Inspection on 21/11/06 for Nazareth House Nursing Home

This inspection was carried out on 21st November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Nursing Home 08/03/06

Nazareth House Nursing Home 20/12/05

Nazareth House Nursing Home 14/07/04

Nazareth House Nursing Home 22/04/04

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 Nursing Home Manor Hill Claughton Birkenhead Wirral CH43 1UG Lead Inspector Mrs Julie Garrity Key Unannounced Inspection 21st November 10:15 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 Nursing Home DS0000020918.V295281.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 Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nazareth House Nursing Home Address Manor Hill Claughton Birkenhead Wirral CH43 1UG 0151 652 7811 0151 653 0816 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) The Congregation of the Sisters of Nazareth Sister Ellen Curran Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 24 beds nursing care / 23 beds personal care in an overall total of 47 Date of last inspection 08/03/06 Brief Description of the Service: Nazareth House is a purpose built care home attached to the original main building. Although it’s a home that is based on Christian values there is no religious requirements for admittance. The home aims to meet all religious and cultural values. Nazareth House as the home cares for 47 people who have nursing and personal care needs. The home offers both nursing and personal care for elderly adults. The care home is situated in Claughton a quiet suburb of Birkenhead and is set in it own grounds, with ample car parking to the front of the house there are gardens around the building that are easily accessed by the residents. There are two main dinning areas both with an attached kitchen separate to the main kitchen. Two main lounges, two smaller seating areas, which the home calls, snugs (one of which residents are allowed to smoke in), a conservatory and a number of smaller seating areas on the main corridors. The majority of the bedrooms in the home are single occupancy and residents are encouraged to make these their own by brining in furniture and personal items. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day. The inspector arrived at the home at 10:15 and left at 16:35. The inspector spoke with 13 residents, 7 visitors, 8 staff and the manager. The inspector completed the inspection by a site visit to Nazareth House, a review of relevant records (detailed in the body of this report) in Nazareth House and CSCI offices. Questionnaires where left in the home at the time of the inspection 6 have been returned and the comments are included in this report. Copies of records were submitted to CSCI for review in this inspection. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review where covered. All of the Key standards were covered in this inspection; these are detailed in the report. Feedback was given to the manager during and at the end of the inspection. The arrangements for equality and diversity were discussed throughout the visit and are detailed throughout this report. Particular emphasis was placed on the methods that the home used to determine individual needs and the practices that they put into place into meeting those needs. What the service does well: Nazareth house is a well managed home that is run in a manner that helps the residents be independent. Residents are encouraged to attend meetings get involved in activities, read their care plans and raise concerns as examples. All the residents spoken with where positive about the care that they received several said that “the staff are excellent”, “they are very caring” and “they know what they are doing”. Staff are recruited to work in the home based on the right person for the job. They are developed to obtain the skills that they need to do their jobs well. Most of the staff work in the home for several years and all have been checked that they are suitable to work with older persons before they come to work in the home. Staff are given training that meet the needs of the residents, good supervision that helps staff gain skills and a good management team that encourages staff and regular staff meetings. All these activities mean that staff have the skills to care for the residents The manager and the staff have made sure that Nazareth house is a warm and welcoming place both to visit and live in. Relatives spoken with felt that they Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 6 where always welcome. One relative said, “Its such a home from home, I never feel like I’m visiting a care home just coming so family and friends”. Care plans in the home that detail to staff what care the residents need are very well written they clearly detail not only the nursing care and physical needs of the residents but how they want to live their lives. All the plans are agreed with by the residents and their relatives. Information for residents is very good and helps them decide if they want to live there and the things that they would like to do. There are clear choices available for the residents such as what activities they would like to take part in and what meals they would like to have. What has improved since the last inspection? What they could do better: There where no requirements made in this report and no outstanding requirements to address the following points are recommendations only. The policies in the home where bought from an external company and some of these arte not suitable to the home, such as the protection of vulnerable adults policy which is inaccurate and likely to cause confusion amongst staff. Staff need to make sure that they follow procedures in the home regarding medications as it was noted that staff where not always following the correct ways of giving out medications. The manager audits risk assessments in the home such as residents taking care of their own medications, care plans and medications. However to Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 7 increase quality these should be formally recorded and the records updated from the findings of the audits. Although there is lots of information available and is in different formats consideration should be made into other ways of getting information to residents such as taped information and written in large print for residents who have sight issues. This is particular relevant with information about menus and activities in the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 8 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 Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3 where assessed. Standard 6 is not applicable. