Inspection on 02/10/06 for Nazareth House

This inspection was carried out on 2nd October 2006.

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

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

Other inspections for this house

Nazareth House 10/12/07

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 2nd October 2006 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.V312721.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.V312721.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 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.V312721.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: This service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 13th December 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 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 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 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 aroma therapist 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. At the time of the visit, (2/10/06) 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.V312721.R01.S.doc Version 5.2 Page 5 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 December 2005. This is to give an overall picture of Nazareth House using evidence and information gathering, in the form of a pre inspection questionnaire, letters to and from the home during that period and comment cards from residents and relatives. The inspection also included a site visit to the home which was completed in one day. It was unannounced, which means that the manager, staff and residents did not know it was to take place until the inspector arrived. Time was spent sitting and talking with people who live at Nazareth House and observing the day to day routines of the home and care staff as they provide support. A tour of the building included bedrooms, lounges, dining areas and bathrooms. The garden areas were also seen. The manager (Sister Rose Ita Doody) and staff were spoken with, everyone was very friendly, welcoming and helpful. A good atmosphere was noted with good relationships between staff and residents. 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 four residents. Administration records were also looked at. There were 35 residents living at Nazareth House at the time of the visit. What the service does well: In line with the home’s policies and procedures, Nazareth House tries to make sure that there is equal care given to all residents, considering their individual choices and preferences and giving equal support to all irrespective of their race, gender, disability, sexuality, age, religion or beliefs. There is equal consideration given to prospective employees and there are male, female, and overseas staff between the ages of 18 and 69 years working at the home, training and development programmes are offered to all staff. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 6 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. At present 54 of care staff have achieved National Vocational Training (NVQ) to level 2 or above, which means that the residents are looked after by suitably qualified staff. Again on this inspection all residents spoken with said they liked living at the home and felt well cared for. Comments included: “Over the moon” with the care. “Couldn’t be better”. Relatives also spoke well of the home, its friendliness and quality care. The home has again achieved Investors In People award. 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. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 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.V312721.R01.S.doc Version 5.2 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): 1,2,3,5 standard 6 does not apply to this home Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. 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. 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. These have been given to all residents. Residents said they knew about Nazareth House from friends they had visited in the home. Some had attended garden parties and other fetes which gave them a chance to have a look around the home. One resident added “I used to come to Mass but I had no idea what the home was like”. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 9 During case tracking, it was clear that residents case files held written contracts between themselves and the proprietor, stating clearly what was and was not included in the cost of staying at the home and their rights as residents of the home. Again during case tracking, files seen, contained full assessments of resident’s needs, these had been completed prior to admission, to ensure that Nazareth House was the right place for that person to live, and that the home could provide the right care for them. Assessments are well detailed and provide a good picture of the individual, including their likes and dislikes. They are completed with the resident, their carers and any one else involved with their care. The pre inspection questionnaire showed that 37 people have used Nazareth House for a respite stay during the last 12 months, some of these people have decided to stay at the home on a permanent basis. All residents spoken with said they had enjoyed a short stay before they had made their decision to make Nazareth House their home. Nazareth House does not offer intermediate care. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. 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 comprehensive arrangements are in place to ensure resident’s medication needs are met. EVIDENCE: Case tracking showed that good care plans are in place for each resident, these include individual’s likes and dislikes and are reviewed regularly. Residents spoken with, confirmed these were completed with their help and were agreed with them. Resident’s may choose to administer their own medication, a locked facility is provided for this. The systems used to administer, store and record medications are good, staff are trained to be competent before they can handle resident’s medication. A local pharmacist visits the home regularly to ensure procedures are correct. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 11 Visits by G.P. s, district nurses, dentists, opticians and chiropodists are recorded. Specialist advice from geriatricians, continence advisors and community psychiatric nurses, is sought when necessary, to meet the needs of the residents. The home has a good working relationship with the local Community Mental Health Team who will visit and give advice when needed. Residents were seen to be treated with respect, privacy and dignity and there were good personal interactions between residents and carers. Staff were noted to knock on bedroom doors and seek permission before entering. Residents said they are always asked how they wish to be addressed, although most use Christian names as the norm. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. 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 confirmed that the home continues to offer a range of activities including arts and crafts, musical entertainment, music and movement, weekly quiz, library services, mini-bus outings and shopping trips. Most residents said they enjoyed the activities provided, all said they enjoyed going out on trips. Many residents attend daily mass in the chapel, some residents said this was very important to them. Some residents are supported by visiting ministers from churches in the local area, others are assisted by relatives to attend local churches. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 13 Nazareth House continues to provide a very good standard of food with a varied menu for all mealtimes. Sister Rose Ita insists on good quality foods and fresh produce to be used in the kitchens, the result is good with meals looking and tasting 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. On the day of the visit, the lunch time meal was presented in an appetising way, diabetic and vegetarian diets are catered for providing equality of choice for all residents. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that residents feel their views are listened to and acted upon. 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. However some comments were made about staff, these are noted in the staffing section of this report. Since the previous inspection, there have been no complaints received by the Commission for Social Care Inspection. All comment cards received from residents confirmed they knew who to speak to if they were not happy, one added “Yes, to Sister, she is very approachable”. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 15 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): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is very 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 lower ground floor, three on the ground floor, four on first floor and four on the second floor. 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 Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 16 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. Since the previous inspection, “hospital” type beds have been replaced with divan beds giving a more homely environment in bedrooms. Records of checks made on all equipment are kept up to date. The maintenance manager, Mr Manifold, 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. Mr Manifold keeps a comprehensive record of all work undertaken throughout the home. The premises were found to be clean and free from offensive odours and visitors commented that the home had a good standard of cleanliness. Since the previous inspection, a new room has been allocated for the storage of care plans, these are now separate from medication storage. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home has a good staff training plan which includes problems suffered by older people, this means that they will be more aware of the needs of residents at Nazareth House. EVIDENCE: A good relationship was again noted between staff and residents and there was a relaxed atmosphere throughout the Home. There appeared to be sufficient staff on duty, during this site visit, to meet the needs of the residents. All residents spoke very well of all the staff, however the following comments were received on comment cards: “Sometimes staff don’t listen, they think they know best”. “They don’t take a blind bit of notice, they go deaf – still they are nice girls”. “Had an experience when ‘she’ needed help and found that the staff were not kind and made to feel that she mustn’t ring the bell”. The matter was raised with Sister. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 18 These comments were fed back to Sister Rose Ita. Staff files contain information to ensure that persons employed are fit to work at the home and competent to do their jobs, training is set up and National Vocational Training (NVQ) is ongoing, at present 54 have achieved level 2 or above thereby achieving the recommended number by the Care Homes Regulations 2000. 17 staff hold first aid certificates. 12 staff are trained to administer medication. All training certification is held on staff files, further training needs and interests are noted and planned for. Criminal Records Bureau (CRB) clearances are on file for all employees, any new staff will need clearances before starting work at the home. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The residents are supported and protected by the management and her leadership, this means that their rights and best interests are safeguarded. 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. Residents hold their own monies or choose someone to act on their behalf. Financial records are kept in a locked office and access on a “need to know “basis only. Angela Sumner is the staff member responsible for finance and administration. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 20 The pre inspection questionnaire showed up to date records and a very thorough maintenance programme throughout the home and in the large grounds. Geoff Manifold is responsible for health and safety issues, he ensures that all routine health and safety checks are completed and that staff are trained accordingly. Sister Rose Ita Doody has many years experience in working with older people and is very aware of the problems associated with old age. Her current position is to change to another home run by Sisters Of Nazareth in Liverpool. The home has again achieved Investors in People Award. Nazareth House DS0000006148.V312721.R01.S.doc Version 5.2 Page 21 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 3 3 X 3 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.V312721.R01.S.doc Version 5.2 Page 22 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.V312721.R01.S.doc Version 5.2 Page 23 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. 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