Inspection on 14/07/05 for Matthews Nursing and Rehabilitation Unit

This inspection was carried out on 14th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Matthews Nursing and... 19/06/06

Matthews Nursing and... 08/11/05

Matthews Nursing and... 10/01/05

Matthews Nursing and... 06/07/04

Matthews Nursing and... 11/03/04

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Matthews Nursing & Rehabilitation Unit Epinal Way Care Centre Hospital Way Loughborough, Leicestershire LE11 3GD Lead Inspector Mrs Carole Burgess Unannounced 14 July 2005 09:45 am th 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 and Care Homes for Adults 18 – 65*. 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. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Matthews Nursing and Continuing Care Unit Address Epinal Way Care Centre Hospital Way Loughborough Leicestershire LE11 3GD 01509 217666 01509 262710 surjit@rushcliffecare.co.uk karen@rushcliffecare.co.uk Rushcliffe Care Limited 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) Miss Oksana Ternowa Care Home (CRH) 37 Category(ies) of Physical disability (PD) 21 both, Mental disorder, registration, with number excluding learning disability or dementia (MD) of places 21 both, Old age, not falling within any other category (OP) 16 both, Physical disability over 65 years of age (PD(E)) 22 both, Terminally ill over 65 years of age (TI(E)) 2 both,Sensory impairment over 65 years of age (SI(E)) 2 both. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person may be admitted to the home who falls within the category MD unless that person has a diagnosed neurological disorder. 2. No one falling within TI(E) may be admitted into the home where there are 2 persons of caragory TI(E) already accommodated within the home. 3. No one falling within SI(E) may be admitted into the home where there are 2 persons of caregory SI(E) already accommodated within the home. 4. To be able to admit the named person of category TI named in the variation application V10993 dated 20th August 2004. 5. The home may accommodate a maximum of 15 persons falling within the category of MD on the ground floor only. 6. Service Users. The home may accommodate a maximum of 6 persons falling within the combined catagories PD/MD dual disability on the first floor only, within rooms 31 to 36 to be known as the continuing care unit. 7. No person under 35 years of age who falls within combined categories of PD/MD dual disability may be accommodated in the home. Date of last inspection 10th January 2005 Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: Matthews Neurological and Continuing Care Unit is one of three units, contained within the purpose built Epinal Way Care Centre, in Loughborough, Leicestershire. It is a specialist unit for thirty-seven residents with mental disorder, physical disability, and sensory impairment, and is able to care for a limited number of residents who are terminally ill. It provides a safe and caring environment. The unit is bright and clean with a high standard of décor throughout. All residents’ rooms have en-suite facilities and are large enough to accommodate wheelchairs and any necessary specialist equipment. The unit is situated on two floors with a lift servicing the first floor. The ground floor is a fifteen bedded neurological unit, with an additional provision of a further six neurological beds on the first floor, providing rehabilitation packages for residents and younger persons with complex, neurological conditions, including acquired brain injury. The remainder of the first floor is a sixteen bedded unit for older persons. The neurological unit provides specialist professional support and equipment of agreed packages of care for individual residents. The unit is staffed twenty-four hours a day by trained nurses and care staff. Situated adjacent to the Loughborough Hospital, and approximately one mile from the centre of Loughborough, the unit is accessible by public transport or car. There is ample parking for visitors. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day. An opportunity was taken to look around the unit, view records, policies and care plans and to talk to staff, residents, their relatives and visitors. The primary method of inspection used was ‘case tracking’ which involved selecting four residents and tracking the care they receive through a review of their records, discussion with residents and relatives, the care staff, and observation of care practices. Many of the residents were seen during the inspection. Two of the residents, who were able, four relatives, and the District Nurse spoken with gave the Inspector their impressions of the home. The term ‘younger’ adult refers to those residents who fall within the age range of 35 – 65 year. Older persons refers to residents who are 65 years or older. What the service does well: Matthews Neurological & Continuing Care Unit, Rushcliffe Care Limited provides a high standard of care for the all of the resident for all ages and needs. The unit is well run by a knowledgeable and experienced Registered Manager. It is well decorated and maintained and provides a safe and homely environment for the residents. Staff are caring and supportive towards the residents and their relatives. Residents’ care plans are detailed to ensure that each resident’s individual and specific needs are met. The specific needs of residents with brain injury are well managed and the unit has extensive facilities to support their rehabilitation programmes and specific care needs. Staff are well trained and able to meet the residents’ needs. The Registered Manager’s knowledge and enthusiasm, with the support of other healthcare professionals, ensures that the residents receive optimum care on all levels. Comments from residents’ relatives, during the inspection, were very positive and demonstrated that they were satisfied with the standard of care provided. Two residents said that they were satisfied with the standard of care they received and had no complaints. One resident said the food was very good. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 & 5. The admission process is well managed and residents and their relatives/representatives are given clear and detailed information regarding the service; thereby ensuring that the residents’ health and welfare needs will be met. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 10 EVIDENCE: There is a comprehensive, recently updated, Statement of Purpose & Service Users’ Guide. Older persons and privately funded residents have a signed contract of residence. The Rehabilitation Unit does not provide residents with a contract/statement of Terms and Conditions because the placing authority purchases the rehabilitation care packages for residents who have a nursing determination; a contractual agreement is agreed between the purchaser and Rushcliffe Care Limited - the provider. The pre-assessment process, completed by either the Registered Manager or a Senior Manager, is detailed and robust and reflective of the aspirations, health and welfare needs of the residents. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 11 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9. Residents and/or their relatives are generally well informed and supported about their assessed care and are encouraged to participate in the decision making process. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 12 EVIDENCE: The unit provides comprehensive care plans, which are regularly evaluated and updated. New care plans have been implemented that provides focus on the specific and individualised care needs of the residents; in consequence the residents or their relative/representative had not yet signed some of the care plans. Residents (who are able) and their relatives are consulted about the care provided. Relatives of residents who are receiving care following a brain injury are consulted about care during the review meetings with staff and Core Brain Injury Team. Two relatives stated on the ‘Relatives/Visitors Comment Cards’ that they had not met with staff to discuss their relatives care needs. Residents are encouraged to risk take, where this is appropriate, following evaluation and risk assessments to enable them to develop some degree of independence, albeit in small ways. Care staff provide relatives with information and advice in this matter. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 &17. Residents experience a stimulating and varied life style matched to their individual and specific needs. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 14 EVIDENCE: Visitors came and went throughout the day and called into the Registered Managers office to chat about their relatives and any concerns they had. Activities are arranged daily for both the ‘younger’ adults and the older persons. The unit is to employ an assistant occupational therapist in the near future to arrange activities. The unit provides qualified nursing and healthcare professional ‘in house’ support services, which includes occupational therapy (OT), physiotherapy and speech therapy. The Core Brain Injury Team, in partnership with the multidisciplinary team, the resident, where appropriate, and their relatives, develop programmes of care to enable residents with brain injury to fulfil their own personal potential. Specialist equipment is provided, which includes a physiotherapy room, with specialist and multi-sensory equipment. Cultural and religious needs are supported. Menus are balanced and appealing, and are flexible enough to accommodate individual preferences and healthcare needs. They are freshly prepared on site and are of a good standard and the residents appeared to enjoy their meals. There is a file with pictorial representation of the meals provided to assist residents to make choices. One resident said that the food was very good and he sometimes had, ‘three extra helpings!’ Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20. Residents are looked after well in respect of their health and personal care needs. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 16 EVIDENCE: Care plans are detailed and reflect residents’ specific and individual needs. New care plans have been introduced which focus on the specific and individual needs of each resident. Contact with other healthcare professional is well documented. The quality of record keeping is reflective of the high standard of care and nursing care observed during the inspection and ensures that the needs of the residents are fully met. Medication administration is managed effectively within the Rushcliffe Care’s robust medication policy and procedural guidelines to ensure the safe and timely delivery of residents’ prescribed medicines. Residents, who are able, self-medicate following a recorded assessment that ensures that the resident is safe to do so. On the day of inspection the drug fridge was operating at 12 degrees centigrade. This may affect the stability and efficacy of medicines, which require refrigeration. Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity. They were seen to be kind and patient and treated the residents in a respectful, friendly and supportive way. A resident and two relatives said that staff are respectful and very caring. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23. Arrangements for receiving and responding to complaints are sound, resulting in satisfactory protection of residents’ rights. EVIDENCE: The complaints file was examined. Two minor complaints were dealt with according to company policy and in an appropriate manner. The CSCI has not received any complaints about the unit and the unit’s complaints process reflects the government’s adult protection guidelines, set out in the ‘No Secrets’ publication. Staff are aware of their responsibilities and have received appropriate training. There are regular staff, residents and relatives meetings to ensure good communication is maintained at all levels. The ‘younger’ residents have ‘Breakfast Club’ every morning where daily events are discussed and information is exchanged. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30. A comfortable, well equipped, homely and safe standard of accommodation is provided for the residents. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 19 EVIDENCE: The unit is safe and well maintained with many adaptations to suit residents’ specific needs. It is decorated and furnished to a high standard which creates a comfortable and homely environment. There is a satisfactory system of maintenance and refurbishment. Residents’ rooms were clean and well decorated. Residents are able to bring items of their own furniture and possessions with them to personalise their rooms. All rooms have en-suite facilities and there are additional toilet, bathing and assisted bathing facilities. Two relatives, in the ‘Relatives/Visitors Comment Cards’, stated that their relative’s room and wheelchair could do with being ‘more hygienic’. They indicated that more care should be taken to ensure that the resident and her wheelchair were clean following meal times. On the day of inspection all areas of the unit were clean and maintained to a high standard. The District Nurse said that the home appeared to be well run and the residents well cared for. Hot water temperatures are checked to ensure they comply with Health and Safety legislation and were satisfactory when checked during the inspection. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) 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, 35, 36. Staff at the unit are well trained and supported, and employed in sufficient numbers to meet the residents needs. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 21 EVIDENCE: Staffing levels, at the point of inspection were satisfactory and above that indicated by the Department of Health Residential Forum Guidelines, and were sufficient to meet the residents’ needs. The Registered Manager maintains overall responsibility for the home and is supernumerary. The home employs a mixed staff group consisting of Registered Nurses, Care Team Leaders, Senior Care Staff and Care Assistants, supported by domestic and catering staff. In addition there are OT’s speech and language and physiotherapy staff. There are always qualified nurses on duty. Relatives said that the staff were capable and caring, and both relatives and staff said that there was sufficient staff on duty to meet the needs of the residents although one staff member said that they could be ‘rushed’ at times. Training for staff is well planned and supports staff in providing for the varied needs of the residents. New staff are provided with a comprehensive induction package. Two of the care staff hold National Vocational Qualification (NVQ) in Care, Level 2 but a number of care staff will commence NVQ’s shortly. Extensive ‘in house’ training supports staff in meeting the residents’ health and welfare needs. NB. Rushcliffe Care Limited, Epinal Way Care Centre undertakes the recruitment process centrally. This will be inspected later in the inspection year. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 & 43. The Registered Manager, a trained nurse, is knowledgeable and experienced; effectively supervises staff and manages the unit to protect the rights and needs of the residents. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 23 EVIDENCE: The Registered Manager has many years of experience in care. The Clinical Manager manages the care of the ‘younger’ adults on the ground floor. A Senior Manager is available at all times to provide help, clinical advice and managerial guidance. There is an ethos of openness in the unit; staff are friendly and helpful towards the residents, their relatives and each other. Staff help and support the residents to make decisions in their everyday life and promote independence where this is possible. Residents’ personal allowances are kept safe and appropriately managed. The Registered Manager undertakes yearly staff appraisals and clinical supervision (a regular review of staff performance and training needs) to ensure that staff maintain the standards of care expected throughout Rushcliffe Care Limited. Health & Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed, to ensure the health and safety of the residents and staff. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 3 3 3 Standard No 22 23 Score 3 3 Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 4 x 4 3 3 3 3 3 4 Standard No 24 25 26 27 28 29 30 STAFFING 4 4 4 4 4 4 3 Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 3 4 4 3 4 4 4 4 3 3 4 4 3 Version 1.40 Page 25 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Matthews Nursing & Continuing Care Unit Score 3 4 3 x 37 38 39 40 41 42 43 D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc NO 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 Regulation NONE 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. Refer to Standard 6 20 Good Practice Recommendations The Registered Persons are recommended to ensure that staff consult with relatives (where appropraite) regarding the residents care and ask them to sign the care plan. The Registered Persons are recommended to repair/replace the medication fridge. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection The Pavilions 5 Smith Way, Grove Park Enderby, Leicestershire LE19 1SX 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. Matthews Nursing & Continuing Care Unit D C51 C01 S1902 Matthews V226794 140705 Stage 4.doc Version 1.40 Page 27 - 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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