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Information for residents is clear and available in different formats that help them read or be told about it. This information helps residents and their families make a decision about coming to live in the home. All residents are assessed before they are admitted to make sure that the home can meet their needs. This assessment is shared with the residents and their relatives and they are supported to give personal information in a sensitive manner. EVIDENCE: The manager makes sure that potential residents are given the opportunity to spend time in the home. The service users guide and the admissions policy contains information for residents and staff that supports this good practice. Residents and relatives said that they where “invited” to spend time in the Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 10 home before an admission. All family members spoken with said came to “look around the home” and they were made very “welcome”. The manager said that she does an assessment on all residents they move in. A copy of any assessments were seen in all of the care plans looked at. Relatives and residents spoken with said that the manager had been “kind and caring” whilst doing the assessment and that they had not felt “embarrassed to answer any of the questions ask”. All residents who have their stay paid for by Social Services have a copy of Social Services assessment obtained by the manager before admittance. Copies of these were seen in the residents’ files. The assessments where used to help the staff write clear care plans that detailed how residents needs were to be meet. Although the home is based on Christian values and offers an opportunity for residents and staff to attend Christian religion services. The assessment takes the opportunity to determine and find ways to support individuals from different cultures and religions. Information to new residents and their families about the home is readily available and a copy of this is placed in each resident’s bedroom. Different formats are available for residents such as large print and Braille. These can be arranged by the home. One resident is partially sighted and cannot read the information. However his daughter said “I have read it to dad, it’s very good and gives him all the information he needs. I occasionally remind him of what’s in it”. A present the home does not have newsletters or information available on tape, video or in picture format. However they are exploring ways of making sure that all information in the home is available for residents in a variety of different formats that are easy to obtain and can be given to the residents quickly. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10 where assessed. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of residents needs, they are guided in the care that they provide by good well written care plans that promotes residents independence and maintains their dignity. Residents are included in the discussions about their care and this has helped in making sure that staff are fully aware of residents needs. In general medications are well managed however the medication policy is in need of updating and staff need to make sure that they meet good practice guidelines at all times. EVIDENCE: Of the five care plans viewed all had been updated and signed by residents or their relatives. One relative described “going through the care plan with mum and the staff in detail. It helped me understand exactly with the staff where doing and why and I was able to give them other bits of information”. The Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 12 care plans viewed all contained lots of good information they described exactly what care staff needed to provide. Staff spoken with, said that they “regularly” read the care plans and talk with the senior staff about the needs of the residents. Each care plan reviewed included risk assessments that looked at the particular areas of risk for residents these included bedrails, diet, developing pressure ulcers (bed sores) and moving and handling as examples. These are checked by staff informally and help maintain the safety of residents and take into account residents’ own choices. Records show that the home arranges for health professionals (GP’s, opticians, dentists, chiropodists and specialist nurses) to visit residents in the home and provide facilities to carry out treatment such as a separate room or the residents’ own bedrooms. Staff make sure that residents are supported to attend hospital appointments and contact GP’s if required. The home has a medication policy, procedure and good practice guidance that is available to all staff. The policy is in need of updating and does not fully reflect what staff need to do to manage medications. Last month the home had problems when their new medication administration records from the chemist arrived. Staff spent several days trying to make sure that they were correct. However a number of items of key information were missing and this prevented staff from maintaining a full account of medications in the home. As such the home could not guarantee that all medications where correct. Where records where clear medications where found to be fully accounted for in all but one case. The manager intended to remind staff to adhere to the policy in the home. Informal checks on medication balances are done monthly. The home intends to make these formal so that medications issues can be rapidly identified and individual staff whom may need extra support can be identified. The home strongly promotes independence and those residents assessed as being able to are supported to keep and take their own medication. Risk assessments where viewed regarding this area, however these had not been updated. The manager detailed that this was done informally when she checked care plans. A written review would enable her and the staff to make sure that risk assessments stayed up to date. The need to respect residents’ privacy and dignity is detailed in the homes information to residents; it is included in staff inductions, discussed as staff meetings and can be clearly seen in the care plans in the home. Residents spoken with where clear that staff are “very polite at all times”, “know when to have a laugh and a joke”, “relaxed and helpful” and “100 fantastic”. