Inspection on 27/10/05 for Ingwood Nursing Home

This inspection was carried out on 27th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ingwood Nursing Home 04/06/07

Ingwood Nursing Home 06/06/06

Ingwood Nursing Home 21/02/06

Ingwood Nursing Home 04/03/05

Ingwood Nursing Home 03/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Ingwood Nursing Home Stainland Road Greetland Halifax West Yorkshire HX4 8BQ Lead Inspector Liz Cuddington Unannounced Inspection 27th October 2005 10:40 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 Ingwood Nursing Home DS0000060152.V254662.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. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ingwood Nursing Home Address Stainland Road Greetland Halifax West Yorkshire HX4 8BQ 01422 374410 01422 375671 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) Philip Bennett (NewCo) Ltd Mrs Cathryn Iqbal Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th March 2005 Brief Description of the Service: Ingwood combines the conversion of a period building with a substantial new build accommodation block. The accommodation is over two floors. The home provides both personal care and nursing care to men and women aged sixty-five and over. There is a choice of single or shared bedrooms. Ingwood is situated about ten minutes drive from Halifax and twenty minutes drive from Huddersfield. There is ample parking. The home is on a bus route. The main entrance to the home is approached by a flight of steps, however there is a level entrance to the rear of the building. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took seven hours and during this time I made a tour of the house and spoke with nine service users, two visitors and three staff members. I also spent time examining records and talking with the home’s manager. I assessed nineteen of the 38 National Minimum Standards. The manager was off work due to illness when I arrived. Even though I said it was not necessary, the nurse in charge called the manager in to work. Whoever is in charge at the time of an unannounced inspection should be able to manage this, as with any other situation which arises. I would like to thank the service users, the visitors and the staff for taking the time to talk with me and express their views, and for their welcome and hospitality. What the service does well: What has improved since the last inspection? One to one supervision of staff has improved and now includes the nursing staff as well as the care staff. Some of the staff have completed Adult Protection training, with more training planned for the remaining staff. Information about advocacy services is now available on the notice board in the main entrance hall. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 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. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 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 Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 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): 3 Pre-admission assessments are carried out. EVIDENCE: The plans examined showed that Social Services’ pre-admission assessments are carried out alongside the home’s own care needs assessment. These documents form the basis of the individual plan of care. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 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 None of these three standards was met and, as a result, four statutory requirements and one good practice recommendation have been made. The plans of care do not fully reflect the current assessed needs of the service users and how these needs are to be managed. Service users or their representatives are not included in developing and reviewing the plans. Some of the medicines storage and administration systems are unsafe. EVIDENCE: Although some sections of service users plans of care had been regularly reviewed by staff, there was no evidence that individuals or their representatives had been involved in developing or reviewing their plans. The plans did not always reflect the current assessed needs of the individual. For example, one service user’s moving and handling plan states that this person can weight bear and needs two staff to assist with transfers. Yet a recent accident report says that this service user fell while walking with a Zimmer frame. This same service user had apparently had six accidents in a recent three-month period. I would expect to see detailed risk assessments and Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 10 action plans to minimise the risks for each activity yet the plan only included a basic assessment of the individual’s general risk of falling. Nutritional screening is undertaken and service users have access to the usual healthcare services such as chiropodists, dentists and opticians. Specialist healthcare advice is taken when needed. The tissue viability nurse is involved when service users’ skin is at risk due to their immobility. Pressure relieving mattresses and chair seat cushions were being used. I did not carry out a full audit of medicine administration systems. However, I was very concerned to see that the medicines being returned to the pharmacy were being stored in open boxes in the manager’s office. This room is frequently unoccupied and the door left open. Service users and visitors have easy access to this room. There is a controlled drugs cupboard securely fixed in the manager’s office. Good practice recommends that this cupboard is not only securely fixed but that the cupboard is sited in a secure area. During the inspection I witnessed a member of the home’s nursing staff and a new agency nurse carrying out secondary dispensing of medicines. This is very poor and unsafe practice. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 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 & 15 There is a choice of dishes at each meal, the food is well presented and mealtimes are unhurried and sociable. Staff assist service users appropriately. Visitors are made welcome. EVIDENCE: Service users have the opportunity to make choices about their meals and how they prefer to spend their time. One lady expressed a wish for a particular item of food and the cook went out of her way to make sure that this was provided and was suitably prepared to enable the lady to enjoy it. The people who commented all said how nice the meals are. The food looked and smelt appetising and the meal which had been liquidised was attractively presented. In genera ,staff assist service users who need help to eat in a relaxed manner, although one person did say that sometimes the staff are a bit rushed. I saw visitors arriving throughout the day and they were all welcomed. Service users can receive their visitors in one of the communal lounges or in their own bedroom. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 12 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): 17 & 18 Information is available about advocacy services. The home needs to make sure that all staff complete Adult Protection training without delay. EVIDENCE: There was a notice on the board in the main entrance hall about advocacy services, which service users or their relatives may wish to use. Part of the recruitment process for new staff is to obtain an enhanced Criminal Records Bureau (CRB) check, which also includes a Protection of Vulnerable Adults (POVA) register check. Some of the staff have completed Adult Protection training; it is important that the rest of the staff group complete this as soon as possible. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 13 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, 21 & 26 The house is well maintained and the alterations have improved the facilities. The laundry meets infection control standards. EVIDENCE: The recent alterations to the house have now been completed. The house and grounds are attractive and look to be well maintained. A new shower room has been fitted. This has been designed as a ‘wet room’ to allow easy, level access to the shower area. There are plenty of toilets and bathrooms available. Many of the rooms have en suite toilets and washbasins. The laundry facilities meet the requirements, with one washing machine having a sluice wash programme. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 14 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): 28, 29 & 30 More care staff need to complete their NVQ qualification. All staff employment records need to show that two suitable references have been received. There are satisfactory arrangements for induction and foundation training for new care staff. EVIDENCE: Of a total of nineteen care staff only 6 have achieved an NVQ qualification in care. The manager said that there are currently thirteen staff working towards NVQ level 2. They are expected to have finished the course by April 2006. Some staff files were examined. Not all of them included two suitable references. For the protection of service users it is vital that all necessary preemployment checks, including references, are completed before a new member of staff starts work. Newly recruited care staff have an induction training period followed by a longer foundation training programme. Staff now attend Calderdale College for their foundation training. There was evidence in staff files that people have taken mandatory training courses such as fire safety, basic food hygiene and health and safety awareness. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 15 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): 35, 36, 37 & 38 Items stored on behalf of service users must be kept secure and written records made. Service users’ personal details are stored in an unlocked cupboard in an unlocked room where anyone can access them, should they wish. EVIDENCE: Records were examined and there are now written receipts for all transactions undertaken on behalf of service users. The home does not handle service users cash. In the individual care plans there were property register sheets, but none I saw had been completed. There is a fixed, lockable cupboard where the home stores valuables on behalf of service users, if they wish. On the day of the inspection this cupboard was unlocked and the room it is in left unattended and unlocked. Even after I pointed this out nobody took the trouble to locate the key and lock the cupboard. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 16 This last point also applies to the lockable storage cupboard housing all the service users records. Throughout the inspection this cupboard was left open and unlocked in an easily accessible and frequently unattended room, even after I commented on the security issue. By contrast the staff records are stored in an upstairs, less accessible office in a lockable filing cabinet. All confidential information must be securely stored and comply with the Data Protection Act 1998. The care staff files which I examined showed that regular one to one supervision sessions are taking place between staff and their line manager. The manager assured me that she has carried out supervision with the nursing staff. The refrigerator, deep freezer and hot food temperatures are taken daily and accurate records kept. I saw evidence that staff have received fire safety training and there was a notice on the board in the entrance hall saying who is qualified in first aid. Shoes, clothing and other personal items were being kept in the dry food storage area. This is unhygienic and inappropriate. Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 17 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 3 X 3 X X X X 3 STAFFING Standard No Score 27 X 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 1 3 1 2 Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 14 & 15 Requirement The personal plans of care must reflect the service user’s current needs. The plans must also show evidence that they have been agreed with the service user or their representative. When a service user is at risk from falling the plan of care must include a comprehensive risk assessment and risk management plan. Medicines, including those awaiting collection by the pharmacy, must be securely stored at all times. Secondary dispensing of medicines must not take place as part of the routine medication administration process. Two satisfactory written references must be obtained before a new staff member is appointed. Service users valuables stored by the home must be kept securely. Service users personal records must be securely stored at all times. DS0000060152.V254662.R01.S.doc Timescale for action 31/12/05 2 OP8 13 31/12/05 3 OP9 13(2) 30/11/05 4 OP9 13(2) 30/11/05 5 OP29 19(b) & Schedule 2 16(2)(l) 17(1)(b) 30/11/05 6 7 OP35 OP37 30/11/05 30/11/05 Ingwood Nursing Home Version 5.0 Page 19 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 OP9 Good Practice Recommendations All nursing staff should attend refresher training in the safe handling of medicines. Before engaging agency nurses their competence in this area needs to be assessed. All staff should attend Protection of Vulnerable Adults training in the near future. More care staff need to complete their NVQ qualification in order to meet this standard. Staff’s personal belongings should not be kept in food storage areas. 2 3 4 OP18 OP28 OP38 Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Ingwood Nursing Home DS0000060152.V254662.R01.S.doc Version 5.0 Page 21 - 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. 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