Inspection on 05/05/05 for Nevetts

This inspection was carried out on 5th May 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

Nevetts 19/02/09

Nevetts 12/02/07

Nevetts 12/01/06

Nevetts 02/12/04

Nevetts 11/08/04

Nevetts 18/03/04

Similar services:

Henrietta House

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Nevetts Bowling Green Lane Buntingford Hertfordshire SG9 9DF Lead Inspector Neil Fernando Unannounced 05 May 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. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Nevetts Address Bowling Green Lane, Buntingford, Hertfordshire, SG9 9DF 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) 01763 271737 01763 275741 Quantum Care Limited Mrs Ann Clay CRH PC 41 Category(ies) of DE(E) - Dementia - over 65 - Number 41 registration, with number OP - Old Age - Number 41 of places PD(E) - Physical Disability - over 65 - Number 41 Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) That respite care is only provided in the agreed and identified Primary Health Trust bed. 2) That service users with dementia shall also be over 65 years of age. 3) That service users with a physical disability shall be over 65 years of age. Date of last inspection 02 December 2004 Brief Description of the Service: Nevetts is a care home that accommodates up to 41 residents who require care due to old age, dementia and physical disability. It also offers respite facility for up to one service user. It is a two-storey purpose built home that was constructed for the Hertfordshire County Council but has since transferred to the independent/voluntary sector and was completely refurbished at that time. The ground floor comprises an entrance lobby, two lounges, a kitchenette and dining room, the main kitchen, the laundry, two offices and two staff rooms. There are also seventeen single occupancy bedrooms, two assisted bathrooms and four toilets. The first floor is served by a passenger lift. This floor comprises a kitchenette and dining room, two lounges, twenty-four single occupancy bedrooms, three assisted bathrooms and six toilets. The home has ample off-road parking places at the front of the building and gardens at the back and side. It is located in a quiet residential area of Buntingford, but within walking distance of the main shopping area and other amenities. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection for the year 2005/6 under the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The last inspection (Unannounced) was carried out on 2.12.04. The establishment is registered to accommodate a maximum of 41 service users of both genders who are 65 years and over, who require care due to old age, dementia and physical disability. In addition, the home provides respite facility for one resident. Nevetts is one of many care homes owned and managed by Quantum Care Limited in the Hertfordshire area. At the time of this inspection, there were 39 service users in residence. The inspection took place over half a day in early May 2005. It found that a significant majority of the standards assessed on this occasion meet the National Minimum Standards. A total of 11 service users, 8 staff members including the Deputy Manager and Registered Manager, and a visiting District Nurse were spoken to, in order to seek their views regarding the quality of life at Nevetts. What the service does well: The arrangements to enable residents and their relatives the opportunity to visit and make an informed decision about the services offered at this establishment is managed very well. The assessment of needs carried out prior to any potential service user being offered a place is comprehensive. The health and personal care requirements are being identified and monitored through a care planning process and review system, respectively. The service user, relatives/friends and significant others are involved in the above process as appropriate. Residents appear to be treated with dignity and their privacy, respected and promoted. A good variety of nutritious food is served in a comfortable setting and service users are consulted regarding their taste and preference. The environment is well maintained, furnished and comfortable. A high standard of cleanliness was evident. Service users are encouraged to make it their home through inclusion in the decision-making process. The home’s complaint procedures are well advertised and service users would be able to make a complaint. There are well-established systems in operation, in order to ensure service users’ protection. In the main, residents spoken to expressed a high degree of satisfaction regarding the services they receive. . Health and safety issues are being attended to. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 6 The staffing arrangements remain satisfactory. The training needs of staff are being identified and addressed. The members of the management team are supportive and very competent to manage this establishment. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Nevetts I52-I02 S19479 Nevetts v223798 050505 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 Nevetts I52-I02 S19479 Nevetts v223798 050505 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) 1, 2 and 5 The arrangements to enable prospective residents and their relatives to make an informed decision regarding the services offered at this home remain satisfactory. A comprehensive assessment of needs is carried out, thus ensuring that service users’ needs could be met. EVIDENCE: The case records for eight service users were examined and these include comprehensive details of the completed pre-admission assessment undertaken by a member of the home management team. Records examined and information gained from two new service users and staff members including the Manager provides good evidence that the arrangements to enable service users and their relatives/friends the opportunity to visit and make an informed decision about the facilities offered at Nevetts is satisfactory. They would spend time looking around, speaking to other service users and a meal is offered, as necessary. A copy of the statement of terms and conditions and placement agreement reflecting the signature of the service user, next of kin and/or Care Manager is also kept in the case file. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 9 Residents are admitted for a trial period to enable them to decide if they want to stay and also to give the home’s staff time to further assess the needs of the service users. A review meeting is held at the end of the trial period with the service user, relatives and placing authority, and only then the placement is made permanent. Information gained suggests that service users and their relatives are being empowered to participate in the decision making process, on issues that matter to them. Nevetts I52-I02 S19479 Nevetts v223798 050505 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, 8 and 10. Service users’ needs and requirements, including health and personal care are being identified and addressed through a care planning process and monitored through a monthly review system. Staff members appear to offer a sensitive and individualised approach to service users, in particular residents with dementia. EVIDENCE: Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 11 The care plan is drawn up by the key worker, a member of the home management team and Care Manager when possible, in consultation with the service user, family and friends, and significant others. A random sample of care plans for 10 service users were examined and in the main, these were noted to be comprehensive. However, minor improvements are required. For example some of the care plans viewed did not reflect the identified cultural and religious needs of the particular service users. Care plans are being reviewed by designated Care Team Managers on a monthly basis to reflect changing needs and objectives for health and personal care. Monthly review notes should however be in greater details, in order to reasonably reflect the changing needs/requirements of each service user. Once the above issues are addressed, this standard would be fully met. Records show that all residents are registered with a local GP of their choice who visits as and when required. Information gathered from service users, care plans, District Nurse records and interview with a visiting District Nurse indicates that the health care requirements of service users are being addressed very well. Service users see their visitors including visiting professionals in the privacy of their own room. Residents are able to make and receive calls from their room or the office as appropriate without being overheard. One of the ways in which residents’ rights to privacy and dignity are promoted and respected is through staff members always knocking on bedroom doors before entering. Mail is delivered unopened. Staff members were seen to interact with service users in a manner conducive to commendable practice. Nevetts I52-I02 S19479 Nevetts v223798 050505 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) 12, 13 and 15. Service users’ interests, expectations and aspirations are being sought by staff and fulfilled as appropriate. Social contact with family and friends is encouraged. The home offers a range of recreational activities that are suitable and adequate for the service users’ general wellbeing. EVIDENCE: Information provided by service users demonstrate that they are free to get up and go to bed when it suits them. Residents have access to various social and recreational activities to suit them. They are able to withdraw from any activity at any time and retire to their room, if they so wish. Group activities are publicised and staff members routinely remind individual service users before an event is due to take place. There is a monthly service held and service users are appreciative of this facility. Overall, service users reported a great deal of satisfaction with respect to the routines of the daily living and the level and variety of activities facilitated. “I would live here for the rest of my life” echoed one service user. Service users stated that they are able to receive their visitors in private. Visiting times are flexible and visitors are welcome. Staff members reported that residents are proactively encouraged to maintain social contact with family and friends. Many service users spoken to stated that they have people visiting them regularly. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 13 Evidence shows that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual needs. Meals are taken in congenial setting and at flexible times. Lunch was observed to be unhurried with residents being given sufficient time to eat. The atmosphere in the dining rooms was relaxed and care practice observed was good. Service users were consistent in their views that the variety and quality of food offered to them is of a high standard. Nevetts I52-I02 S19479 Nevetts v223798 050505 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 and 18. Information on how to make a complaint is available and service users should be capable of making a complaint. There are a number of effective systems in operation and these should offer adequate protection to a service user. EVIDENCE: The home has procedures for dealing with complaints. Information on how to make a complaint is given to each service user and their relatives on admission to the home, as part of the terms and conditions of service. Staff members interviewed demonstrated an understanding of the complaint procedures and felt able to respond to complaints satisfactorily. Service users spoken with felt able to make a complaint if they are dissatisfied with any aspect of their care. There have been no complaints received by the home or the Commission about any aspect of care, since the last inspection. Evidence suggests that complaints are dealt with speedily and satisfactorily. The whistle blowing policy is available and accessible to the staff team. The home also had procedures on the protection of vulnerable adults from harm. Discussion regarding the procedures is part of the induction for all new staff members and as part of NVQ assessment. Staff members spoken to are clear that any allegation or incident of abuse would be reported to a senior member of staff and followed up immediately. 