Inspection on 18/08/05 for Neville House

This inspection was carried out on 18th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Neville House 02/07/08

Neville House 30/07/07

Neville House 17/05/06

Neville House 07/12/05

Neville House 09/03/05

Neville House 10/05/04

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 Neville House Neville Street Chadderton Oldham OL9 6LD Lead Inspector Michelle Haller Unannounced 18 August 2005 th 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. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Neville House Address Neville Street Chadderton Oldham OL9 6LD 0161 627 5874 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) Dr Bhima Odedra Mrs Patricia Grice CRH - Care Home PC - Care Home only 17 Category(ies) of DE(E) Dementia over 65 - 5 registration, with number LD(E) Learning Disability over 65 - 1 of places OP Old Age - 9 SI(E) Sensory Impairment over 65 - 2 Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Service users to include up to 9 OP up to 5 DE (E), up to 1 LD (E) and up to 2 SI (E). Date of last inspection 9th March 2005 Brief Description of the Service: Neville House is a privately owned residential care home for older people. Local amenities such as shops, pubs and a GP practice are close by and bus services run to Oldham centre and surronding areas. The front of the home faces to a side road. The rear of the premisies has a small car park and garden area. The property has been extended to provide accomadation in seven single and five shared rooms. Accomadation is available on the ground and first floors and a passenger lift is available for the use of service users. On the ground floor there is a large lounge and a dining room. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of Neville House was unannounced and conducted over a nine hour period. Five service user files and record and reports concerning the running where examined. Two members of staff where interviewed and general observations made of the routines in the home and the interaction between service users, staff and other visitors to the home. The home is warm with a friendly atmosphere, positive and caring relationships between staff and service users was evident and the ethos of the home has fostered positive and caring relationships between service users. Service users and their representatives where keen to communicate their contentment with the care and support provided by the staff in respect of health, phsychological and social care. What the service does well: Potential service users and their representatives are encouraged to spend time in the home prior to a move into the home. All health care is made available to services users and health needs are dealt with promptly. Instructions given by health professionals are followed. Service users choice and independence is promoted and the home is open to relatives and friends. The service users enjoy the meals and snacks provided. Service users are encouraged to bring their own belongings into the home and a homely atmosphere is promoted. Staff are provided with opportunities to gain and develop relevant skills through access to comprehensive training. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Further development and review of care plans must be introduced and care plans must relate to the assessed and changing needs of service users. Tighter control must be exercised over the acceptance, administration and recording of medication coming into the home. An immediate requirement was made at the last inspection and though action taken errors where still evident and a further immediate requirement was issued. The home needs to ensure the introduction of a cleaning programme to that covers all areas of the home. In order to maintain a consistently satisfactory standard of care and service user provision, the practice and actions taken by staff should be more stringently monitored. Records of the food intake of service users must be introduced. Records of the activities undertaken and enjoyed by service user should be made available. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 7 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. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3, and 5 Service users have been provided with a written statement of terms and conditions about living at Neville House. Service users are only admitted following an assessment of needs. Service users and their representatives are able to visit the home prior to admission to Neville House. EVIDENCE: On this unannounced inspection five service user care files where examined. These included the most recent admission. All the files contained a signed terms and conditions of residency document. This detailed the services and facilities available to the service user and terms under which notice for leaving the home could be given. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 10 Each file contained a comprehensive assessment of needs completed by the referring agency prior to admission. Furthermore the manager and senior staff at Neville House had completed a additional assessment of care, health and social needs for some service users, soon after admission. These assessments included moving and handling risk assessments, dietary assessments and falls risk. During the course of the inspection discussion with service users and relatives confirmed that they were given the opportunity to visit the home prior to admission. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 The individual care plans do not consistently reflect the assessed needs of the service users. All the needs of all service users are not consistently met. The recording of medication coming into and administered by the home is unsatisfactory. The service users right to privacy and respect is upheld. EVIDENCE: During this unannounced inspection five service user care files where examined in detail. It was found that although the assessments identified specific health and social needs, the manner in which these needs where to be met was not detailed in the care plans. In addition appropriate specialist monitoring was not carried out. Examples included lack of additional observations and support for someone assessed as ‘frail with a poor appetite’, and there was inadequate guidance relating to the social and psychological needs for others. Furthermore Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 12 the record of accidents strongly suggested that reassessment was required for one person and this had not been undertaken. Examination and cross referencing of records indicated that, care plans had not been