Inspection on 18/10/06 for Netherwood

This inspection was carried out on 18th 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

Netherwood 22/05/07

Netherwood 22/11/05

Netherwood 09/06/05

Netherwood 09/11/04

Netherwood 24/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Netherwood Haughton Village Shifnal Shropshire TF11 8DG Lead Inspector Joy Hoelzel Key Unannounced Inspection 18th October 2006 09:45 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 Netherwood DS0000020718.V297449.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. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Netherwood Address Haughton Village Shifnal Shropshire TF11 8DG 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) 01952 462192 01952 462494 anharrison@netherwoodhome.fsnet.co.uk Mr David Harrison Mrs Ann Harrison Care Home 31 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (31) of places Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 31 older persons can be accommodated which can include a maximum of 6 over the age of 65 with dementia. 22nd November 2005 Date of last inspection Brief Description of the Service: Netherwood is a Care Home Registered with the Commission for Social Care Inspection to provide accommodation and personal care for a total of 31elderly people. The Home is in the village of Haughton, on the outskirts of Shifnal. Set back from the road, in its own grounds, the Home enjoys a peaceful location, where views of the surrounding countryside can be enjoyed from most aspects of the building. The accommodation comprises an original building, which has been adapted and extended, with the additional provision of a 10-bedded Unit in 2002. Bedrooms, of which 19 offers single accommodation and 6 shared double accommodation, are situated on two floors serviced by 2 passenger lifts. All areas are maintained and furnished to a high standard, providing welcoming and comfortable surroundings. The grounds are laid to lawn, with mature trees and shrubs flower borders and garden seating to enable Service Users, of various physical abilities, to enjoy them. Weekly fees range from £361.76 - £424.72. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. Commission for Social Care Inspection Reports for this service are available from the provider or can be obtained from www.csci.org.uk Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection is the first of key inspections for 2006/07 and took place over five hours on Wednesday 18th October 2006. It was conducted by one Commission for Social Care Inspection regulation inspector. Twenty three of the thirty eight National Minimum Standards for Older People were inspected. Thirty one people are currently living at the home; and throughout the time of the inspection were observed to be accessing all areas of the home. The deputy manager was on the premises and in charge of the building and was supported by four care staff with additional domestic and catering staff. The owner was at the home during the inspection. Four case files were selected for case tracking, relevant documents were inspected, discussions were held with residents, visitors and members of staff. Observation was made of the various daily activities and a tour of the premises was conducted. What the service does well: What has improved since the last inspection? Comments received from the on site survey about improvements in the last six months are ‘improving all the time, gets better’, ‘ still as good as six months ago’, ‘stayed the same – no faults – very happy with it all’, Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 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. Netherwood DS0000020718.V297449.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 Netherwood DS0000020718.V297449.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): OP 1,3,6 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their care needs assessed before moving into the home and when ever possible have the opportunity to visit the home to assess its quality, facilities and ability to meet an individual’s needs prior to admission EVIDENCE: The home has a statement of purpose and service user guide detailing all aspects of the care provision. Both documents are readily available to prospective residents and other interested parties. The case file of the person most recently admitted to the home was inspected and included an assessment carried out by a senior staff member prior to the person moving into the home. Other pre admission information was available from the local primary care trust and local authorities. One person at the home for day care discussed their future plan for moving into the home, realising that it was a great life change but stating that he thought the time was right as living alone was becoming increasingly more difficult. The home does not provide an intermediate care service. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 9 Netherwood DS0000020718.V297449.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): OP 7,8,9,10 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident has a care plan. The plan in most cases includes the basic information necessary to plan the individuals care, some omissions of recording information has the potential for not fully meeting a persons needs. EVIDENCE: Four case files were selected for inspection each contained some information of care needs and risk assessments. The care plans are formulated at the point of admission based on the information gained from the pre admission assessments. Not all identified needs have been linked to a specific plan of care. The preadmission assessments included in the first case file identified a care need of assistance with aspects of personal care; a specific plan of care had not been developed for the action needed by staff to adequately meet these needs on a daily basis. Staff had not completed the daily intervention section in the case file after they had assisted with personal care; the deputy manager informed that this information was recorded in another document. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 11 A nutritional risk assessment identified a ‘cause for concern’ result. A specific plan of care had not been completed to ensure adequate nutrition is maintained. Some risk assessments and the review of the care plans had not been dated. All case files are being updated at least monthly with a general overview of any changes of need or concerns of the individual. One case file had been agreed and signed by a relative. However all residents looked extremely well groomed, well nourished and all people spoken with commented positively on the care they received. The deputy manager and staff spoken with demonstrated a good in depth knowledge of the individual care, health and social needs of all the residents. The care plan and the content of them was discussed with the deputy manager in depth explaining the importance of recording of all information and interventions. The deputy manager explained that changes have recently been made to the management and senior levels at the home and that some systems will be reviewed and revised. The care plan contained details of visits to and from health care professionals and included GP’s, District nurses and speech and language therapists. The home operates a twenty eight day regimen for the administration of medication using a blister type system with the additional use of bottles and boxes. Current medication is stored in a locked cabinet with surplus and additional medication stored in a locked cupboard. The lunchtime medication round was observed, staff appeared to be offering and assisting residents to take their tablets in an appropriate manner. The Medication Administration Record charts were completed at the time of the administration. Some external products were not being dated upon opening and the deputy was advised introduce this practice and discard tubs of creams after one month of opening and tubes of ointments after three months of opening. In the storage cupboard external medications were being stored with boxes and bottles of medications, these must be stored separately and all medications without a prescribing label must be returned to the pharmacy for disposal. Traniderm patches were being stored in the lockable safe within the cupboard and had a prescribing label of ‘to be used as directed by your doctor’ the Medication Administration Record did not identify when these were to be administered and the deputy manager could not confirm the precise instructions. It was recommended that the prescribing GP be contacted to clarify if the patches were still required and if so the exact instructions for the administration. Staff have received training in the safe handling of medications, with certificates kept in the individual personnel files. The care staff were observed to be assisting service users with personal care discreetly and in a manner which promotes service users’ dignity. Staff, residents and visitors were observed to be interacting well with lots of chatter and conversation occurring. Netherwood DS0000020718.V297449.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): OP 12,13,14,15 Quality in this area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a full and stimulating life style with a variety of options to choose from. The home has sought the views of residents and considered their varied interests and abilities when planning the routines of daily living and arranging activities. EVIDENCE: The activities coordinator organises a very active programme for leisure and recreational interests based on the preferences and capacities of the residents. Residents were busy knitting in preparation for the international knitting day coffee morning organised for the day following the inspection. One resident discussed the planned ‘Poppy Ball’ in the local hall in November and was looking forward to it. Another resident stated that he was looking forward to the physiotherapist visit during the afternoon and the keep fit session organised. Other residents were going for walks in the garden with staff, were out with relatives and others were watching television. Church of England and Methodist services are arranged in the home on a monthly basis. One resident stated that they attend the local church on a regular basis in addition to the arranged services within the home. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 13 Many people were visiting the home during the inspection and confirmed that they are able to visit at times suitable to their relative and that they always felt welcome to visit. The statement of purpose details the unrestricted visiting hours and the anticipated maintenance of contact between the residents and their family and friends. During the tour of the premises many of the bedrooms were seen to be highly individualised with personal possessions. Staff were observed to be offering residents choices and preferences as to the activities of the day in an appropriate way, very much dependent on the capabilities and capacity of each individual. The inspector was invited to have lunch with the residents; the dining rooms were very attractively prepared in advance of the lunchtime. The meal was served and presented in a commendable way. One resident explained the difficulties with a medical condition and the need for a special diet. She went on to explain that she spoke on a daily basis with the catering staff to discuss the menu and was offered alternatives if the main menu was not suitable. She commented that ‘staff in the kitchen are very good they listen to you’. Other residents expressed their satisfaction with the meals provided and stated that it was always lovely. Some surveys were distributed to residents at the beginning of the inspection and returned on completion some comments regarding food were ‘ would like to have more fruit instead of cake’, ‘ very good at changing the menu to suit personal tastes’. Netherwood DS0000020718.V297449.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): OP 16,18 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are dealt with promptly and professionally and robust procedures and practices are in place to ensure that individuals are protected from abuse. EVIDENCE: The statement of purpose and service user guide contains information of the home procedures for dealing with concerns and complaints. A copy of the procedure is displayed at the entrance of the home. A complaint log is maintained for the auditing of complaints, the deputy manager stating that no formal complaints have been received and that if any one had any concerns staff would attempt to expediently find a satisfactory solution. Visitors commented that if they had any problems they would not hesitate to see the manager or deputy and were confident that they ‘would sort it out’. The Commission for Social Care Inspection have not directly received any concerns or complaints since the last inspection. Multi disciplinary local procedures for the protection of vulnerable adults are available for staff reference as are the homes procedures for dealing with adult abuse issues. The deputy demonstrated a good knowledge of the protection of vulnerable adults. Staff have received training in abuse awareness, certificates of attendance are kept in the personnel file. Staff do not safe keep any residents personal monies for the residents, the relatives and the joint owner of the home deal with sundry expenditure. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 15 Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 16 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): OP 19,26 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The home has a well-maintained environment, which provides aids and equipment to meet the care needs of the residents. EVIDENCE: Netherwood is a well maintained, very comfortable, and a homely place in which to live. Fifteen of the twenty surveys completed and returned made positive comments of the environment ‘ its like a home from home’, ‘very comfortable’, ‘very homely atmosphere’. During the tour of the premises some doors were being propped open with the use of ornaments and doorstops. A letter has been received confirming that the practice of propping open doors has now ceased. The gardens are well maintained and easily accessible to residents. All parts of the home were spotlessly clean; all staff involved with this task must be commended for maintaining such a high standard of cleanliness. Bedrails are in use on some beds for maintaining a safe environment when there is an assessed need to do so. All bed rails must be suitable for the Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 17 purpose and fitted correctly. This was discussed with the deputy manager and owner of the home. Some communal toilet and bathrooms have been supplied with paper towels and liquid soap for the effective infection control purposes. The owner and deputy manager confirmed that suitable hand wash facilities will be provided in all areas at the point of the delivery of care. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 18 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): OP 27,28,29,30 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. This good recruitment procedure is followed in practice with the service recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of residents. EVIDENCE: The deputy manager explained that a minimum of three care staff are on the premises at all times during the twenty four hour period, with additional staff being available at peak and busy periods. The people in charge of the building (manager or deputy) are supernumery at all times. Catering and domestic staff are additional to the care staff. The deputy manager and staff stated that many staff have been at the home for a period of time and staff turnover is very low. Two staff personnel files were selected for inspection and included the necessary identity checks and references. The deputy confirmed that all staff are subject to a criminal record bureau disclosure prior to starting work at the home. These disclosures were not available during this inspection as they are kept in the owner’s office for confidentiality purposes. A training log is maintained for all staff members detailing the type, content and date of training undertaken. Certificates and records of achievement in the personnel files included National Vocational Qualification accreditation, manual handling, emergency first aid, positive dementia care, protection of vulnerable adults, and Parkinson disease awareness. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 19 The statement of purpose details the relevant qualifications and experience of staff members. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 20 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): OP 31,33,35,38 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. There are very clear lines of accountability within the homes management structure and the management approach creates an open and positive atmosphere from which the service users benefit. EVIDENCE: Since the last inspection in November 2005 the registered manager has taken retirement. An existing staff member has been recruited and is working in the role of acting manager. A formal application for the position is currently being processed. The acting manager was not on duty at the time of this inspection but called into the home during the morning and discussed her new role. The deputy manager confirmed that quality assurance and monitoring systems are in place with satisfaction questionnaires being distributed to residents and their families at the beginning of October 2006. Monthly staff meetings continue with all staff encouraged to attend. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 21 Staff do not safe keep any residents personal monies for the residents, the relatives and the joint owner of the home deal with sundry expenditure. The procedures for dealing with personal monies was not inspected at this time due to the joint owner being off the premises. Documentary evidence is available for promoting and protecting the health, safety and welfare of service users, staff and visitors. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 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 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement The registered person must ensure that the care plans contain details of all identified care needs and reviewed at least monthly. The registered person must ensure that all medications are stored correctly. The registered person must ensure that all medications in use have a prescribing label attached with full details of the required administration. Timescale for action 30/11/06 2 3 OP9 OP9 13(2) 13(2) 30/11/06 01/11/06 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 OP9 Good Practice Recommendations It is recommended that all external medications are dated upon opening with tubs of creams/ointments discarded after one month of opening and tubes after 3 months of DS0000020718.V297449.R01.S.doc Version 5.2 Page 24 Netherwood opening. Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Netherwood DS0000020718.V297449.R01.S.doc Version 5.2 Page 26 - 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!