Inspection on 10/09/09 for Nazareth House

This inspection was carried out on 10th September 2009.

CQC found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Nazareth House 08/02/10

Nazareth House 30/10/09

Nazareth House 06/04/09

Nazareth House 14/04/08

Nazareth House 25/04/06

Nazareth House 07/02/06

Nazareth House 27/07/05

Nazareth House 08/02/05

Nazareth House 01/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for older people Name: Address: Nazareth House 118 Harlestone Road Northampton Northants NN5 6AD     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Williamson     Date: 1 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Nazareth House 118 Harlestone Road Northampton Northants NN5 6AD 01604751385 01604580435 sheila@naznptn.plus.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Congregation of the Sisters of Nazareth care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category of service only: Care Home only - Code PC to service users 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 Date of last inspection Brief description of the care home Nazareth House is a care home providing personal care for Older People, it is a large home located on the outskirts of Northampton. The home has been established for many years and is run by The Congregation of the Sisters of Nazareth who also offer a comprehensive range of spiritual support and guidance to meet the individual religious needs and preferences of people living within the home. Mass and The Rosary are celebrated on a daily basis, in the Church which is attached to the home . Accommodation is provided over the ground and first floor, with access to the first floor being via a passenger lift, the ground floor provides all the communal amenities, Care Homes for Older People Page 4 of 23 Over 65 50 0 Brief description of the care home along with bedroom and bathing facilities, whilst the first floor provides additional bathing facilities and bedrooms. Bedrooms in some instances include an en-suite facility, some of these being added recently. Nazareth House has a large and very well maintained garden, with mature trees, shrubs and plants and benefits from a large water fountain. Information about Nazareth House is provided in the form of a Service Users Guide and a Statement of Purpose. The Manager provided information on the day of the site visit with regards to fees. Fees range from £469.00 to £539.00 per week; the fee charged is dependent upon the specification and amenities of the personal accommodation. Care Homes for Older People Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspection is on outcomes for residents and their views of the service provided. The main method of Inspection used was case tracking which involves selecting a sample number of people and tracking the care they received through talking with them where possible, and looking at their records and accommodation, in this case three residents were chosen. This visit took place over one day, commencing at 9.30am and took six hours to complete. An opportunity was taken to talk with residents, the acting manager and staff, look around the home, view records, policies and care plans. Residents made some comments that have been included in this report. Information was obtained from the Annual Quality Assurance Assessment, which gives information about the home, and is filled in by the registered manager. A copy of the last Care Quality Commission (formerly the CSCI Commission For Social Care Inspection) report is displayed in the foyer of the home, and copies of this report are available from the registered manager. The quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. Care Homes for Older People Page 6 of 23 Care Homes for Older People Page 7 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 23 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents receive information on the home and have their needs assessed before moving in. Evidence: Prospective residents can expect to have their needs assessed before they move into the home this should ensure that staff have the experience and numbers to meet peoples needs. All the residents files were found to include an assessment of their needs, completed by a social worker or the senior staff member from the home. The Statement of Purpose and Service User Guide have been updated with the latest staffing changes. These are documents given to people considering moving into the home. Two of the three people admitted recently are using their visit as a trial, to consider if they want to remain in the home permanently. Care Homes for Older People Page 11 of 23 Evidence: This home does not provide Intermediate Care Care Homes for Older People Page 12 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The inability of staff to closely monitor the medication administration puts people in danger in the home. Evidence: Residents care plans details the care they receive whilst in the home. This is important so people know how they will be looked after. These plans were up to date and had been reviewed regularly with the resident or a member of their family. Care plans are risk assessed, which gives staff vital information how to keep people safe in the home. Again these risk assessments are reviewed periodically. From records kept by the home it was evident that health care services including General Practitioners and community nurses visit on the residents behalf. Staff working at the home are very aware of the individual care needs of the residents, and those spoken with stated that peoples care needs were being met. Care Homes for Older People Page 13 of 23 Evidence: Medication is poorly administered, with prescribed medication not being given in line with the Medication Administration Record (MAR chart). Some medicines were not receipted properly, with staff being unaware of what medication people should be given. There were two drugs that were not received with the normal delivery from the pharmacy. Staff were unaware when these had been delivered, or where they were stored in the home. The system used to check in medication is confusing and not used properly, and so puts people in danger of not receiving the correct medication. Care Homes for Older People Page 14 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are given choices in