reviewed monthly or updated to reflect the changing needs identified in the daily reports provided by care staff. These requirements are outstanding from the previous two inspections. General health needs for service users are met. The files confirmed that routine health checks including dentist, podiatry, optical was provided. Specialist input from the district nurses and general practitioners was generally prompt and instructions followed. Service users who where interviewed confirmed that they were able to keep their own general practitioners. Visits from the district nurse took place over the day of the inspection. The district nurse also commented that the home co-operates with health instructions and upholds the service users dignity. The district nurses care plans are followed. The medication administration sheets where examined and found to contain omissions. An Immediate Requirement was served to relation to this standard. Improving the medication system was highlighted during the previous inspection. In the course of the inspection observation of the routines and interaction between staff and service users was observed, it was noted that rapport was good and staff where respectful at all times. It was observed however that a number of service users had unkempt hair and others had not been supported in changing tops that had been soiled during breakfast. This was discussed with the manager. Service users stated that staff where pleasant and caring. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 The lifestyle in the home meets the needs of most service users, but activities are provided infrequently. Service users are encouraged and supported in maintaining contact with family, friends and the local community. Service users are supported in making choices and keeping control over their lives. Service users are provided with a variety of wholesome meals. EVIDENCE: During the inspection it was stated by service users that they had the opportunity to participate in a variety of activities in the home and the local community. Pictures on display confirmed those special holidays such as Easter and St Georges Day where celebrated. Service users discussed outings from the previous year but stated that none had taken place this year. The staff confirmed this, however a trip to a local pub is being planned. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 14 Service users with family confirmed that visitors where always made welcome and encouraged. One service users stated that he was able to come and go from the home without any restrictions, this was confirmed in his daily report. Two service users felt that that though there where activities in the home such as, armchair exercises, arts and crafts, bingo, and entertainers, there were not enough opportunity to visit farther a field. This assertion appears justified in that the last outing confirmed by staff was a trip to Hollingsworth Lake in 2004. Others interviewed where content with the activities that took place, or had family and friends who escorted them out regularly. It was not possible to fully assess the success of activities because these were not routinely recorded and an activities calendar has not been developed. An Age Concern advocate is currently completing a ‘Life Story’ project with some of the service users living at Neville House. Examination of the fridge, freezer and larder identified a good selection of fresh and frozen meat and frozen vegetables. Fresh fruit and vegetables were not really evident. There where also popular branded cereals and convenience foods. Hot and cold beverages where offered to service users. It was noted and brought to the attention of the manager that the fridge and freezer needed defrosting and some frozen and cold items did not have labels detailing the use by or expiry date. The fridge door was also dirty. Service users stated that the food provided in the home was sufficient and of good quality- this was reiterated by visiting relatives. The district nurse also noted that the meals in the home where of a good standard. Meals are served in an unhurried manner. Service users requiring a soft diet or diabetic diet where adequately catered for. A shortfall in this area however is that the intake for service users requiring particular observation was not recorded. Neither could the home produce a menu relation to previous meals. It must be noted however that all service users and their representatives where keen to confirm that meals, snacks and drinks provided by the home where plentiful and varied. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Service users expressed confidence in the home’s complaints procedure. The service users are protected from abuse. EVIDENCE: Discussion with service users indicated that if they had a complaint they would address them to the manager. Service users stated that they did not have nay complaints. Staff who where interviewed where aware of the complaints procedure. Discussion with staff confirmed that they had a good understanding of the actions and omissions that constituted elder abuse and where confident about the actions they would take if such actions where witnessed or disclosed. In the course of the inspection the inspector was informed of staff being dismissed following a possible adult protection issue. It was evident that the CSCI was not notified of this incident at required under Regulation 37 of the Care Standard 2000. This omission was discussed at the time of inspection. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 standard(s) , 20,21,22,23,24,25 and 26. Neville House is reasonably well maintained. Service users can access all internal and external communal areas of the home safely. There are sufficient lavatory and bathing facilities to meet the needs of the service users. Bedrooms meet the needs of the service users. Standards of hygiene in the home could be improved. The home is not clean. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 17 EVIDENCE: In the course of this unannounced inspection a tour of the entire building was undertaken, including all private, communal, laundry and storage areas. Service users and staff where also interviewed. The main hallway has been redecorated and carpeted. New carpets have also been installed in one bedroom. The carpets in one of the bedroom corridors and one lounge were stained and sticky. The grounds have been tidied since the last inspection and services users were observed enjoying this area independently and with staff assistance. The large lounge area and dining room provides sufficient space for a variety of activities to take place at anyone time. Service users were observed reading, knitting and conversing in both areas. At previous inspections the shower room was being used as a smoking area. This has now reverted to a shower room and service users are permitted to smoke one corner of the dining room near a large window that is kept open in summer. Staff where observed smoking outside. Now that the ground floor shower room is available there are sufficient adapted bathing facilities to meet the needs of the service users. All bedrooms where inspected. Many contained furniture belonging to the service users occupying the room. Shared bedrooms contained partitioning curtains for use as necessary. Furniture and fittings in many bedrooms where grubby in that, doors, walls and other surfaces where dirty. A number of the bedrooms had an unpleasant smell. All the bedroom radiators had been fitted with guards. The laundry area was clean and the equipment met with the current water regulations and infection control requirements. Service users where observed using specialist equipment including grab-rails, walking sticks and zimmer frames. Service users asserted that they liked their rooms and had no complaints about any of the physical aspects of living in the home. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 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) 27,28,29 and 30 There is sufficient staff with a sufficient skill mix to fully meet the needs of the care needs of services. Staff receive health and safety training. The home recruitment and selection policy provides protection to service users. Staff are provided with sufficient training to carry out their duties. EVIDENCE: On the morning of this unannounced inspection there where 17 service users being supported by three care staff and one domestic. Staff rotas confirmed that three care staff are generally on duty each morning. The manager was also on duty. This number of care staff on duty was satisfactory. The manager stated that the home does not currently have a cook and so care-staff take it in turns to prepare meals, however a temporary cook has recently being employed. The home’s recruitment and selection process includes taking up two references, applying for POVA first and CRB checks. Files also continue a copy Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 19 of the completed application form, confirmation of date of birth and address and a picture of the person. Care staff records contained certificates confirming that comprehensive training is provided by the home. Courses completed include: ‘Nutritional Update’, Fire training, emergency first-aid, moving and handling, infection control, medication administration and abuse aware The manager also indicated that training in dementia care and other specific and specialist training was being planned. The domestic has received first–aid, infection control and Control of Substances hazardous to health (COSHH) training. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 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) 36,37 and 38 Supervision of staff needs to be improved. The homes record keeping, policies and procedures are satisfactory. The promotion of health and safety in the home must be monitored more closely. EVIDENCE: Records in staff files and discussion with staff confirmed that the manager provides one to one supervision and appraisal on a regular basis. However some aspects of practice in the home should be more closely monitored. Records examined on the day of inspection where maintained and stored in accordance with the Data Protection Act. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 21 Records indicated and staff confirmed that moving and handling training is provided, observations during the day provided further evidence that service users and staff are safeguarded in this aspect of care. First-aid and infection control and COSHH training is provided. However the omission of labelling on stored cold and frozen foods does not meet food safety requirements. Records confirmed that fire safety drills and checks take place regularly and staff provided detailed information about the actions to be taken in the event of a fire. As detailed earlier in standard 18 the home must ensure that details of any event that affects service users must be forwarded to the Commission. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 1 STAFFING Standard No Score 27 2 28 3 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 3 x x x x x 2 2 2 Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 23 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 7 Regulation 15 Requirement The registered person must ensure that the care plans provide detailed instructions to staff about the interventions required by them to fully attain the goals of the service users. The registered person must ensure that the needs of service users are regularly reassessed and careplans revised accordingly. The registered person must ensure that care plans reflect the actual needs of service users. (Timescales 30/09/04 and 01/05/05 not met) 2. 9 13 (2) The registered person is required to ensure the records of medicines into the home are fully documented and accountable in accordance with the guidelines of the Royal Pharmaceutical Society of Great Britain. The registered person must ensure a record of food provided for service users is available in sufficient detail to enable any Immediate Timescale for action 01/02/06 3. 15 17 (2) 01/02/06 Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 24 4. 37 37 5. 26 23(d) 6. 7. 36 12 18 16 (2) (m) person inspecting the record to determine whether the diet is satisfactory in relation to nutrition and otherwise. The registered person must ensure that the CSCI is notified of any events in the home that may adversly affect service users including allegation of abuse of any one working in the home. The registered person must ensure that standards of hygiene and cleanliness within the home are imporved. The registered person must ensure that staff receive regular supervison. The registerd person must following consultation with service users provide a program of activiites. Immediate 01/02/06 01/12/05 1/10/2005 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 38 Good Practice Recommendations The registered person should ensure that all food items stored in the freezer have an used by date. Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 OQD 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 Neville House F54 F04 s5512 Neville House ann v236296 180805 Stage 4.doc Version 1.40 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!