Inspection on 04/01/06 for Lower Farm Nursing Home

This inspection was carried out on 4th January 2006.

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

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

Other inspections for this house

Lower Farm Nursing Home 01/11/06

Lower Farm Nursing Home 11/04/05

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 Norfolk PE30 3PB Lead Inspector Mr Christopher Handley Unannounced Inspection 4th January 2006 09:30 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 Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 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. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 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 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) Imalgo Limited Mrs Jane Lewis Care Home 43 Category(ies) of Learning disability over 65 years of age (1), Old registration, with number age, not falling within any other category (41), of places Physical disability (1) Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Forty-one (41) older people may be accommodated. One (1) person named in the Commission’s records, with a Physical Disability and who is under the age of 65 years may be accommodated. One (1) person, named in the Commission’s records, with a Learning Disability may be accommodated. The total number not to exceed forty-three (43). Mr Abdul Mukadam is registered subject to receipt of satisfactory CRB references. 11th April 2005 2. Date of last inspection 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 DS0000053263.V274678.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which forms part of the annual inspection programme. The Inspection commenced at 9.30 and was completed at 2.45.pm. A wide range of documentation was seen and examined. Residents, visitors and members of staff were interviewed as part of this inspection. A tour of the home was carried out. The Manager Mrs Lewis, and the Responsible Person Mr Hamdulay, were present during the inspection. What the service does well: What has improved since the last inspection? What they could do better: • Continue to improve the care planning documentation and briefly reflect the inclusion of the residents in reviews of care. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 6 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. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 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 Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 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&5 A pre-admission assessment is undertaken on all prospective residents. Prospective residents and their relatives are welcomed to visit the home prior to admission. EVIDENCE: A full health assessment is carried out on all prospective residents, either by the Manager or Senior Nurse prior to the admission of a resident to the home. The Inspector was shown the document used to record these assessments. When completed it provides a wide range of information upon which to base the decision as to whether or not the home can meet the person’s needs. Prospective residents and their relatives are warmly welcomed to visit the home prior to admission ,the Manager said, and she sees the benefits to the residents of doing so. A tour of the home is undertaken, written information in the form of the Service Users Guide, and Statement of Purpose are provided. Prospective residents talk to residents and staff. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 9 Residents interviewed by the Inspector told him that they had visited the home prior to being admitted and had found it to be very helpful. Staff are aware of these visits take place, and the importance of them to the prospective resident. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 10 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 All residents have an individual Care Plan. The health care need of residents are met. The medicines are stored, administered and recorded in an effective and safe manner. EVIDENCE: All residents have an individual care plan, three of which were read by the Inspector. The files are clearly marked “Private and Confidential”. There are the essential elements of the care plan namely, assessment, plan, implementation, and review. In the inspection dated 11/4/05 a recommendation was made that there should be a brief record in the review to indicate where possible that the residents, and where appropriate the relative, should be involved in the review. In the files read there was no such comment made and the Inspector repeats this recommendation. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 11 A detailed record of Daily Care is made and number of these were seen by the Inspector. The arrangements for implementing health and personal care needs ensure that the residents privacy is respected at all times. There is a detailed assessment of health care needs which is recorded. The assessed needs are met by wide range of health care professionals. All residents have a G.P. who would refer them to a consultant or other the appropriate health care professional. The Manager described how a full range of the health care needs of residents are met. Based on what was said it is apparent that health care needs are identified and met as soon as is practical. The residents interviewed all spoke very highly of the care provided. The Senior Nurse showed the Inspector the medicines in the home. The medicines are kept in a locked medicine room. This room was very neat and tidy. The medicines are kept in two locked trolleys which are kept locked to the wall when not in use. The content of both trolleys were neat and tidy. There were no loose or unaccounted for medicines. The medicine charts are clearly, and neatly marked with the initials of the person administering the medicines. There are no residents in the home who self medicate, the Inspector was informed. Only trained nursing staff administer medicines in this home. There are Controlled Drugs in use which are kept in a designated Controlled Drug Cabinet. One of these Drugs was counted and found to be correct against the Register. There is a small Drug fridge in this room the temperature of which is recorded. If staff had any concerns about the effect of medicines on a resident they would contact the prescribing G.P. The home enjoys a good working relationship with the supplying pharmacist, the Senior Nurse said. She also described the method of disposing of medicine which sounded satisfactory. The home has a detailed medicine policy. The Inspector is pleased to report that the home maintains its high standards with regard to the medicines in the home. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 12 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): 15 The home provides nutritious and varied meals for residents. EVIDENCE: The menus were read by the Inspector, they appeared varied, nutritious and interesting. Special diets are provided and recorded. In the inspection dated 11/4/05, a requirement was made that special diets should be recorded. This is now done and the requirement is fulfilled. Residents and their visitors spoke very highly of the meals provided, “They are always very nice”, “There is always a variety” were just some of the very positive comments made. The Inspector discreetly observed some residents taking their midday meal with obvious enjoyment The staff also made favourable comment about the meals provided. Drinks are provided throughout the day and the Inspector observed this frequently during the course of the inspection. There were no artificial feeding programmes in place, on the day of the inspection. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has an effective complaints procedure. Residents are protected from abuse. EVIDENCE: The home’s complaint procedure is posted up around the home. The Manager said that there had not been any complaints since the last inspection. The Manager believes in dealing with any concerns as quickly as is possible in order to resolve them quickly to the residents satisfaction, if at all possible The complaint procedure forms part of the induction programme the Manager said. Staff are aware of how to make a complaint, and are also aware of the importance of dealing with any concerns, or reporting them quickly. Residents interviewed are aware of the complaints process and said that if they had any concerns they would approach the first member of staff they saw. The home has an Adult Protection Procedure. The Manager and the Senior Nurse have received training in this matter and staff who have undertaken NVQ training have also undertaken training in this matter. The Company intends to ensure that all care staff receive training in this matter Mr Hamdulay said. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The location , and layout of the home is suitable for its purpose. The home is clean, pleasant and hygienic. EVIDENCE: The home is situated on one of the main roads into Kings Lyn. The home appears well maintained, and the surroundings are pleasant. The home has a plan of routine maintenance. The handyman was working in the home on the morning of the inspection. The building complies with the local fire brigade and the environmental health department. At present there is an extension being built at one side of the home. This extension consists of 8 bedrooms and an extension to the lounges/communal space. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 15 Two of the bedrooms will be additional rooms, the other bedrooms will replace the previous double rooms. Mr. Hamdolay undertook to have copies of the drawings sent to the Norwich office of CSCI. The home already has the registration application papers required, and these will be completed and sent to the Norwich office also. The home was neat, clean and tidy on the day of the inspection. Some of the residents interviewed told the Inspector that it was always “nice and clean”. The home has its own dedicated laundry. Soiled clothing or washing is not taken through the kitchen or where food is stored or prepared. There are hand washing facilities in the laundry. The floor finish is impermeable, and the walls are washable. There are two large semi industrial machines washing machines which have inbuilt sluicing facilities. The home has polices and procedures for control of infection and the safe handling and disposal of clinical waste, dealing with spillages, hand washing and the provision of protective clothing, which were seen by the Inspector. The washing machines are on a maintenance contract Mr Hamdulay said. The services and facilities comply with the Water Supply Regulation (Water Fittings) Regulation 1999, and Mr Hamdulay provided the Inspector with copies of official letters confirming this. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The needs of residents are met by the numbers and skill of staff. Residents are in safe hands at all times. Residents are protected by the home’s recruitment policy and procedures. Staff are competent to do their jobs. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 17 EVIDENCE: On the morning of the inspection there were The Responsible Individual, the Manager, the Senior Nurse, 1 registered nurse, 8 Care Assisstants, 5 domestic Staff, 2 Laundry Staff, 3 Catering staff, 1 Maintenance Man, 1 Activities Organiser and 1 Student nurse working in the home. Whilst the Company are commended for this staffing level, they are aware of the high dependency of most of the residents in the home, and this amount of staff and spread of skills are needed to provide a good quality of care for them. The home has an NVQ training programme and the Manager gave the up to date figures which were: Number of staff who have NVQ II, 10 staff. Number of staff taking NVQ II 4. Number of staff who have NVQ III, 4 Number of staff taking NVQ III, 3. Total number of staff who have NVQ 14 Total number of Care staff 32. The figures show that there is just below 50 of staff who have NVQ training. The Company, the Manager and all the staff involved and those who support them are commended for this and are recommended to continue. Staff receive an increase in their pay once they have obtained their NVQ. The home has a recruitment procedure which was seen. In the inspection dated 11/4/05 a recommendation was made that there should always be two people involved with interviews. This practice is now carried out and the residents are now safer, because of the home adopting this safer practice. The home has a wide range of training programmes. The Induction and Foundation Training programmes meet TOPPS specification, other training provided includes First Aid, Manual Handling, Infection control, Food Hygiene, Updates in nursing skills also take place on a regular basis. There is a programme for trained nursing staff to keep their clinical skills updated, which ensures that they are aware of, and have the skills to implement the new techniques required to implement these new procedures. At present this programme is not in writing and the Inspector recommends that it should be recorded, which will enable the programme to be reviewed and evaluated. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36, & 37 The home has an effective and competent Manager. The home is developing Quality Assurance. The home has supervision for staff. The home holds records required by regulation in safety. EVIDENCE: The Manager is a qualified nurse and fulfils the criteria for being a Manager , except the she has not yet got her Managers award. The reason for this being that she is undertaking Assessment Training at present. The Inspector recommends that without wishing to over whelm her, she should make enquiries about taking her Managers Award, which she is aware she has to take. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 19 Mr Hamdulay said that the company was in the early stages of discussion with Investors in People in the matter of Quality Assurance. The Manager, who is to take the lead role in this matter, undertook to keep the Inspector informed of progress in this matter. The Inspector advises the Manager and Responsible Person, to use this process as a learning opportunity and feels that they will both benefit from gaining more knowledge about the system. The home has a wide range of employment polices, and procedures. It also has its own training plans. There is individual supervision for a staff, and each member of staff have an individual record book for this, and the Inspector was shown the one of these record books. The home holds the records required by regulation for the protection of residents and the effective running of the home. Residents have access to their records, but none have asked to see them the Manager said. Records are kept up to date and they are held secure. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 X X 3 3 x Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 5 Refer to Standard OP7 OP28 OP30OP30 OP31OP31 OP33 Good Practice Recommendations It is recommended that residents and relatives are present at reviews of care, and that this is recorded. It is recommended that the NVQ training programme continue. It is recommended that the clinical skills update for trained staff be recorded, reviewed ,and evaluated. It is recommended that the Manager make enquiries about taking her Registered Managers Award. It is recommended that the Manager continue to pursue the application of Investment In People. Lower Farm Nursing Home DS0000053263.V274678.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Norfolk Area Office 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 DS0000053263.V274678.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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