daytime activities meals, resulting in a good quality of life. Evidence: Residents continue to be offered choice on a daily basis. The residents agreed these included when to get up or go to bed, what to wear, a choice of meals and whether to join in the activities provided. These are important as they ensure residents can retain a good level of control over their lives. The activities offered include armchair exercise, music quizzes, jigsaws and reminiscence. There is an activities organiser employed to assist in this area, as staff have a limited time they can spend helping with pastimes. Spiritual comfort is regularly offered to people with the resident group of nuns from the attached convent. The menu system has been changed and people are offered a list of alternative choices. This is in the form of a printed list, from which people chose if not wishing the main choice on the menu. People agreed the food was good and one person commented the cook comes out to see if we liked our meals, and writes it down. The person agreed there was an alternative meals list to choose from and commented the writings a bit small, but I know whats on the list now. Care Homes for Older People Page 15 of 23 Evidence: The list of likes and dislikes remains in place, and the staff are aware of peoples individual preferences. Care Homes for Older People Page 16 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are now protected by staff having an improved knowledge of safeguarding and complaints information. Evidence: The complaints policy and procedure have been re-written, and people in the home made aware of the changes. Residents are aware that there is a complaints procedure in place and are made aware of this at the point of applying to be admitted. One resident stated, I would speak to the person in charge or my family if I was concerned. The staff have received four complaints since the last visit. These were investigated appropriately, within the appropriate time scales. There have been no complaints forwarded directly to the Care Quality Commission (CQC). Care staff spoken with during the inspection were aware of what to do should they suspect any act of abuse. There has been further training on this subject. There were no safeguarding issues forwarded directly to the Care Quality Commission (CQC). Both requirements made at the last visit have been completed. Care Homes for Older People Page 17 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The well-maintained environment provides specialist aids and equipment to meet peoples needs. Evidence: The home is clean and comfortable, and is set in grounds. The grounds are well kept and spacious, and includes a secure enclosed area to the rear, many of the bedrooms look out to the garden area. Decoration continues to be of a good standard and furnishings in the communal areas are domestic in character and in good condition. A further selection of public and bedrooms were seen during the visit. These again included personal items and adaptations such as raised toilet seats which improves the lifestyle for people. Staff have received training in infection control and observations during the inspection again confirmed that staff used the appropriate protective clothing when carrying out their duties. The laundry is well appointed and the floors and walls are easily cleaned. This is important as it helps guard against cross contamination within the home. Care Homes for Older People Page 18 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a poor recruitment procedure with shortfalls in recording being evident. Evidence: The senior management team have began the process to employ a manager for the home. The residents are assisting in this process, where they are part of the interview team. This includes assisting with setting and asking questions along with the others on the interview panel. This is beneficial as it includes people living there playing an active part in the running of the home. We looked at the records of a number of people volunteering and employed in the home. One of the volunteers had a povafirst check, but no Criminal Records Bureau (CRB) check in place. There were no details available on the address or contact details for the person. This does not protect people in the home. Training is ongoing, staff having undertaken a vigorous training programme; where a number of refresher courses were run in a short period of time. This was to ensure staff were up to date with current work practices. Staff were also being trained to undertake training with other staff in the home, which has increased the availability of training at short notice. Care Homes for Older People Page 19 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff work hard to ensure that health and safety process and checks, protects people in the home. Evidence: The acting manager is looking to the resident group to assist in developing areas such as Quality Assurance, this should help in the overall progress of the home. We looked at the periodic health and safety tests. The fire detection and lift are serviced more regularly than required. This is over and above the minimum required standards and indicates that the staff see this as an important area in ensuring peoples safety. The responsible person, who is appointed to see the home is safe and staff are meeting peoples needs, continues to visit and copies of the reports from the visits were seen. This again indicates the home is being overseen on a regular basis and any areas of improvement are being recorded. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must ensure the safe handling and disposal of medications in the home. This is to ensure the safety of people in the home. 19/10/2009 2 29 19 The registered person must ensure all people working in the home have the appropriate checks in place. This is to ensure the safety of people in the home. 16/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 9 15 Regular audits of the medication system would ensure errors and omissions were found promptly. The size of typeface on the list of alternative meals could be made larger, to aid people in reading the choices. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 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. 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!