Inspection on 10/12/07 for Nazareth House

This inspection was carried out on 10th December 2007.

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

Nazareth House 02/10/06

Nazareth House 13/12/05

Nazareth House 27/06/05

Nazareth House 11/10/04

Nazareth House 19/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Nazareth House Ashton Road Lancaster Lancashire LA1 5AQ Lead Inspector Mrs Gwen Miller Unannounced Inspection 10th December 2007 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 Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 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. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nazareth House Address Ashton Road Lancaster Lancashire LA1 5AQ 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) 01524 32074 01524 841344 nazarethhouse@lancaster320.freeserve.co. Poor Sisters of Nazareth Sister Ann Brigid Quinn Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP The maximum number of people who can be accommodated is: 41. Date of last inspection Brief Description of the Service: Nazareth House is registered to accommodate 41 residents of either sex, aged 65 years and above, in need of personal care. Established in 1899 by the Sisters of Nazareth, the home is set in beautifully landscaped gardens, which includes a wildlife pond. There is also a greenhouse for residents who may be interested in gardening. The home is within easy reach of Lancaster and on accessible bus routes. Accommodation is provided in 39 single rooms and 1 double room, all with ensuite facilities. The bedrooms are individually decorated and furnished to a high standard. There are several lounges to encourage privacy and individual programmes, entertainment and activities. Doorways and corridors are wide to provide wheelchair access. The home has two passenger lifts, one that accommodates a wheelchair and ramps, affording residents freedom of movement throughout the home and to the gardens. A full time member of staff is employed for activities (Mon - Fri) and a dedicated activites room accommodates the twice daily activities programe that is available to residents wishing to participate. The home provides in house beauty therapy - residents are able to book their own appointments, a variety of treatments is available. Three kitchenettes have new equipment and one has been totally refurbished, these are for the use of the residents and their guests. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 5 An Ice Making Machine has been purchased for Resident and staff use. The catering team have produced a suggestion slip for new menu ideas and speak regularly with the residents regarding their choices. The chef attends residents meetings to discuss menus. Nazareth House caters for residents of different denominations and the home has its own chapel, clergy from all denominations visit the home and conduct services. At the time of the visit, (10/12/07) the information given to the Commission for Social Care Inspection, showed that the fees for care at the home are from £350 to £480 per week, with added expenses for hairdressing, newspapers and chiropody. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of this home has been carried out over the period since the previous inspection in October 2006. This is to give an overall picture of using evidence and information gathering, in the form of a pre inspection questionnaire, letters to and from the home during that period, discussions and interviews with residents, management and staff. The inspection also included a site visit which was unannounced, which means that the manager, staff and residents did not know it was to take place until the inspector arrived. This visit included an Expert by Experience. An Expert by Experience is a person who, because of their shared experience of using services, and /or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Time was spent talking with residents and observing the day-to-day routines of the home and care staff, as they provided support. During the visits we (CSCI) spoke with residents, staff and the manager and examined a number of documents including resident’s individual care plans and staff personnel files. We also carried out a tour of the building looking at resident’s communal living areas and private bedrooms. We also sent some written questionnaires to residents and their relatives asking them about their opinions of standards within the home. A total of 12 were returned to us. Throughout the report there are references to ‘case tracking’, this is a method whereby the inspector focuses on a small number of residents, all relevant records relating to them are examined, from their initial assessment, throughout their period of care, to the current time. This was carried out for two residents. What the service does well: It is the policy of Nazareth House, regardless of background, gender, faith, disability or ethnicity and to make sure that there is equal care given to all residents, considering their individual needs. All staff understand and adhere to the home’s policy and procedures regarding equality and diversity. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 7 There is equal consideration given to prospective employees in that there are male, female, younger and older staff between the ages of 18 and 65 years working at the home, training and development programmes are offered to all staff. On this site visit we found the home to be bright, well decorated, pleasantly furnished and generally well presented but with the client’s needs in mind. The home ensures that all residents have equal access to different parts of the home via lifts and ramps, aids and adaptations are in toilets and bathrooms. Nazareth House continues to provide a friendly, informal atmosphere where dignity is acknowledged and independence is encouraged. The home has a large staff group who are keen to provide residents with the individual care needed and build relationships with them. Residents spoken with on this visit spoke well of the staff, and daily living at the home. Comments included: “ The homes cares for the whole person.” “I find the physical and spiritual needs are well taken care of – and of someone is not a Roman Catholic, absolutely no difference.” “Just to say I am quite content with my life here” and “I am grateful to have been able to experience Nazareth House”. “”We both feel very ‘safe and loved’ here and part of a family and I know others who feel the same”. What has improved since the last inspection? Information provided by the manager showed that during the past twelve months, areas of improvements were: Assessments are carried out by the Care Manager. Prospective resident are given a Guide to Services prior to the assessment. The Care Manager now offers a two week respite visit to enable the resident and their family / friends to get a feel of the Home (this is additional to the three month trial period). During the Doctors’ and Multi Disciplinary visits, a member of staff is designated to accompany residents during these, this is to improve the efficiency of the visit and promote good relations between the professionals and the care team. More detailed notes are kept after each of the visits. Residents photographs are now on their kardex and blister packs. A meeting was held with the Pharmacist to discuss shortfalls, he now does regular staff training. New MAR sheets (records of medication given) have been introduced that are clearer and easier for staff to use. The number of rooms with a private telephone has increased. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 8 The opening of the shop. A new mini bus has been purchased and the number of outings increased. A full time member of staff has been employed for activities (Mon - Fri) and a dedicated activities room created to accommodate the twice daily activities programme that is available to residents wishing to participate. In House Beauty Therapy - residents are able to book their own appointments, a variety of treatments is available. Three kitchenettes have had new equipment and one has been totally refurbished, these are for the use of the residents and their guests. An Ice Making Machine has been purchased for Resident and staff use. In the dining room new crockery and place settings have been purchased, there has been the introduction of a service rota to ensure that each table is served first in turn. The catering team have produced a suggestion slip for new menu ideas and speak regularly with the residents regarding their choices. The chef attends residents meetings to discuss menus. Residents encouraged to speak with the Care Manager regarding any concerns. A new Stand Aid has been purchased. Five bedrooms and two lounges have been re-decorated, kitchenettes have been refurbished and there is new crockery in the dining room. A shop has opened on the premises. A third housekeeper has been employed and four reception staff. Staffing levels have increased on the day time shifts and the Care Manager is on call during the night shift. Panel in place for staff interviews. Appointment of Registered Manager whose sole responsibility is the Care Home. All these items were put in place since the previous site visit. What they could do better: On this subject one comment from a resident was “one thing that worries me slightly is the ‘big lounge’. Many of the residents there have some form of mental frailty and although some provision is made for them (there has been a change of activity co-ordinator and this may or may not change) – there are still some who are happy to sit. Some, of course, do not wish to be stimulated and this is their right – but I can remember a day a young harpist came and entertained and let the residents have a go – they were delighted”. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 9 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. The summary of this inspection report can be made available in other formats on request. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 10 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 Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5 standard 6 does not apply to this home Quality in this outcome area is excellent Good information is provided which allows people to make informed choices whether or not the home will meet their needs. Full assessments of needs are carried out for all residents to ensure the home can look after them properly and give the right sort of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Home’s Statement of Purpose and Service User Guide contains all the relevant information needed for prospective residents to make an informed choice when they are considering Nazareth House as their home. Copies of the home’s information are placed on a table in the entrance to the home and the manager and staff welcome visitors to the home to have a look around and speak with other residents and staff. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 12 We (CSCI) found that many residents said they had spent a short stay at the home prior to making any decision about living there. Some said they had made their choice after quite a while and during this period they were classed as temporary residents, some said they had visited friends in the home which had influenced their own decision to make Nazareth House their home. The Care Manager now offers a two week respite visit to enable the resident and their family / friends to get a feel of the Home (this is additional to the three month trial period). Comment cards received, confirmed that written information about the home had also been received, prior to making any decision and that contracts had been received. Resident’s case files seen during case tracking, contained contracts made between themselves and the provider, stating clearly what was and was not included in the cost of staying at Nazareth House, contracts also explained their rights as residents of the home. One resident said “I made a conscious decision to come here, having visited several other homes and having stayed in one”. The manager said that a detailed assessment of prospective resident’s needs are undertaken by the Care Manager (or an experienced person) either at their home or during a hospital visit, to ensure that Nazareth House will be the right place for them to live, and that the home can provide the right care for them. These assessments were seen during case tracking and were very detailed. Assessments are completed with the resident, other relevant agencies such as social workers or health professionals are included if needed. Nazareth House does not offer intermediate care. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. The health needs of residents are well met and people are treated with dignity and respect. The systems for the administration of medication are clear and arrangements are in place to ensure resident’s medication needs are also met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Case tracking showed that care plans are in place for each resident, these contribute to individual’s personal profiles. Care plans include action to be taken by staff in areas of health, personal and social care needs of each resident. These are reviewed regularly with residents and as the norm, signed to confirm their agreement although on this visit, some did not contain signatures. Care plans contained a large amount of information about each resident and provided a picture for all care staff of what the individual could achieve on their own, what tasks they required help in and what areas they could not manage at all. However, care plans are currently being re organised Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 14 and will in future be completed and reviewed on a computer system. Staff will be trained in this by the manager. We found visits by G.P. s and district nurses are recorded and specialist advice from geriatricians, continence advisors and community psychiatric nurses, is sought when necessary, to meet the needs of the residents. Comments received from residents, included “the home does its job well and cares”. Many written and verbal comments were received from relatives, these included “H is very well cared for and the staff are always so kind and friendly”, and “as user and relative, we are both satisfied”. The home’s medication policies and procedures are followed to ensure the safe administration of all medicines etc. prescribed for the individual. Staff receive training in the safe handling of medications, the home’s storage and administration of medicines is appropriate and records seen, were up to date. The home’s information includes ‘ Residents who self medicate must sign the appropriate form and keep medication in their lockable unit.’ Residents said they felt their privacy is respected and their care is provided in a dignified manner. Staff were noted to knock on bedroom doors and seek permission before entering. All bedrooms are en suite to ensure personal privacy. Residents may choose to have their own telephone or may use the telephones in the home in private. Residents said they are always asked how they wish to be addressed, although most use first names as the norm. Residents have their own en-suite bedrooms, providing privacy and dignity. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Religious and recreational needs are catered for, links with families and the community support and enrich resident’s chosen lifestyle. The meals are good offering both choice and variety, whilst catering for special dietary needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: When asked “does the care service meet the different needs of people?” (e.g. race, ethnicity, age, disability, gender, faith and sexual orientation), one comment was “I am Anglican. This is a retirement home (Roman Catholic). I was welcomed here and invited to attend mass whenever I wished, which was held everyday at 10.00. An Anglican priest gave communion from the same chapel once a month. I myself went in several times to pray on my own”. The manager provided the following information about this section, prior to the visit: Daily Living - religious and recreational needs are catered for. The activities Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 16 co-ordinator works Monday - Friday and regular outings are arranged using the home’s mini bus or local companies. Residents may wish to join in activities in the communal areas but have the choice of staying in their own rooms, using one of the quieter lounges or going out. Minutes of residents meetings record various outings and activities, their wishes for future events are sought. Visitors - the Home welcomes visitors at any time, within reason. Smaller lounges and kitchenette facilities are available for residents wishing to entertain their visitors. Regular social events are held in the Home and family and friends are welcome. Residents have commented at meetings complementing the Home on how welcome their visitors are made to feel. A high standard of meals with a good choice of healthy food is provided. Residents with special dietary needs have this information recorded in their care plans, the kitchen / dining room staff are informed and a record is made on the meal planner. Individual dietary needs are catered for. Snacks and drinks are available at regular times or upon request. Resident’s comments included “ The