Inspection on 27/06/05 for Nazareth House

This inspection was carried out on 27th June 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 13/12/05

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 Gwen Miller Announced June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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 F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Nazareth House Address Ashton Road Lancaster Lancashire LA1 5AQ 01524 32074 01524 841344 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Poor Sisters Of Nazareth Sister Johanna Rose Ita Doody Care home only 47 Category(ies) of OP Old Age (47) registration, with number of places Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate 47 older people(OP). The service should employ A suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 11th October 2004 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 F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over one day. The inspection was carried out with Sister Rose Ita Doody, the registered manager and other members of the management team. The inspector spoke with eight residents, relatives and six staff members on duty. Seven comment cards were received from relatives and residents. Case tracking (whereby the inspector focuses on a small number of residents and examines their care, from admission to the present time) of three residents, was carried out. Part of the inspection was spent looking at daily notes and information about the home and residents. Time was spent observing the workings of the home and how staff members supported residents. Information about the home, was 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? When a person wishes to live at the home, information about them is collected from them or their family members to make sure that the home will be able to provide the right sort of care they need. This information is now more detailed so that both the person and the home can be sure it is the right choice for them. The home also now involves other professionals if they are still unsure of a residents needs or how to care for them. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 6 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 F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 standard(s) 3.5. The home has a detailed assessment that is carried out for all residents to ensure that the care needs of residents are met. Prospective residents are encouraged to stay at Nazareth House for short periods of time to see if they like it, before making a decision to make it their home. EVIDENCE: Individual records are kept for each resident, these include assessments of the person’s needs, and this is completed before a resident moves into the home. This ensures that the home will be able to give the right care for the individual before offering them a place at Nazareth House. Assessments seen were well detailed and gave a true account of the resident’s physical, emotional, intellectual and social needs, they also included the likes and dislikes of the individual. Staff spoken with were aware of the care needs of identified residents, this was a result of the improved assessment process. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 9 A relative said she had discussed her Mother’s care needs and visited the home before inviting her Mother to accept a trial basis, her Mother said she had then decided to move into the home, following several periods of short stays. Another resident had used the home for respite, to give her carers a break, she then decided to make Nazareth House her permanent home. Records of a recent staff meeting showed that where a resident is assessed as having high dependency needs, the home we will offer a trial basis and review the placement within the week”. Again this is to ensure that Nazareth House is the right place for the individual person, before inviting them to make it their home. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 standard(s) 7.10 There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet the resident’s needs. Personal support in this home is offered in such a way as to promote resident’s dignity, privacy and independence EVIDENCE: Care plans are completed with the resident or any other person they may wish to involve, these identify their areas of need and what staff must do to care for them appropriately. Reviews are carried out regularly, these are signed and dated. Since the previous inspection, assessment processes and care planning have been improved. Sister Rose Ita (the registered manager) has accepted the help of mental health professionals in planning the care programmes for residents who suffer from confusion. Residents spoke well of the care received from staff and management alike, comments included “Nazareth House could not be better – no complaints” and “Girls are efficient, all do their jobs, its very nice and the food is very good.” A good relationship was noted between staff members and resident Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 11 All comment cards received said, “yes “ to the question, “is your privacy respected?” Staff were observed to knock on bedroom doors and ask permission before entering the resident’s room. Residents were entertaining their visitors in the privacy of their own rooms or in the large gardens of the home. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 standard(s) 13.14 There are no restrictions on maintaining contact with family and friends or being involved with the local community, thereby ensuring social interaction and variety to their lives. The systems for resident consultation are good and evidence indicates that resident’s views are both sought and acted upon. EVIDENCE: Comments cards received from relatives said “yes” to the question “do staff welcome you to the home at any time” and to “can you visit your relative in private”. Residents said their visitors were encouraged and were always offered drinks, meals and were offered over night accommodation if required. One resident said that his wife was particularly welcomed in maintaining his relationship, they often shared meals together at the home. Written information about the home states a commitment to “open” visiting, this means there are no restrictions to the times families or carers wish to visit. Nazareth House hosts frequent fairs and functions, these are always well attended and supported by the local community. Residents are asked to make choices in what to eat, when to rise and retire, how to spend their time, how to furnish their room, how they wish to be addressed, who they wish to keep company with, who they want to manage their affairs (if they do not want to manage themselves). Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 13 They are also asked if they wish to manage their own medication and given a choice of locking their bedroom doors. Records showed that families / carers and residents are helped to access social services or other agencies who will act in their interest, this may be in getting funding for their care or getting in contact with a solicitor, pensions departments or a medical service. 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. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 standard(s) 16.18 The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Staff have an understanding of Adult Protection issues, which protects residents from abuse. EVIDENCE: Since the previous inspection, concerns from an anonymous source were received at the Commission For Social Care Inspection, these were unfounded. There have been no other complaints received. All comment cards from residents confirmed they knew who to speak to if they were unhappy with their care. One resident said “the home is excellent, could not be better, I would see Sister Rose Ita if I was not happy with any aspect of my care”. Nazareth House has a good complaints procedure, which is found, in the home’s information and on the notice board. A good abuse procedure provides all staff with clear instructions on what to do if abuse is suspected, furthermore a good whistle blowing policy ensures staff feel secure to report any unacceptable practice. Staff said these issues are discussed at their induction and included in their training. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed on this visit EVIDENCE: These standards were not assessed on this visit. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27.29 The numbers of staff on duty were satisfactory to meet the needs of the people living at Nazareth House. The policies and procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. EVIDENCE: Three out of four comment cards received from residents confirmed “there are always sufficient staff on duty”. One resident said “there are generally enough staff, there is always someone to help you”. Staffing levels were sufficient for the number of residents living at the home, the staff group are a mix of long term experienced carers and younger carers, all said they worked as a team. There appeared to be plenty of staff to meet the needs of residents and spend time talking with them. The home’s recruitment procedures are good and the manager said that no person is allowed to work at the home without all the paper work being in place and checks made. All staff files contained full references, detailed application forms including past histories of work, CRB (Criminal Records Bureau) clearances and POVA (Protection of Vulnerable Adult) checks. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33.35.38 The home reviews aspects of its performance through consultation, which includes seeking the views of residents, thereby ensuring the home is run in their best interests. There is good leadership guidance and direction to staff to ensure residents receive a consistent level of quality care thereby safeguarding their health and safety. EVIDENCE: Comment cards received from relatives confirmed they are kept informed about important matters affecting their relative/ friend and all resident’s comments cards were complimentary to the overall service and care given by Nazareth House. One resident said “Sister Rose Ita has excellent leadership qualities which permeates throughout her staff. Residents are asked if they are happy with the way their care is given and a suggestion box is used with comments acted on. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 18 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. The pre inspection questionnaire showed up to date records and a very thorough maintenance programme thought the home and in the large grounds. Geoff Manifold in the staff member responsible for health and safety issues, he ensures that all routine health and safety checks are completed and that staff are trained accordingly. Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation none Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard none Good Practice Recommendations Nazareth House F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 1, Tustin Court Portway 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 F57 F09 S6148 Nazareth House V221720 270605 Stage 4.doc Version 1.30 Page 22 - 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!