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15 where assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management of the home promotes the rights of the residents and helps them to be supported about how they wish to live their life in Nazareth House. This attitude also helps to encourage relatives to feel very welcome in the home. The residents influence the running of the home and as such activities and meals are in place to meet the residents needs and choices. EVIDENCE: On the day of the visit there was a lot of activities going on, this included a clothes party, a religious service and an art activity. Residents spoken with said that they “enjoyed what happens in the home”. Care plans clearly showed individual choices and their preferred daily routines. Some of the residents spoken with detailed how they where consulted, one resident said, “I’m always asked what I want to do”. Daily records didn’t always reflect what activities or individual routines had been put into place for residents and information boards in the home detailing the activities where not complete. However most of the residents spoken with where aware of what was happening in the home, two said “I can join in I want” and “they try to keep us active” Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 14 The home has regular residents meetings and minutes of these are available to be seen by all residents and their relatives. They have also recently undertaken a quality assurance system that asks the views of the residents and acts on these views. Care records clearly detailed that the routines in the home where in place for each resident specifically. Residents are encouraged to get up when they want, go to bed when they want and access areas of the home as they see fit. Although mealtimes are set, individual preferences can be accommodated. Residents who are out for the day are provided with their meal and medications on return depending on their needs. The chef writes the menus and this is done by talking with the residents in the home. The catering staff have received training in lots of areas such as food presentation, special diets and were able to tell how they meet the various diets of residents. One of the residents said that they would like spicier food the chef said that this could easily be accommodate and would arrange it. Each meal had different options available so residents where able to make choices, this included making sure that residents where asked what they would like on their plate at each meal. Residents spoken with said that they enjoyed the food provided. Menus were displayed but these were in small writing and not suitable to be easily read by all the residents. The manager is intending to look at this and provide menus in formats that easily meet the residents’ needs. On the day of the visit the home had 19 visitors all of whom where family and friends. Through out the home visitors and residents where seen enjoying each other’s company getting involved in activities or visiting in private. Visitors were welcomed at any time and facilities are available for them to have a drink or a meal with the resident. One relative said, “I always get offered a drink, I sometimes leave sloshing from all the drinks I got”. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 where assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that any concerns they have will be recognised and dealt with in order to make them feel safe. Good training for staff supports residents’ confidence and makes sure that staff are aware of how to protect residents. There is a need to change the current policy in order that all residents, relatives and staff can have clear and useful information. EVIDENCE: Nazareth House has a complaints procedure, a copy of this is available in each residents bedroom. Residents meetings are also an opportunity for residents to raise concerns and influence services. Any complaints are recorded and addressed with full information given to the individual raising the complaint. There have been no complaints made to CSCI regarding Nazareth House. All staff have received training in protecting vulnerable adults. This is covered in induction, in policies in the home, in regularly updated training and in staff meetings. The policies and procedures regarding protection of residents are in place. However these do not detail the correct information they guide the staff in the home to investigate these concerns themselves, which goes against the policy in place from Social Services, and confuse staff. Discussions with staff Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 16 showed that they where aware of how to raise concerns but were unsure as to whose responsibility to investigate it was. All of the residents and relatives spoken with where confident that home supported the residents to be safe. One relative said, “ I have absolute belief that my aunt is safe here. The staff make me feel happy that they know what they are doing”. One of the residents said, “Anytime I’ve had anything I didn’t like I just told some-one. They moved heaven and earth to make sure it was right. The only times I’ve had a problem was for things that where outside the home like hospital appointments. They made sure it was all fixed and I didn’t have to worry”. An other resident said, “these girls are excellent, faultless, wonderful, they make sure we are happy”. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 where assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Nazareth House is a warm and welcoming care home. Decorated in a manner that the residents appreciate and in style similar to their own houses. It is maintained to a good standard and is clean and tidy. A variety of areas for the residents to use are available and this offer residents a lot of choice. EVIDENCE: Nazareth House is a modern building attached to an original large family house. The building was built for the purpose of being a care home and is on two floors. The main corridors are decorated in an unfussy manner and have been personalised by using small areas for seating and pictures. There is a smoking area on the second floor called a “snug” and is the only area in the home that residents can smoke in. Another “snug” with a conservatory is located on the ground floor. On each floor there is a dinning room and lounge Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 18 area with a small kitchen attached. There is a lot of choice of space for residents to sit in and offers an opportunity for different activities to occur in the home at once. It also supports residents to see their families in private as they wish. The choice of decoration makes the home feel very comfortable and more in keeping with the kind of decoration that the residents would have in their own houses. One resident said “Although the day rooms are really big, they feel nice and cosy. I like the fact that I can sit wherever I want, go where ever and want and do what I want during the day All the bedrooms looked at had been personalised by the residents and held items that they had brought from their own home. One resident said “I’ve got my own bed, chair and family pictures it makes me feel settled to be amongst my things”. Lots of the bedrooms had beds in that where adjustable to help with residents getting in and out of bed. When bedrooms are vacant they are redecorated ready for any new resident who would wish to move in. Kitchen and Laundry areas where viewed all these had cleaning records in place that guided staff to keep all areas clean and identified any problems quickly. In the Laundry staff tried very hard to make sure that residents clothing was identified for each individual and returned to that individual. All items where identified for each individual and returned directly to their own bedroom when washed and ironed. All of the residents clothing was observed as well cared for at the site visit. Records in the home showed that all maintenance areas are regularly checked and any issuers that are identified are attended to quickly. This makes sure that residents’ safety is always maintained. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30 where assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is sufficient staff available in the home to meet the needs of the residents. The manager has put into place training for staff that is designed to meet the needs of the residents and to aid the staff in supporting the residents to maintain independence. Staff are recruited in on their skills and attitude and are well developed by the manager and other management members to gain the appropriate skills and to continue to develop their skills. EVIDENCE: All the residents and relatives spoken with where sure that there was enough staff available. Three of the relatives said “I’m falling overt staff whenever I come”, another said, “there are lots of staff, they are here there and everywhere all day” and a third relative said, “there are lots of staff, they are always very good and keen to help”. A review of the duty rota, which details how many staff are on duty at any one time showed that there where extra staff brought into the home for special events and trips out side the home. One resident said “they are so good, I want for nothing, wait for nothing. They are always ready and happy to help”. Staffing files for 10 staff where viewed. All the files had good evidence that staff where checked as being appropriate and of good character before they Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 20 started work. This included appropriate references, police checks and checks that staff where fit to work with the elderly. The majority of files where well maintained but the information in them was not always consistent. Some would have identity proof and photos others did not. It would be easier for the manager to make sure that all staff where suitable if the same information were kept on all the files. The need to recruit new staff in the home is very rare as the majority of the staff work in the home for several years. Of all the staff spoken with none had worked in the home for less than 3 years. This is good practice as it means that residents can be confident that they will be supported by staff that are experienced and know their needs. All of the staffing files had clear guidance for equality and diversity and made sure that all staff were recruited in the same way and given the same opportunities to be successful. The interview checklist concentrated on experience, demonstration of skills and good attitude to the care of the elderly. The manager was keen that only staff who had a good attitude be recruited and that training could meet any knowledge needed. Most of the staff files viewed had a copy of the staff member’s job description that clearly stated what their role was. All the qualified nurses had provided proof that they where legal able to work as a nurse and this was regularly checked by the manager. There is a variety of training available for all staff and not just the care staff, kitchen staff had received training in a number of areas that helped them to maintain a good quality of food provided. Care staff had received training in several areas not just those areas that they have to so to meet health and safety. Training in areas specific to the needs of the residents was also being put in place. Where possible the manager uses external a training organisations in order to make sure that training is of a high standard. Good supervision is in place that helps the manager identify when staff need training in other areas and what that training might be. Several residents had a lively debate about the staff all were very positive, there comments included “lovely staff”, “totally faultless”, “they know what they are doing” and “they do a lot of training here, its really good for them”. All staff receive a full induction when they start working in the home. This covers all the areas that staff need to start with and also forms part of a more formal qualification in care known as National Vocational Qualification’s. The majority of staff have achieved this qualification with many staff working towards achieving the higher kevel of this qualification. The home sees this as part of staff skills and rewards achievement of this qualification by paying those staff who achieve it a higher rate of pay. This encouragement helps make sure that staff feel happy to undertake extra learning and promotes a home where staff training and development is given a high value. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36, 38 where assessed. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a good management team that strives to maintain and increase the quality of the services in the home. Residents, relatives and staff are supported to put forward their point of view and this is used to help the service meet the resident’s needs. Residents are supported to be as independent as possible and encouraged to manage as many areas of their lives, as they would wish to. Health and safety issues are monitored and any areas that need fixing are done so promptly in order to protect the health and welfare of residents, relatives and staff. EVIDENCE: Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 22 Discussions with the residents, relatives and staff showed a great deal of support, faith and belief in the manager. Every person spoken with where very positive about the manager and her ability to make sure that the home did the best that it could. There is a team of nurses who each have been given a responsibility for different areas they are supported and encouraged to develop good skills as part of a wider team by the manager. Regular staff meetings take place and further support the individual and home development. The minutes of these where reviewed and showed where the staff had been praised and supported by the manager, where improvements had been noted and areas for improvement identify by the staff are raised to develop quality. The home has recently gone through an external quality audit that looked at all aspects within the home and used residents, families and staff views about the service. There are regular residents, relatives and staff meetings in which all parties are able to put forward their points of view and influence the service that they receive or are part of. One resident said, “I feel as though what I have to say is listened to and acted on. It can take a little time some times but it always happens. They are so good here”. All of these good practice points enable the manager to deliver a service that is designed to meet the needs of the residents and is as they ask for it to be. Staff supervision is on a regular basis all staffing files viewed contained records about staff supervision and these clearly showed that staff are being offered support to develop and encouragement for good practice that they deliver. Staff spoken with said that they appreciated the staff supervision services available. All staff where involved in developing the supervision policy. Training session where held that detailed to them what the supervision would be for and how it was to develop good quality services. A copy of the policy was given to the staff who signed it and kept a copy for themselves. This approach made sure that staff where fully aware of this support process and how to be involved. The manager intends to repeat this approach with other areas developed in the home. Residents are encouraged to manage their own money. The home has legal responsibility for four residents and holds money for others either at their request or the request of the families. Some residents receive their personal allowances and look after it themselves. Others have purses that are kept in the safe in each of the units. Only small amounts of money are kept for each of the residents. The records viewed for these were detailed, they showed what money had been received who it had been given to and copies of receipts where kept of the money that had been spent. Residents who looked after their own money made positive comments one resident said, “I like to have a few pennies handy you never know when you will need it”. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 23 Risk assessments where viewed for the home for fire and the environment that where up to date. Staff training records had clear information regarding staff training in health and safety and it was clear that this was maintained for all staff and regularly reviewed. Staff spoken with said that the training that they had received in this area was of good quality, informative and helped them do their jobs safely. The manager makes sure that all equipment is regularly checked and has taken action on changes in good practice for things such as legionella (a bacteria that can be found in hot water systems if they are not managed properly) which was identified last year as presented a big risk to the elderly. It is clear from the checks on the environment and staff training that the staff and manager keep themselves up to date on best practice and quality. Copies of best practice information were available throughout the home such as medications management and social care guidelines. The maintenance man monitors all areas of maintenance in the home. Staff report to him if there are any things that need fixing and he makes sure that it is dealt with quickly or if expertise outside the home are need the manager is made aware of this so it can be arranged. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 24 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 4 X 3 Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 25 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. 1 2 3 4 Refer to Standard OP9 OP12 OP33 OP33 Good Practice Recommendations Staff should adhere to medication procedures at all times. All information in the home should be easily available in formats suitable to the residents needs this includes information on notice boards. Audits should be formally recorded and records that are audited updated from the audit findings. All policies and procedures should be reviewed and updated to meet the homes specific needs. Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Nazareth House Nursing Home DS0000020918.V295281.R01.S.doc Version 5.2 Page 27 - 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. 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