Inspection on 30/07/07 for Neville House

This inspection was carried out on 30th July 2007.

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

Neville House 02/07/08

Neville House 17/05/06

Neville House 07/12/05

Neville House 18/08/05

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 Sandra Buckley Unannounced Inspection 30th July 2007 09:30 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 Neville House DS0000005512.V343902.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. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Neville House Address Neville Street Chadderton Oldham OL9 6LD 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) 01616275874 Dr Bhima Odedra No registered manager at present . Application to be submitted Care Home 17 Category(ies) of Dementia - over 65 years of age (5), Learning registration, with number disability over 65 years of age (1), Old age, not of places falling within any other category (9), Sensory Impairment over 65 years of age (2) Neville House DS0000005512.V343902.R01.S.doc Version 5.2 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). 5th October 2006 Date of last inspection 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 surrounding areas. The front of the home faces to a side road. The rear of the premises has a small car park and garden area. The property has been extended to provide accommodation in seven single and five shared rooms. Accommodation is available on the ground and first floors and a passenger lift is available. On the ground floor there is a large lounge and a dining room. Fees in the home range from £320 to £330. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was made on 30th July 2007. This inspection looked at all the key standards and included a review of all available information received by the Commission for Social Care Inspection (CSCI) about the service provided at the home since the last inspection. A new manger had been in post since April 2007. An application to be registered with the CSCI had been requested at the time of this inspection. The new manager demonstrated an awareness of their statutory duties. During the site visit information was taken from various sources, which including observing care practices and talking to people in the home. The manager, relatives and some members of the staff team were also interviewed. A tour of the home was undertaken and a sample of care, employment and health and safety records were seen. Comments from professionals and questionnaires returned from residents and their relatives are also included in this report. All the requirements made at the last inspection had been addressed. The CSCI requires the home to complete an Annual Quality Assurance Assessment (AQAA) in order to demonstrate the level of care provided. Comparisons are made with this document at the time of inspection. What the service does well: The atmosphere within the home was relaxed and staff related well to people in the home. People and visitors spoke highly of the staff team. Comments included: ‘Staff treat everyone exceptionally well and are nice to people’ and ‘They are very good staff and will help you with anything.’ Information gained from professionals through interviews and questionnaires included the following comments, one GP said ‘Staff are supportive and people are well cared for.’ One district nurse said, ‘Staff always keep me informed of any changes.’ Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 6 Good communication systems were in place and routines were flexible. One person said, ‘Staff always bring me a drink, even at 11.30 at night or 4 am if I cannot sleep.’ Staff knew people well and were able to link people’s past experiences with behaviour in the home. 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. The summary of this inspection report can be made available in other formats on request. Neville House DS0000005512.V343902.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 Neville House DS0000005512.V343902.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 Quality in this outcome area is good. The manager obtains a professional assessment of need prior to people entering the home to ensure their needs can be met. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Three case files were examined in depth and were found to have an assessment of need from professionals. The manager undertakes her own assessment should a person be self-funding. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 9 One person said, ‘I visited the home regularly to see my husband and found the care to be very good, before I made a decision to come in myself.’ Another person said, ‘I have been in two homes previously for respite care but decided to stay at Neville House, it was smaller and more welcoming.’ The home does not provide intermediate care. Neville House DS0000005512.V343902.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 & 10 Quality in this outcome area is good. Care planning and medication documentation were sufficient to show that people’s needs were being met. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: People were neatly presented and well cared for. Three case files and care plans were looked at in depth. The new manager was reviewing and updating documentation at the time of inspection. The manager provided examples of completed care plans, which reflected people’s assessed needs, risks assessments, social interests, personal history and religious practices. One file recorded that the person wanted regular visits from the church for Holy Communion, which had been arranged. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 11 One file had not been fully transferred from the assessment, which required details or explanation regarding how Alzheimer’s may present. The manager said they were aware of this and were reviewing the file. Daily notes also needed more detail on care delivery. The manager provided evidence that this issue was included on the next staff meeting agenda. Sitting weighing scales had recently been purchased and regular nutritional screening was undertaken for those who showed any weight loss. Professional visits were recorded and specialist referrals had been sought for one person. One person said, ‘I find the staff very respectful.’ Another person said, ‘They are very good staff and will help you with anything.’ Several people were aware of who their key worker was, saying ‘I have a regular key worker who helps me to have a bath which is good, but if they are not available, the other staff are quite good too.’ The inspector spoke to a visiting district nurse who sees three people in the home. They said, ‘Staff always keep me informed of any changes in care or prescriptions. I feel people are treated well and staff are always available when needed.’ Moving and handling equipment was available and care plans indicated that pressure relieving items, such as mattresses and cushions had been provided. Two relatives interviewed said, ‘When we visit our relative, she always looks neat and tidy although poorly and nursed in bed. Staff treat everyone exceptionally well and are nice to people. Our relative has also put on weight.’ Accidents were recorded; these would benefit from additional information. However, they were followed through to daily reports and care planning. The manager said there were a number of recording issues identified as needing more details, with this also on the agenda for the next staff meeting. Medication and administration practices were observed and found to be satisfactory and safe. Medication is securely stored and the administration records were accurately completed. Neville House DS0000005512.V343902.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15 Quality in this outcome area is good The daily routines in the home were flexible with people’s religious needs being identified. Visitors were made welcome, increasing a sense of fulfilment for people in the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Daily routines were flexible and people confirmed that they could choose when to get up and go to bed. People said, ‘I can go to bed at any time, staff come with me if I want help’ and ‘Staff always bring a drink round even when I’m in my room at 11.30 pm and sometimes 4 am when I can’t sleep. Also I have a newspaper delivered daily.’ Visitors said ‘we are always made welcome when we visit and are provided with a cup of tea’. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 13 The local church visits to give Holy Communion to people who wish to attend. Bingo was being played on the morning of the inspection. People spoke about an entertainer who had visited on 17th July 2007, that they really enjoyed and would like more often. An activity co-ordinator visits the home every two weeks for arts and craft. One person said, ‘I enjoy doing the arts and crafts; we made birthday cards last time’. Another said, ‘I like to sit out in the sunshine, the garden’s very nice.’ Other activities are reliant upon staff availability; however, a record was completed of what has been provided and who has participated. People also said that the hairdresser visits every two weeks. People were consulted on menu planning with evidence that changes had been made at their request. A choice of food is available and the inspector dined with people at lunchtime when one person requested a sandwich for tea rather than another hot meal. People said, ‘food is always very good.’ Some aspects of the dining experience could be improved, i.e., pots and cutlery were poor and required replacing. The manager was able to provide evidence that they had identified this, and had submitted an order for replacements. Staff at interview knew people’s history well and were able to link present activities in the home with people’s experiences. Neville House DS0000005512.V343902.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18 Quality in this outcome area is good. The home operates a robust complaints procedure. People in the home feel comfortable in raising any concerns, knowing they would be acted upon. Staff training in the protection of vulnerable adults ensures people are protected from abuse. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home’s complaint procedure is freely available to visitors and people in the home. Complaints or concerns were recorded and detailed outcomes of the investigation. One person said, ‘I would complain to the manager, which I have done in the past and felt very comfortable about it. Another said, ‘I would not be here if I had anything to complain about.’ Staff at interview demonstrated a good knowledge of how abuse may present and their role in reporting such an event. Training is provided in the protection of vulnerable adults. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good. People live in a safe clean environment which is reviewed and upgraded to ensure peoples comfort. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: A tour of the home was undertaken which was clean and tidy. Ancillary staff are employed 46 hours a week to maintain standards. The double glazed units in the lounge had failed and some furnishing and fabrics required replacing. The manager said that she was going to bring this to the attention of the registered owners. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 16 Although bedrooms have no en-suite facilities, they are situated in close proximity to toilets and bathrooms. Some commodes in bedrooms were outdated and needed replacing. There is a high proportion of shared rooms, with some being allocated for single use. Privacy curtains are provided for people in shared rooms. Most people’s rooms were personalised with items brought from home. One person said, ‘I brought in several things from home.’ Outside, the building grounds provided a pleasant garden and seating area. The laundry was clean and tidy with new equipment recently having been purchased. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 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 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 Quality in this outcome area is good. Staffing levels and training were sufficient to meet the needs of people in the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Staffing levels were maintained at an appropriate level to meet people’s needs. At the time of this visit 14 people were accommodated in the home. Three staff and the manager were on duty throughout the day, three staff were on duty late afternoon and evening and two night staff, together with cooks and ancillary staff. The home had a relaxed atmosphere, staff did not rush and interactions with people are good. Staff interviewed could link training they had undertaken to care practices. Staff induction was in line with Skills for Care. They gave examples of their role has a key worker, which included checking wardrobes, attending to personal care and working with families and professionals. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 18 A senior carer identified what additional responsibilities they had, for example, administration of medication. Staff were knowledgeable about the care people needed and were able to link previous life experiences to their behaviour in the home. Staff said they felt supported by the new manager and were positive about the changes made. Regular staff meetings and supervisions increased communications within the home. Employment records were examined and generally all the required information being obtained. One copy of a POVA first check was held electronically and should be placed on files. The manager had picked up on irregularities in recruitment and selection, prior to them taking up post and was investigating these at the time of inspection. All the people interviewed were positive about staff, saying ‘Staff treat me well.’ Several people made similar comments. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 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 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 & 38 Quality in this outcome area is good. Management of the home is inclusive of staff and people’s views, which promotes accountability and involvement for people living there. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The new manager has been in post since April 2007. They hold a BA Honours degree in Health and Social Care and have enrolled for NVQ level 4 in management. They have previous experience of working in care in a senior position. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 20 At the time of this inspection, an application for registration with the CSCI had been requested. Supervision and staff meetings were held on a regular basis. The agenda consisted of: security checks to be maintained, staff development and training issues, key workers to ensure all people’s hygiene tasks were completed and ensure people were offered drinks in the evening, even those who had gone to bed. Record keeping was also discussed, for example, the need for more detail in daily notes and not to use correction fluids on any documents. A residents meeting was held on 3rd July 2007, the agenda included: food presentation, how they would like this to be improved, with comments from people saying they enjoyed the arts and crafts but would like more entertainment. Any money held on behalf of people in the home is appropriately secured with cash reconciling with records. A quality assurance system was in place, including the views of people in the home and health professionals. One GP said, ‘Staff were very co-operative and people were well cared for.’ District nurses’ comments were also positive, saying, ‘Staff always keep me informed of any changes in care and prescriptions.’ Family questionnaires have been sent out but few had been returned at the time of this visit. Staff had completed health and safety courses and regular checks on equipment in the home were made. A fire assessment was undertaken by professionals on 25th May 2007, the requirements of which were being addressed at the time of this inspection. Neville House DS0000005512.V343902.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 22 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 Refer to Standard OP7 Good Practice Recommendations The manager should continue with the review of care plans, ensuring these are recorded to a consistent standard making sure all assessment information is transferred and people in the home and their representatives are involved. The good practice in the home of continually assessing the need to refurbish would benefit from a detailed refurbishment plan, which included replacement of the failed double-glazing and outdated commodes. Information relating to recruitment and selection of staff should be retained on files. 2 OP26 3 OP29 Neville House DS0000005512.V343902.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Manchester Local Office 11th Floor, West Point 501 Chester Road Old Trafford Manchester M16 9HU 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 Neville House DS0000005512.V343902.R01.S.doc Version 5.2 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. 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!