inglewood Nursing Home 24/06/04

Inglewood Nursing Home 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Inglewood Nursing Home Deal Road Redcar TS10 2RG Lead Inspector Neil McKenzie Key Unannounced Inspection 25th September 2006 10:30 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 Inglewood Nursing Home DS0000000179.V311529.R02.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. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Inglewood Nursing Home Address Deal Road Redcar TS10 2RG 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) 01642 474244 01642 492735 www.bupa.co.uk BUPA Care Homes (GL) Ltd Mrs Susan Betty Ashton Care Home 50 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0) of places Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age category is for individuals with dementia aged 55 . Date of last inspection 17th November 2005 Brief Description of the Service: Inglewood provides care for up to 50 older people with dementia. The home was purpose built approximately 10 years ago and has two floors. The home is situated on the outskirts of Redcar and there are shops close by. Inglewood has pleasant well kept gardens for the residents to enjoy. BUPA is the registered provider and the Responsible Individual is Lesley Tart. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspection lasted for 7 hours. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards for Care Homes. During the visits the inspector spoke to 3 residents, 3 relatives and 4 staff to find out what their views were about living and working at Inglewood. The inspector also spent time speaking to the manager of the home. The inspector spent some more time watching how staff and residents are with each other. A tour of the home took place and records looked at included staff recruitment and training, resident care plans and how the home handles money and medication. There was also questionnaire’s sent to the home, residents and relatives and these were looked at to help decide how good a job the home does in meeting the National Minimum Standards. At the time of the inspection the minimum cost for a bed was £351.00 per week and the maximum cost for a bed £515.00 per week. There are additional costs for hairdressing and chiropody. What the service does well: What has improved since the last inspection? Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 6 Since the last inspection the home has acted on the one recommendation to make things better for residents living at Inglewood. Residents are now supported by staff having regular supervision on the work they do. This is recorded in staff records as happening once every 2 months. 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. Inglewood Nursing Home DS0000000179.V311529.R02.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 Inglewood Nursing Home DS0000000179.V311529.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3. The home does not provide intermediate care The quality in this outcome area is good as residents’ benefit from a written contract describing the conditions of the home and a needs assessment before moving into the home. This judgement has been made using available evidence from resident care records and interviews with staff and residents. EVIDENCE: The 3 resident records examined contained written contracts describing the conditions of the home. All contracts signed by a resident and or relative to demonstrate they were in agreement with the contract. This contract included details of any personal financial contribution toward the cost of residing in the home. Resident records sampled by the inspector demonstrated detailed assessments of the residents’ original needs completed by qualified professionals. As one relative stated,’ I do remember a meeting and we have a review of this meeting where we are listened to if we have any concerns’. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 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 the following standard(s): 7,8,9 and 10 The quality in this outcome area is good. This judgement has been made using available evidence from resident files, the pre-inspection questionnaire, and interview with resident, staff and manager. EVIDENCE: In the files sampled by the inspector each resident’s had a personal care plan that included daily records documented in their file. These plans and daily records were up to date in their recording and demonstrated involvement of other health specialists such as district nurses and doctors. One resident interviewed stated ‘I am having a meeting with my local doctor today’. Care plans included risk assessments on manual handling, nutrition, pressure sores, falls and these were reviewed once every month. Each care plan demonstrated relative involvement with ‘relative communication sheets’ used and referred to staff on a daily basis. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 10 In addition plans were personalised with ‘likes and dislikes’ about activity, personal care and food. The home promotes ‘key-workers’ to encourage one to one development between resident and staff. A resident interviewed at inspection had a photograph of her key-worker in her bedroom and a family member visiting that day described the key worker as ‘a canny person’. During the inspection the home’s policy and procedures and arrangements for receiving, storing, administering, recording and disposing resident’s medication were observed, examined and discussed in depth with the manager and senior staff member qualified to administer medication. At the time of the inspection visit, medication was seen to be correctly stored with accurate records for the medication held. This includes separate records for controlled drugs counter signed when administered by 2 qualified members of staff. The manager was also able to show and describe how medication is disposed of including a waste contract for unused medication to be collected from the home. Individual residents’ medication record sheets contain photographs of the person to help ensure that residents receive the correct medication. At the time of the inspection there were no residents who were administering their own medication. The residents’ who spoke to the inspector stated that staff treated them with respect and dignity and care plans showed evidence of consultation with residents with regard to how they like things to be done. For example, it was clearly documented in one resident file that ‘likes to be involved in any decision that affect them’. Comments made by residents included: ‘I like it here, every one friendly and staff’ ‘Staff very good’ ‘Staff are friendly’. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 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 the following standard(s): 12,13,14 and 15 The quality in this outcome area is good. This judgement has been made using evidence from a tour of the home, observation, resident surveys and interview with resident, staff and relative. EVIDENCE: All relatives who returned survey questionnaires (4) said they were made to feel welcome in the home at any time. As one relative visiting on the day of the inspection stated, ‘made to feel welcome here’. The inspector observed a number of relatives visiting family members and talking to staff. Residents interviewed confirmed that family members visit on a regular basis. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 12 Residents who spoke to the inspector suggested there could be more activity particularly trips out. One resident stated, ‘ afraid I don’t know about any activities’. Residents who returned surveys, 9 in total, 2 said there were never activities arranged by the home that they could take part in, and 3 said sometimes there was an activity they could take part in. A staff member stated ‘not a lot of activity, people sitting about, could be more day outings’. During the inspection a planned activity programme was available for residents to choose from, which included games, hairdresser, beauty therapy, cookery, reminiscence and individual time. This is organised by a part time activity coordinator. There was no planned activity outside of the home. The home no longer has a mini bus to take people out. This was discussed with the manager who said that activity is promoted on a one to one basis. On the whole residents were observed to receive a wholesome and balanced diet. At the time of the inspection the menu of the day was not displayed and the main meal, in the evening, provided one main course. The manager stated that choice for a more personal menu for example, salad, sandwiches and or alternatives to solid food is catered for. Choice of sandwiches provided as the main course for lunch. One relative visiting at the time of the inspection had brought in food that was a particular favourite of the resident and did this on a daily basis. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 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 the following standard(s): 16 and 18 The quality in this outcome area is good. This judgement has been made using evidence from the pre-inspection questionnaire and documentation of complaints and investigations, interview with staff and the relative survey. Residents are protected by a complaints procedure and a policy and procedure on adult protection and prevention of abuse. EVIDENCE: All the surveys returned by relatives (4) said they were aware of the homes complaints procedure. One relative stated in her survey, ‘with regard to complaints procedure there is always someone at hand if I have any comments or queries’. Another relative stated at the time of the inspection, ‘we are listened to if we have any concerns’. The residents are protected by an Adult Protection and Prevention of Abuse policy. This was last reviewed in 2003. Training on the protection of vulnerable adults is regularly organised by the manager and this provides further protection for residents. One staff member interviewed confirmed that she was due to attend a course on adult protection next month and another stated, ‘we don’t force feed or clean, always talking to ensure permission and are aware of signs of bruising and changes in mood’. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 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 the following standard(s): 19, 24 and 26 The quality in this outcome area is good. This judgement has been made using evidence from a tour of the premises, the pre-inspection questionnaire and interview with staff. The residents live in a well maintained home. EVIDENCE: Whilst on the whole the home is well maintained both dining room carpets are worn and stained. This was discussed with the Manager who informed the Inspector carpets are due to be delivered. Cracked and missing tiles in downstairs toilet need to be made good. The home has a maintenance worker responsible for repairs and these are identified and recorded by staff in a maintenance book. Corridors had recently been decorated with paint. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 15 Residents’ benefit from a pleasant enclosed garden area and bedrooms in which they can choose to have their own furniture and belongings. Bedrooms are identified by memory boxes in which residents can place personal photographs of themselves, family and friends. The home also presented as clean and free from unpleasant odours. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 16 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 and 30 The quality in this outcome area is good. This judgement has been made using evidence from, the pre-inspection questionnaire, rota, staff files and interviews. EVIDENCE: An audit of the duty rota was carried out. At the time of the inspection there were 46 residents living at the home. There were 2 qualified nurses and 7 care assistants during the morning shift. There were 2 qualified nurses and 6 care assistants during the afternoon and evening shift. Included in the day shift and supporting all the residents in the home a chef and 2 kitchen assistants, a maintenance worker, 3 domestics, a laundry worker, 1 activities coordinator and the manager. There were 2 qualified nurses and 3 care assistants for the night shift with 1 additional care assistant between 7.00 pm and midnight. At times of staff sickness the home draws on bank staff. All relative surveys returned commented that there was always sufficient numbers of staff on duty. 6 resident surveys out of the 9 said staff always available when they need them, 3 said usually. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 17 The manager has promoted National Vocational Qualification (NVQ) Level 2 and 3 in Care training to staff to offer residents’ safe and competent staff. At the time of the inspection 65 of care assistants had an NVQ level 2 or 3 in Care. In addition there was evidence of staff completing externally certificated training specific to resident needs. For example, Level 3 training in Dementia by the Joseph Rowntree Trust. The recruitment files of 4 staff were looked at. All files contained application forms and were backed up by two written references. Evidence was in place to show that Criminal Records Bureau disclosures at Enhanced level had been received for staff members working in the home. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 18 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 and 38 The quality in this outcome area is good. This judgement has been made using evidence from the pre-inspection questionnaire, interview with the manager, staff files, and records. The home is run and managed by a person who is fit to be in charge. Financial procedures were up to date. EVIDENCE: The manager is a qualified nurse and manager with 5 years of experience as manager at the home. The manager presented as clear about her role and responsibilities, and handled the inspection in a knowledgeable and professional manner. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 19 The 4 staff files examined demonstrated that supervision was happening on a regular basis that included review of mandatory training in first aid, fire awareness, manual handling, wound care, food hygiene and basic health and safety. The home has annual resident and relative surveys to ensure the home is run in the best interests of residents. This is published on an annual basis. The home has financial procedures for handling resident money and examination of financial records demonstrated that this was being followed. Details of health and safety were made available through the pre-inspection questionnaire and tour of the premises. These records were recorded as up to date with relevant certificates available on request. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 20 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 3 3 X X N/A 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 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 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 Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 21 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. 1. Standard OP15 Regulation 16 (I) Requirement Timescale for action 31/10/06 2. OP19 23 (2) The registered person must ensure there is a menu offering a choice of meals displayed in a format easy to read by residents. The registered person must 31/10/06 ensure cracked/missing tiles in toilets made good. 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 OP12 Good Practice Recommendations The registered manager should encourage activities that include trips out for residents. Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Inglewood Nursing Home DS0000000179.V311529.R02.S.doc Version 5.2 Page 23 - 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!