34 of the current 44 staff members have received training on the protection of vulnerable adults. Essential training on the protection of vulnerable adults should be made accessible to the remaining members. Overall, the systems in place should be adequate to protect service users. Nevetts I52-I02 S19479 Nevetts v223798 050505 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) 19 and 26. This establishment continues to provide good living conditions to its service users. The standard of cleanliness was high and furnishings are suitable for the individual and collective needs of the service users. EVIDENCE: The home is suitable for the use of the service users. There is a rolling programme for maintenance in addition to quick response to any problem arising. The communal areas and bedrooms are decorated and furnished in a style to reflect the period features of the building. Recent decoration includes the main lobby area, corridor near the ground floor kitchen, the care station and one first floor Toilet. Furniture and fittings are of a good standard and bedrooms viewed are comfortable. Overall, the home and gardens are well maintained, which service users appear to appreciate very much. There is a high standard of housekeeping throughout those areas viewed during this visit. Considering the high level of incontinency with the current service users, there were no mal-odours present – a view echoed by a visiting District Nurse. This is quite an achievement and the ancillary staff team are to be commended for their achievement. Liquid soap and paper towels are Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 16 provided in areas where personal care is carried out and in high-risk areas such as the laundry. Staff members are conversant with infection control procedures. There were no health and safety hazards noted. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 30. The levels and deployment of day and night staff at this establishment are deemed to be satisfactory. The recruitment process for staff remains robust hence promoting a higher degree of protection for vulnerable service users. Training received by staff members enables them to deliver an improved level of service. EVIDENCE: This establishment is registered to accommodate up to 41 service users who are 65 years and over. It also provides respite facility for up to one resident. On the day of the inspection there were 39 service users in residence. Staff duty rotas for the period between 9.04.05 and 6.05.05 was scrutinised and information gathered from staff members including the Deputy Manager and Manager provide evidence that the day and night staffing levels are adequate to meet the needs of the resident group. In addition to the care staff team, the home has administration, maintenance, catering and ancillary staff members, and these arrangements remain satisfactory. The Deputy Manager and Manager work on a full time basis and their times have not been included in the care staff calculation. The home has robust procedures for the recruitment, induction and training of staff members. Good evidence is available to demonstrate that the procedures are being translated into practice. The recruitment files for five staff including new members were scrutinised and found to be in order. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 18 Information gathered from five staff members and their individual training profiles indicates that mandatory training has been provided to all staff, as appropriate. There are 7 staff members who have completed NVQ Level 2 or equivalent. Another 8 members are currently undertaking the same assessment. The organisation plans to support another group of staff to start their NVQ level 2 in care in September 2005. The Manager is aware that 50 of the care staff team should achieve NVQ level 2 or equivalent. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31, 36 and 38. The management of this home remains satisfactory. Policies and procedures ensure that the health, safety and welfare of service users, and staff are safeguarded. Nevetts continues to be a safe home for residents to live in. EVIDENCE: The Manager has over 12 years management experience in a care setting, is the holder of a City & Guilds 325.2 award and has undertaken periodic training to update her skills and knowledge whilst managing the home. She has recently completed the NVQ 4 in Management and Care. The Manager is competent and experienced to run the establishment and clearly meets the aims and objectives of the Home. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 20 There is good evidence to indicate that staff members have on going supervision whilst carrying out their daily task. There is at least 1 member of the management team (Duty Manager) available on each day or night shift, whose main task is to support and monitor care practices. A formal supervision system is in operation and staff members interviewed confirmed that they receive formal one to one supervision every two months and that they are very satisfied with management support they receive. The home has robust and detailed procedures to ensure the health and safety and welfare of service users and staff. The Manager has arranged for all staff to receive ongoing training that ensures safe working practice. Fire drills and weekly test of break glass points have been carried out within the required frequency and a record maintained. Hot water temperature is monitored regularly, in order to ensure a safe limit of 43 degrees Centigrade at the point of outlet. Windows have been fitted with restrictors for the safety of service users and security of the building. Portable electrical appliances are checked, tagged and a record maintained. The only shortfall identified is that records indicate that the fridge temperatures ranged between 9 to 10 degrees Centigrade occasionally. Fridge temperature should not exceed 8 degrees Centigrade. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x x x x 3 x 2 Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 22 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 OP38 Regulation Requirement Timescale for action 5.05.05 and ongoing. The Food The fridge temperature must not Safety(Te exceed 8 degrees Centigrade. mperature Control Regulation 1995 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. Refer to Standard OP7 OP7 OP18 Good Practice Recommendations Monthly review notes should be in greater details, in order to reasonably reflect the changing needs and requirements of each service user. The cultural and religious needs of the service user should be wooven in their care plan. Training on the protection of vulnerable adults should be made accessible to those staff members who have not received this essential course. Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Nevetts I52-I02 S19479 Nevetts v223798 050505 Stage 4.doc Version 1.30 Page 24 - 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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