dining room and food is excellent”. Some residents (after risk assessment, with regular reviews) have the use of the kitchenettes or may have a kettle in their room. Celebration of resident’s birthdays and theme days such as Halloween, Saints Days, Festivals and many more, staff spoken with, said this was much appreciated by the residents. The Home has its own chapel and chaplain. Daily services are held for Catholics and a minister from the Priory visits every four weeks to provide a religious service for those of other faiths. In the dining room new crockery and place settings have been purchased, there has been the introduction of a service rota to ensure that each table is served first in turn. The catering team have produced a suggestion slip for new menu ideas and speak regularly with the residents regarding their choices. The chef attends residents meetings to discuss menus. We (CSCI) found that the dining room and eating experience in general, was very good, the expert by experience said “it was like sitting in a restaurant”. The expert by experience also noted: Fresh fruit is available to the residents all day and large bowl is on the table at mealtimes, drinks are brought round 5 times a day but residents only have to ask for a drink and they will have one made for them. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 17 Comments from relatives, confirmed they are welcomed at the home at any time and always offered refreshments. They also added they are encouraged to spend as much time as possible with their relative or friend and encouraged to join in celebrations such as birthdays and festive activities. By talking with residents, it was clear that they are asked to make choices in what to eat, when to rise and retire, how to spend their time, how to furnish their room, who they wish to keep company with and who they nominate to manage their affairs (if they do not want to manage them themselves). They are also asked if they wish to manage their own medication (as mentioned previously) and given a choice of locking their bedroom doors. All residents spoken with said they chose what to do with their time, although they were encouraged to join in activities in a communal setting, their choice to remain in their own rooms or go out into the community, was acknowledged. The expert by experience noted: Activities were in process when I arrived, they were making calendars and dough Christmas decorations in the morning and in the afternoon they were playing bingo. In the evening of the inspection a choir was coming into the home to entertain the residents. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. The home has a satisfactory complaints system with evidence that residents feel their views are listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information is clearly provided for residents in the event of them, or their relatives wanting to make a complaint about the home or its staff. All residents were asked if there was anything they were not happy with at the home, all spoke very positively about their care, accommodation and management at the home. Since the previous inspection, there has been one complaint received by the Commission for Social Care Inspection. This involved staff relationship with the manager, this was investigated and issues were addressed by the home’s Responsible Individual. All comment cards received from residents confirmed they knew who to speak to if they were not happy. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,29,21,22,23,24,25,26 Quality in this outcome area is excellent The residents are provided with a clean and comfortable environment, where bedrooms are well personalised. This means that residents will feel at home with their belongings around them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has three lounges, a quiet room, visitors’ room, dining room and a lounge diner, all are decorated and furnished to a good standard, all bedrooms have en-suite facilities. The home has four bathrooms, all of which have assisted bathing facilities and four shower rooms. There are four toilets on the lower ground floor, three on the ground floor, four on first floor and four on the second floor. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 20 Again on this visit, case tracking showed that on an individual basis, aids and adaptations are in place to meet residents’ needs. A range of other aids and adaptations were seen in communal areas, such as grab rails, raised toilet seats, hoists and specialist baths for assisted bathing. There are two passenger lifts, one of which accommodates a wheelchair, affording those with mobility problems equal access to all parts of the home. Doorways to communal areas and bathrooms are wide enough to enable wheelchairs to pass through and wheelchair storage is available. The corridors are wide and have handrails fitted. A loop system is in place in rooms and the chapel so that those with hearing problems are not disadvantaged. All rooms used by residents have emergency call bells. The expert by experience noted that all rooms had private facilities and were very spacious and residents could take their own furniture with them, if they chose. Residents have their own telephone landlines if they wish and are allowed to keep their own independence by making their own beds and keeping their rooms tidy. Records of checks made on all equipment are kept up to date. The maintenance manager ensures all equipment and areas inside and outside the home, are well maintained. All the radiators throughout the home are fitted with touch cool surfaces, to protect residents from the risk of injury. Fail-safe devices are fitted to all hot water outlets used by residents to ensure water is delivered close to 43ºC. Regular checks of water temperatures are made by the maintenance manager and recorded to maintain safety. A system is in place to minimise the risk of Legionella and a comprehensive record of all work undertaken throughout the home is kept on file. The premises were found to be clean and free from offensive odours and visitors commented that the home had a good standard of cleanliness. A comment received was “cleaning is always carried out to he highest standard”. Again on this visit, all residents spoken with were very satisfied with their accommodation. The expert by experience also noted that the home was very tranquil, televisions were not switched on unless it was in the resident’s own room. One resident added that she found the new shop which sells toiletries, sweets and small items such as birthday cards, was a most welcomed addition to Nazareth House. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. The numbers of staff on duty were satisfactory to meet the needs of the people living at the home. The policies and procedures for the recruitment of staff provide safeguards for the protection of residents This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided by the home showed that all care staff have achieved National Vocational Qualification to level 2, a staff qualification chart provided by the manager showed that many staff also have qualifications well in excess of this. A training programme has now been set up for further training which is identified for all staff members. Many of the staff have been at the home for a long time, many have got to know residents very well. All residents spoke highly of the staff, comments included “The care and attention to detail has been exemplary, nothing is too much trouble.” “Everyone is very friendly and helpful”. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 22 Further comments regarding staff were “Care is always available. I personally have had a problem accepting it as I have always been independent. Sister and staff are always encouraging me to accept more care!” Residents said their call bells were answered promptly during the night and that staff were always pleasant to them. When asked the question “Do staff listen and act on what you say?” the response was positive. Staff files seen held two references, Protection of Vulnerable Adult checks and employment histories. A good relationship was noted between staff and residents and there was a relaxed atmosphere throughout the home. The expert by experience said “The staff were very caring towards the residents, one came into the lounge with his slippers on the wrong feet and they were changed very quickly and with out fuss so that the resident did not trip”. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. Good procedures are in place to safeguard the financial interest of residents and the management ensures up to date maintenance in the home, this is to protect the health, safety and welfare of residents This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are asked if they are happy with the way their care is given and a suggestion box is used with comments acted on. One comment from a resident was “I think the ethos of the home helps – but obviously to have a strong person at the helm is paramount. All services are well integrated – carers, kitchen, secretarial, cleaning and maintenance – this Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 24 gives a good structural basis to the residents who, perhaps, are more mentally challenged”. Residents hold their own monies or choose someone to act on their behalf. Financial records are kept in a locked office and accessed on a “need to know “basis only. Angela Sumner is the staff member responsible for finance and administration. Information provided by the home prior to this visit, showed up to date records and a very thorough maintenance programme throughout the home and in the large grounds. The management ensures up to date maintenance is carried out. Good procedures are in place to safeguard the financial interest of residents. The Responsible Individual for the home completes monthly reports addressing the well being of the residents and relating to the National Minimum Standards, Care Homes Regulations 2000. Resident’s views are sought through their meetings which are held on a regular basis. Comments received about staff and the general running of the home, were very good and residents were in general happy with the way their home is run. Whereas some staff spoke well of the manager, some others felt they were not supported in their care roles in the manner they would choose. This view was fed back to the manager and Responsible Individual. Records showed that an inventory of personal goods and furniture brought into the home, is completed for each resident and that any financial transaction undertaken on behalf of their behalf is recorded, although the home does not act as appointee for anyone. Residents are encouraged to handle their own finances or elect family or a solicitor to do this for them. Nazareth House has comprehensive Health & Safety Policies, knowledge of these forms part of staff induction, staff undertake mandatory training in Moving & Handling, Fire, Control of Hazardous Substances, First Aid, Infection Control and Food Hygiene. Fire drills are carried out, maintenance of equipment is completed and relevant certificates are held. The home has again achieved Investors in People Award. Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 25 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 3 4 3 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 26 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. Refer to Standard Good Practice Recommendations Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Nazareth House DS0000006148.V351731.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!