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Inspection on 07/07/05 for Littledale Nursing Home

Also see our care home review for Littledale Nursing Home for more information

This inspection was carried out on 7th July 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

Service users at the home said they were looked after well by the staff, that they were treated with respect and that their privacy was respected. They also said that they receive good meals and have a stimulating and varied life at the home. The service users said "the staff are lovely and the food is very good``. Relatives said they could visit the home at any reasonable time and that the staff worked hard and provided a good service for the old people. They described the staff as being a "grand bunch``. Staff demonstrated they were able to use, efficiently and effectively, policies and procedures that were in place should an allegation of abuse be made. The staff team were well trained and worked hard to build good relationships with service users and their families.

What has improved since the last inspection?

Systems have been implemented to ensure the safe storage of medication and hazardous substances. The number and skill mix of the staff employed at the home meets service users needs. Eighty-five per-cent of the staff were trained to NVQ level two, which contributed to them being competent to do their jobs. Service users have more opportunities for stimulation through leisure and recreational activities, which the service users said suits their individual needs. Some areas around the home have been redecorated.

CARE HOMES FOR OLDER PEOPLE Littledale Nursing Home 669 Prince of Wales Road Sheffield South Yorkshire S9 4ES Lead Inspector Janice Griffin Unannounced 7 July 2005 09:00am 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. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Littledale Nursing home Address 669 Prince of Wales Road Sheffield S9 4ES 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) 0114 261 1644 0114 261 9095 None Dr Abdul Khan Mrs Tahir Majid Khan Mrs Janet Cooper N - Care Home with Nursing 37 Category(ies) of OP - Old Age (37) registration, with number of places Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24 August 2005 Brief Description of the Service: Littledale is a 37-bed nursing home on two sites. The main building is a large detached property, which has 30 beds. The other 7 beds are situated in a semi-detached property across the road from the main building. The 7-bed unit is currently closed for alterations. The main house is a spacious property, it has one lounge, one dining room and a conservatory. Only one bedroom has an en-suite. Both properties are situated on a main road and accessible to community facilities such as shops, pubs, parks and a post office. Both buildings have small gardens and a car park. The manager stated that the philosophy of the home is to provide good quality nursing care whilst respecting and promoting the rights and needs of the individual service users. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over six hours. Ten service users, 6 members of staff, 4 relatives, and the registered manager were spoken to. A poster informing visitors that an inspection was in progress, and that any comments would be welcomed was displayed in the entrance to the home. An inspection of the building was made, selections of records were examined and observations made of the care provided, including the attitude of staff towards service users. What the service does well: What has improved since the last inspection? Systems have been implemented to ensure the safe storage of medication and hazardous substances. The number and skill mix of the staff employed at the home meets service users needs. Eighty-five per-cent of the staff were trained to NVQ level two, which contributed to them being competent to do their jobs. Service users have more opportunities for stimulation through leisure and recreational activities, which the service users said suits their individual needs. Some areas around the home have been redecorated. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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 Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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) 3 One service user had moved into the home without having his/her needs assessed, this does not allow the staff or service users to be assured that the needs could be met. EVIDENCE: One of the three files checked did not contain an assessment to show that the service users needs had been assessed prior to moving into the home. Staff confirmed that most service users did move into the home with assessments being completed and that the staff carried out a further assessment after admission. This ensures that staff have the information they need to make a judgement about whether the home has the facility to meet service users needs. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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 and 10. Service users had an individual plan of care, however, further work is required to ensure that all the service users health care needs are met. The recording of medication administered needs to be improved. Service users told the inspector that they were treated with respect, and the staff respected their privacy and dignity. The inspector observed staff closing doors and speaking with respect when assisting service users. EVIDENCE: Service users said they were consulted about their care plans and they knew that the home kept records, which they were able to look at if they wished. Staff said that care plans were reviewed regularly in consultation with other staff, service users and relatives. One care plan checked did not contain any details of whether the service user had been offered any dental checks. This does not contribute to maintaining the health care needs of service users. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 10 Records were kept of medication received, and disposed of. The member of staff spoken to confirmed that she had been trained to administer medication. A pharmacist had checked the home’s medication systems at regular intervals. All medication was noted to be securely stored. This ensures the service users are protected from harm. One service users medication recording sheet had not been signed on three occasions to indicate whether medication had been given or not. This could affect the health and well being of service users. Staff interacted well with the service users, furthermore they were observed closing bedroom, toilet/bathroom doors when attending to service users personal care needs. The service users said this helped to make them feel respected and ‘at home’. All service users said that the staff treated them with respect and their right to privacy was always upheld which helped to make them feel comfortable. The manager said that service users post was only opened if the service user or their representative requested this. This promotes the privacy of service users. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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) 12,13,14 and15. Service users were able to have social contact; activities took place both inside and outside of the home. They were able to maintain contact with family and friends and representatives of the community if they wished. Service uses were helped to make choices and to have control over their lives. The meals provided were in the main wholesome, appealing and balanced. EVIDENCE: A programme of the daily leisure activities was displayed on the notice board. This allows service users to have a clear understanding of what activities are on offer. Service users said the staff provided them with a variety of activities and outings to occupy their time. Staff confirmed this. Service users confirmed that the routines of daily living were flexible and suited their individual preferences. They also said they were able to see visitors in private and that visitors were made welcome, encouraging the maintenance of contact with family and friends, which creates a home that people want to visit. The service users said the food was “good and always plenty”. Three meals were offered each day and snacks and drinks were provided in-between meals. This ensured that service users were never hungry and could exercise choice over their diet. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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 standard(s) 16 and 18. Service users were confident that their complaints would be listened to, taken seriously and acted upon. The home’s complaints procedures need revising. The homes policies and procedures protected service users from abuse. EVIDENCE: Service users said that if they had any concerns they would feel comfortable in talking to the staff or the manager. Complaints procedures and an ethos were in place to enable service users and relatives to feel confident that any concerns they voiced would be listened to. The homes complaints procedure did not give details of how to contact the local office of the CSCI. This does not fully ensure that the rights of service users are protected at all times. Staff had received formal adult protection training. This helps to ensure that service users are protected from abuse. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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 standard(s) 19,21,24 and 26. The location and layout of the home is suitable for its stated purpose, however, some rooms need redecorating and some of the floor coverings need replacing. Service users bedrooms met individual’s needs in a comfortable and homely way. The home smelt fresh, but some of the windows looked dirty and the area above the cooker was greasy and dirty. Service users do live in a home that is reasonably maintained. EVIDENCE: Since the last inspection redecoration of some communal areas and bedrooms had taken place, but some areas still had damaged decoration and stained floor coverings, which made some areas look shabby. The windows were dirty and the cooker hood was greasy and needed cleaning. The home did not have enough assisted baths, and the room layout of the toilets did not ensure that there is enough room at either side of toilets to enable access for carers and equipment. This could be a potential safety risk for staff and service uers. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 14 The bedroom doors were fitted with suitable door locks but lockable facilities were not provided in all the bedrooms. This does not assure privacy. The service users interviewed said that they were happy with the furnishings in their room. At least two double electric sockets, an easy chairs and a table to sit at were provided in each bedroom. Promoting comfort for the service users. Some of the easy chairs in the lounge area were in a poor condition and looked shabby and dirty. Nails were noted to be sticking out of the walls in some bedrooms; they were there for service users to hang pictures on. In some bathrooms, the baths were of the domestic type and very low. This does not ensure that the health and welfare of service users and staff is protected at all times. The area above the cooker and some windows were dirty, this made the home look neglected. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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 and 29. The number and skill mix of the staff employed at the home meets service users needs. Recruitment procedures did not fully protect service users. Staff were trained and competent to do their jobs. EVIDENCE: The service users said that there were always enough staff on duty. They added that staff worked very hard and described them as “very caring”, “Kind” and “understanding” and added that staff treated them like human beings; they were not intrusive and that you could have a joke with them. Three staff files were checked, these contained all the information required by the regulations, to safeguard the service users. Gaps were noted in the employment history of one staff member. This does not fully safeguard the service users. Eighty five per cent of the staff were trained to NVQ level two, this demonstrates the providers commitment to investing in the staff. This assists in promoting the care and well-being of service users, by developing a well trained workforce. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 16 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 and 38. The service users and staff said the manager was approachable and very professional. Service users were benefiting from the care given by well-trained staff. The proprietor visits the home on a regular basis. EVIDENCE: The registered person was visiting the home on a regular basis and talking to service users, a report was written following the visit. This allows the provider to ensure that the home is run in the best interest of the service users Arrangements for all staff to undertake fire training and the regular servicing of the homes equipment and appliances were satisfactory. Staff had received training on moving and handling, food safety and infection control. Which assisted the protection of service users and staff from a risk of harm. The manager stated that there was a programme for the regular servicing and maintenance of gas appliances. All fire exits were clear and hazardous substances were securely stored, maintaining service users safety. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 x 1 x x 1 x 2 STAFFING Standard No Score 27 3 28 4 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 3 x x x x 3 Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 18 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. 2. Standard 19 19 Regulation 23 23 Requirement Those areas around the home with stained/damaged decoration must be redecorated. The room layout of the toilets must ensure that there is enough room at either side of toilets to enable access for carers and equipment The low baths must be replaced with a suitable assisted type baths. Service users must be admitted to the home on the basis of a full needs assessment. Service users must have access to dentists at regular intervals. MAR sheets must always be signed to show whether medication has been given or not. The homes complaints procedure must include details of how to contact the CSCI. The stained damaged chairs and floor covering must be replaced. All parts of the home must be kept clean at all times. The nails sticking out of the bedroom walls must be removed. All bedrooms must have a J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Timescale for action 1/10/05 1/11/05 3. 4. 5. 6. 21 3 8 9 23 14 12 13 1/11/05 1/9/05 Immediate Immediate 7. 8. 9. 10. 11. 16 19 26 24 24 5 16 23 12 23 1/9/05 1/9/05 Immediate Immediate 1/11/05 Page 19 Littledale Nursing Home Version 1.30 lockable facility 12. 29 19 Gaps in the employment history of staff must be explored. 1/9/05 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 31 Good Practice Recommendations By 2005 the manager must have NVQ level 4 in management or equivalent. Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR 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 Littledale Nursing Home J55 21793 Littledale V218780 07.07.05 UI Stage 4.doc Version 1.30 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. 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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