Inspection on 13/12/05 for Nazareth House

This inspection was carried out on 13th December 2005.

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

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

Other inspections for this house

Nazareth House 10/12/07

Nazareth House 02/10/06

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 13th December 2005 10:00 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.V271018.R01.S.doc Version 5.0 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.V271018.R01.S.doc Version 5.0 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 Johanna Rose Ita Doody Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Nazareth House is registered to accommodate 47 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 14 acres of 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 29 single rooms and 9 double rooms, all with en-suite 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 which accommodates a wheelchair and ramps, affording residents freedom of movement throughout the home and to the gardens. There is an activities coordinator employed and one of the sisters is a qualified aromatherapist and provides aromatherapy and massage for the residents. 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. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one half day. The inspection was carried out with Sue Wearing (a member of the management team) and Sister Minion, the proposed Responsible Individual of Nazareth house, was present at the home. Several of the residents were spoken with, two staff members assisted in the inspection, lunch was sampled by the inspector and a tour of the premises was carried out. Case tracking (whereby the inspector focuses on a small number of residents and examines their care, from admission to the present time) of two residents, was carried out. Time was spent observing the workings of the home and how staff members supported residents. Information about the home, had been provided by the manager, in the form of a pre-inspection questionnaire, some of this is included in the following report. What the service does well: What has improved since the last inspection? What they could do better: As mentioned in the body of the report, one bedroom was malodorous and further medical support must be sought to remedy the occupant’s medical problem. A requirement has been issued. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 6 Care plans should not be kept in the medication room, these should be accessible to all care staff. Key holders for the medication room must have suitable training in procedures for the receipt, recording, storage, handling, administration and disposal of medicines, other staff members should not have access to this room. The replacement of hospital type beds / headboards with those of a divan type beds, would provide a more homely environment for residents. A minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent), should be achieved by 2005 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. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These core standards were assessed and met on the previous inspection, also Nazareth House does not offer intermediate care (standard 6). Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8, 9 The health needs of residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure resident’s medication needs are met. EVIDENCE: The pre inspection questionnaire showed that residents are enabled and supported to receive the same medical services as people living in the community. Staff accompany residents to hospital appointments. Doctors, , district nurses, physiotherapists and other medical services, visit Nazareth house on a regular basis. On the day of inspection, one doctor was visiting her patient at the home, she spoke very well of the care given to her patient and added that she would like him to remain at Nazareth House. Another doctor spoken with said that all his patients received the medication he prescribes for them, this is administered, stored and recorded in a correct way by all the staff who are trained to handle medication. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 10 The inspector found that medication records were completed correctly and kept up to date. Those residents who chose to self medicate are provided with a lockable facility for storage and sign a “self medication assessment” to confirm that this is their choice. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 15 Religious and recreational needs are catered for, links with the community are good, these support and enrich resident’s chosen lifestyle. The meals are particularly good offering both choice and variety, whilst catering for special dietary needs. EVIDENCE: The pre inspection questionnaire listed a range of activities including arts and crafts, musical entertainment, music and movement, weekly quiz, library services, mini-bus outings and shopping trips. Residents said they were looking forward to the Christmas entertainments and recently enjoyed their Christmas Fayre. The Houghton Weavers are regular supporters of Nazareth House and the home includes visitors from the community in events such as, fashion shows and cheese and wine evenings. Many residents attend daily mass in the chapel, others are supported by staff members to attend churches in the local area, if that is their choice. Nazareth House provides a very good standard of food with a varied menu for all mealtimes. Sister Rosita insist on good quality foods and fresh produce to be used in the kitchens, the result is good with meals looking and tasting Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 12 appetising. The dining room is set out with matching table linen, crockery and fresh flowers on each table. There is plenty of room for all residents to eat at one sitting and room for their visitors too. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These core standards were assessed and met on the previous inspection. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25, 26 The standard of the environment within this home is good and well maintained providing residents with a safe and attractive place to live 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 basement floor, four on first floor, four on second floor and three on the ground floor. One resident said she found the additional toileting facilities sited near the lounge to be particularly beneficial. Case tracking showed that on an individual basis, aids and adaptations had been received 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 residents freedom of movement throughout the home. Doorways to communal areas and bathrooms are wide Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 15 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. for the benefit of those with hearing problems. All rooms used by residents have emergency call bells. Records of checks made on all equipment are kept up to date. 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. The maintenance manager keeps a comprehensive record of all work undertaken throughout the home. The premises were found to be clean and free from offensive odours with the exception of one bedroom, this was brought to the attention of the management team member who conducted the inspection. A requirement has been made to remedy this. Residents and visitors commented that the home had a good standard of cleanliness. The manager was advised to use an alternative room for the storage of care plans other than the medication room which is used at present . Nazareth House was formerly registered for both nursing and residential care, some of the beds still in use are of the type used in hospitals and nursing homes. The home is now registered to provide residential care only, all residents have had their needs assessed accordingly, divan type beds / headboards should be used to provide a more homely environment. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home has produced a written plan for the training of care staff which includes some of the problems suffered by older people, this will further their awareness of the needs of the residents at Nazareth House. EVIDENCE: The home’s pre inspection questionnaire showed that at present 41 of the care staff have achieved NVQ training to level 2 and that 14 members hold first aid certificates. It is recommended that a minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent) is achieved by 2005. 16 members of staff have been trained to administer medication. The inspector was given the names of staff who had completed basic training this year, other areas than mentioned above included training in, moving and handling, abuse, health & safety, infection control, nutrition and fire lectures. Advanced training to be undertaken includes, NVQ level 3, wound knowledge & prevention, diabetes, dementia awareness, Parkinsons awareness and equality & diversity. Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These core standards were assessed and met on the previous inspection EVIDENCE: Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 3 3 3 x 2 3 2 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X x x x x x x x Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 19 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. 1 2 Standard OP9 OP26 Regulation 13 16 (2)k Requirement Timescale for action 01/01/06 The registered person must make arrangements for the safekeeping of medicines The premises must be kept free 01/02/06 from offensive odour throughout. 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 OP24 OP28 Good Practice Recommendations The home should provide accommodation which is furnished to meet the assessed needs of the resident. A minimum of 50 trained members of care staff (NVQ level 2 or equivalent) should be achieved by 2005 Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Nazareth House DS0000006148.V271018.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!