Inspection on 11/04/05 for Lower Farm Nursing Home

This inspection was carried out on 11th April 2005.

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

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

Other inspections for this house

Lower Farm Nursing Home 01/11/06

Lower Farm Nursing Home 04/01/06

Lower Farm Nursing Home 19/10/04

Lower Farm Nursing Home 20/05/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Grangewood

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

CARE HOMES FOR OLDER PEOPLE Lower Farm Nursing Home Grimston Road South Wootton Kings Lynn PE30 3PB Lead Inspector Christopher Handley Announced 11 April 2005 9.30am 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. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Lower Farm Nursing Home Address Grimston Road South Wootton Kings Lynn Norfolk PE30 3PB 0208 904 8989 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) Imalgo Limited Mrs Jane Lewis Care home 43 Category(ies) of LD(E) Learning Disability over 65 (1) registration, with number OP Old Age (41) of places PD Physical Disability (1) Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Forty-one (41) older people may be accommodated. One (1) person named in the Commissions records, with a Physical Disability and who is under the age of 65 years may be accommodated. One (1) person, named in the Commissions records, with a Learning Disability may be accommodated. The total number not to exceed forty-three (43). 2. Mr Abdul Mukadam is registered subject to receipt of satisfactory CRB references. Date of last inspection 25 October 2004 Brief Description of the Service: Lower Farm is a 43 bedded nursing home providing care for elderly people. The home, originally a farm, has been developed and enhanced over the years. There is good access to all parts of the home. The home is on the ground and first floor and there are two lifts in the home. The home is decorated and furnished to a high standard. There is a car park at the front of the home. The home is situated on Grimston Road, in the suburbs of Kings Lynn, and is adjacent to local shops and facilities. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and was carried out as part of the annual inspection programme. A full tour of the home was undertaken. Six residents, 4 of whom had visitors and eight staff were interviewed. A total of twenty two standards were inspected. The Inspection was taken by The Responsible Person Mr. A. Muckadam, The Care Manager, Mrs J. Lewis, and by Ms L. Hammond, Assistant Care Manager. What the service does well: What has improved since the last inspection? There has been an improvement n the documentation, which is provided to residents The quality of the care provided continues to improve. The Manager, and Responsible Person, have gained a better appreciation and knowledge of the Care Standards. There has been a very large increase in the number of Comments cards returned, last year 9, this year 31 were returned Training has become an integral part of the development of staff, and care of the residents. A total of 22 training session have been held. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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 Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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) 1 & 2 The Management of the home provide a good range of documentation. All residents have Terms and Conditions which contain all the information required. Excellent “Preadmission assessments” are carried out on all prospective residents. EVIDENCE: All residents are provided with a Statement of Purpose and Service Users Guide. These documents are in a print size which makes it easy to read them. Some of these documents were seen in residents rooms. Residents and visitors are aware of them and one visitor said that it provided a picture of the home. All residents have a Terms and Condition document. A copy of this was seen. They are in a readable print size. One of these documents is retained by the resident and a signed copy is kept in the office. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 &10 The elements of the care plans need to be more comprehensive so as to ensure the home can fully meet the needs of the residents. The home has a safe and effective system for the reception, storage, administration and recording of medicine. Privacy is provided to residents. EVIDENCE: All residents have an individual care plan. Three were read in detail. The documents are clearly marked Private and Confidential The elements of assessment , planning, implementation and review are present. There is a wide range of assessment documentation which is of a high quality, which fully completed. Some blank spaces were seen in the Admission information document. There was no written evidence of residents or relative being involved in reviews of care, and there were some blank spaces in the documents seen A daily record is maintained which provides a record of the residents day. A positive and constructive discussion took place on the format of the Care plans, and the Manager is advised to review them, thus making them more effective working documents. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 10 The health care needs of the residents are thoroughly assessed and the needs are met either in the home or in a local hospital. All residents have a service provided by a G.P. which was said to be good. One of the comment cards made reference to chiropody services, and the background to this was explained. There are two residents who have pressure sores, the Manager said. The home has a comprehensive procedure for the prevention and treatment of pressure sores. The residents interviewed spoke highly of the nursing care provided. The Assistant Care Manager showed the Inspector the medicines in the home and explained how the system worked. Based on this information the medicines are effectively received, stored, administered, recorded and disposed off in a proper manner. The provision of privacy forms part of the training of staff in this home. Knocking on doors prior to entering is the practice of this home. Residents have access to a telephone, some having phones in their room. Privacy is always provided when carrying out personal care, medical examinations, or consultations. Residents are addressed by their preferred name. Privacy curtains are provided in double rooms. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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) 15 The home provides a nutritious and varied menu for residents EVIDENCE: The menus were read, they appeared varied, nutritious, and interesting. The home has four weekly menus. There is an alternative choice which is ascertained on a daily basis. Special diets are not recorded. The residents and their visitors spoke highly of the variety and content of meals. The comment cards indicated that residents liked the food. If needed the Manager would contact the Dietician for advice. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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) 16,17 &18 The home has an effective complaints procedure. The home ensures that the legal rights of residents are protected. Residents are protected from Abuse. EVIDENCE: The home has a complaints procedure which is posted up around the home. The practice is to deal with concerns as quickly as possible. In this way residents can see that action is being taken, which allays their concerns. Residents and relatives spoken to were aware of what steps to take if they wanted to make a complaint. Resident’s legal rights are protected and the Manager would facilitate legal advice if needed. The Manager has just dealt with the information relating to postal votes, and residents are enabled to vote if they wish. The home has an Adult Protection Procedure. Staff have received training in this matter through the Norfolk & Suffolk Consortium. Staff are aware of the potential seriousness of this matter, and were aware of the policy. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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) 21, 24 & 26 There are sufficient toilets and washing facilities in the home to meet the needs of the residents. Residents’ rooms are of a high standard, they are well decorated, and meet the needs of residents. The laundry in the home is effective and meets the Standard required. EVIDENCE: There are sufficient toilets to meet the needs of residents. All rooms are en suite, and these are of a high standard as are the communal toilets. During a tour of the home 10 bedrooms were seen. They were all decorated to a very high standard and have been personalised by the resident. There is a range of beds to meet the individual needs of the residents. All the rooms have pleasant outlooks. The residents and visitors spoke highly of the rooms. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 14 The home is clean, hygienic and free from offensive odours. There are two sluice rooms in the home. The home’s laundry meets all the standards required by Standard 26. The home has polices and procedures for the control of infection including the safe handling and disposal of clinical waste, dealing with spillages and the provision of protective clothing. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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) 28, 29 & 30 The home has a recruitment policy but elements of the practice need to be improved. The home has a recognised induction and foundation training programme. There is good ongoing training and development. EVIDENCE: There are 4 staff who have NVQ level 2, and 9 people undertaking NVQ level 2 training. There are 3 staff who have NVQ level 3 and 2 who are undertaking this training. The Manager will have completed her Manager Award training within the next few months. The home has Induction and Foundation training which meets TOPPS Standards. There is ongoing training for both qualified and non qualified staff, and documentation provided showed that there have been twenty two training session on a wide range of topics which directly relate to the care of the residents. The home has a recruitment policy which was seen. The home’s practices in this matter needs to be changed as the Care Manager said that at times she interviews on her own, this practice must stop. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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, 36, 37 & 38 The home has an effective and competent Manager. The approach of the management is open and positive. The home has not got a recognised Quality Assurance System. The home practices supervision. The storage of records is good. The home has good practice in health and safety. The home has all the Health and Safety documentation required. EVIDENCE: The Manager is a qualified nurse and fulfils the criteria for being the Manager of the home. She will be completing her Managers Award in a few months time. The Manager ensures that there is an open, positive and inclusive atmosphere in the home. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 17 The Manager communicates with a clear sense of direction and leadership. The Senior members of the company provide a positive input to the home on a weekly basis. At present the home does not have a recognised Quality Assurance system and this needs to be pursued. Initial training in this matter has been provided. The home has a wide range of employment polices which were seen. There is supervision of staff and is recorded. Care records are kept in the Nursing office which is locked when not in use. The home has effective health and safety practice and all the Health and Safety documentation required was seen. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION x x 3 x x 3 x 3 STAFFING Standard No Score 27 x 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 2 x x 3 3 3 Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 15 Regulation Shed,4, 13 Requirement Special Diet to be recorded. Timescale for action 4 weeks RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 7 28 29 33 Good Practice Recommendations That there are no blank spaces in care planning documentation. That residents and relatives are present at reviews of care and that this is recorded. That the NVQ training programme continue. That interviews are carried out by two people. That the Manager continue to pursue the application of a recognsed System of Quality Assurance. Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Lower Farm Nursing Home I55 S53263 Lower Farm V212357 110405 Stage 4.doc Version 1.20 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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