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Inspection on 19/12/05 for Ings House Nursing Home

Also see our care home review for Ings House Nursing Home for more information

This inspection was carried out on 19th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

Ings House is a relatively small, friendly care home. Service users and visitors spoke of the kind and caring staff, the hospitality and the friendly welcome they receive when visiting the home. Service users felt safe and happy in the home and relatives advised of the confidence they have in the nursing staff and the good level of communication between staff in the home and relatives. Service users and relatives said they were aware of the complaints procedure and would be confident to raise concerns if they had any. The care home was clean, tidy and appeared well maintained at the time of the visit. Records are clearly maintained in the home and regularly reviewed.

What has improved since the last inspection?

Recommendations made following the last report have all been addressed.

What the care home could do better:

Some information in care records needs to be recorded in more detail. Staff must continue to work toward achieving NVQ level 2 in care. The company must carry out management visits as required by Regulation 26 of The Care Homes Regulations 2001. Care must be taken to ensure weekly fire safety checks are carried out.

CARE HOMES FOR OLDER PEOPLE Ings House Nursing Home 350 Bradford Road Liversedge West Yorkshire WF15 6BY Lead Inspector Sally McSharry Unannounced Inspection 19th December 2005 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 Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 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. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ings House Nursing Home Address 350 Bradford Road Liversedge West Yorkshire WF15 6BY 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) 01924 411166 01924 410131 ken.woolford@btconnect.com Mr John Keen Mr Kenneth Royston Woolford Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (31), Physical disability (1) of places Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 Brief Description of the Service: Ings House care home was built in the early 1800s and was extensively renovated and refurbished in 1990, when it was converted for use as a nursing home. It is situated just off a main road from Heckmondwike to Cleckheaton and it is convenient for those travelling on public transport. Shops and local amenities are located fairly closely within 5 minutes’ walking distance. The home offers single and twin accommodation, some with en-suite facilities for up to 32 elderly people. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and undertaken by one inspector over the course of four hours on 19 December 2005. Only those standards were inspected that the CSCI determine are central to the caring process. A sample of policies, procedures and records were examined that were relevant to the standards inspected. Two service users’ files were examined in detail. The inspector spoke with eight service users and privately with three visiting relatives. A brief tour of the accommodation was undertaken. The home’s manager and senior nurse assisted the inspector. The inspector would like to thank the service users, staff and managers of Ings House for their time, cooperation and hospitality during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 6 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 Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 7 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): EVIDENCE: None of the above standards were assessed during this visit. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 8 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 and 8. Service users’ health, personal and social care needs are written in an individual care plan. Service users’ health care needs are being met in the home. EVIDENCE: Each service user has an individual care plan. The plan identifies the service user’s health, personal and social needs and advises staff how these are to be met while the service user is in the home. Risk assessments have been carried out. Care plan documentation is reviewed monthly. Service users and relatives are involved in the care planning process and some have signed their care plan to confirm they have read it. Some information about service users is not recorded in detail, such as the size and description of wounds and dressings, etc. It is recommended that such detail be recorded to enable staff to assess the wound’s progress. Service users and visiting relatives said that they were confident in the staff and that service users’ needs are being met in the home. There is evidence in service users’ records that where staff at the home are unable to meet service users’ needs, other health care professionals are accessed and specialist advice is sought. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 9 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. Activities are offered in the home and service users’ religious needs are addressed individually. Contact with families and the community are encouraged and service users are offered choice in the home. Meals provided are wholesome. EVIDENCE: Activities are offered in the home. The activities organiser aims to engage each service user in some form of activity at least once a week. Group activities, such as quizzes and games are offered; individual one to one sessions also take place. Short, local trips out are arranged. Service users told the inspector about the arrangements for the Christmas party and the home had a festive feel. Relatives were also aware of the party and planned to attend. Contacts with service users’ families, friends and the local community are encouraged and relatives who visit regularly said that they were always welcomed at the home. The manager has also produced an informative Christmas newsletter, which has been given to service users and their friends. Service users are offered choice in the home. In some cases choice is limited due to service users’ frailty. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 10 Service users said meals are wholesome and that portions are ample. There is a choice at breakfast and a set menu at lunchtime, however service users advised that if they did not like the lunch offered, the kitchen staff always provided an acceptable alternative. Relatives also commented positively on the standard of meals provided. During this visit the inspector saw staff assisting service users with drinks and meals. This was done in a sensitive manner. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 11 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): EVIDENCE: None of these standards were inspected during this visit. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 12 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 and 26. Service users live in a safe, well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: A brief tour of the building was carried out. Rooms were clean and tidy and no unpleasant odours were noted. Some service users have personalised their rooms with photographs and memorabilia. The home is in good decorative repair and appears well maintained. Recommendations made in the last report have been addressed. Two relatives and a service user, who is new to the home, said that they had been impressed by the standard of hygiene and cleanliness in the home. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 13 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 and 30. The staffing levels provided are sufficient to meet the needs of the current service users. Staff training is being provided; this helps ensure staff are competent to do their job. However, the home has not reached the target of having 50 staff with NVQ level 2. EVIDENCE: Staffing levels remain unchanged and are sufficient to meet the needs of the current service users. Care staff, domestic staff and catering staff are provided. Staff training is ongoing and records show that staff have attended a variety of care related training courses throughout 2005. Some staff are working toward achieving NVQ level 2, however the home is not meeting the recommended target of 50 of care staff with NVQ level 2 in care by 31 December 2005. All care staff have attended relevant induction training. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 14 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, and 38. The manager is competent to run the home. The home is being run in the best interests of the service users, however the company is not carrying out monthly management visits as required. Generally the health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The registered manager has completed NVQ level 4 in care and is waiting for his final assessment. He is working toward the Registered Managers Award and aims to complete this by July 2006. Quality assurance surveys are being carried out. Service users and relatives are asked to provide feed back about the service in an effort to improve standards. The company is not currently carrying out monthly monitoring visits and producing a report as required in Regulation 26 of The Care homes Regulations Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 15 2001. Such monthly visits and reports must be carried out with a copy of the report being forwarded to the CSCI. Generally, there is a high level of health and safety checks and tests carried out and recorded. Since the last inspection staff at the home have started recording and evidencing that appropriate checks are carried out against the Legionella bacteria. At this visit the record of weekly fire alarm checks and tests showed that one test had been missed at the end of November 2005. This was the only fire alarm test that had been missed. The registered manager must ensure weekly tests are carried out. All other routine tests and checks appear to have been completed and clearly recorded. Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 16 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 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 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X X X X 1 Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 17 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 OP33 Regulation 26 Requirement Visits required under Regulation 26 of the Care Homes Regulations 2001 must be carried out and a copy of the report produced forwarded monthly to the CSCI. Weekly fire alarm tests and checks must be carried out and recorded. Timescale for action 31/01/06 2. OP38 23(4) 19/12/05 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 Some information about service users is not recorded in detail, such as the size and description of wounds and dressings, etc. It is recommended detail be recorded to enable staff to assess the wound’s progress. 50 of care staff should be trained to NVQ level 2 by 31.12.05. 2. OP28 Ings House Nursing Home DS0000001086.V268778.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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. 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