Inspection on 24/01/06 for Newford Nursing Home

This inspection was carried out on 24th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Newford Nursing Home 12/12/08

Newford Nursing Home 14/12/07

Newford Nursing Home 07/02/07

Newford Nursing Home 26/09/05

Newford Nursing Home 23/02/05

Newford Nursing Home 03/11/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Newford Nursing Home Newford Crescent Milton Stoke-on-trent Staffordshire ST2 7EQ Lead Inspector Mrs Yvonne Allen Announced Inspection 24 January 2006 9:45 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 Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newford Nursing Home Address Newford Crescent Milton Stoke-on-trent Staffordshire ST2 7EQ 01782 545547 01782 536364 newford@btopenworld.com 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) Newford Limited Mrs Joanne Marie Webb Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (40) of places Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. PD between the ages of 30 and 60 years - 8 beds. Day Care PD - 2 beds. Day Care OP - 6 beds. Date of last inspection Brief Description of the Service: Newford Nursing Home is registered to provide nursing care for up to forty older people. Of the 40 registered beds up to eight can be used for younger people aged between 30 and 60 years on admission who have a physical disability. The home also provides day care facilities for up to six older persons although younger adults with a physical disability can access two of the day care places. The home is a purpose built single storey building situated approximately half a mile from the village of Milton. All of the bedrooms are single rooms with an adapted en-suite consisting of toilet and wash hand basin. There are three assisted bathrooms, one ‘step-in bath and one ‘walk-in’ shower for service user use, six small lounges, a dining room with bar and a conservatory. There is a central kitchen and laundry facilities. The home is located within close walking distance of bus and road networks. There are parking facilities close to the main entrance. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over four hours by one inspector. A tour of the home was undertaken where all of the communal areas and a selection of bedrooms were inspected. Discussions were held with several residents, two visitors and several staff members. Discussions were also held with the registered manager and deputy manager of the home and the new management company who had recently taken over the operational management of the home. Relevant records documentation and supporting evidence were examined. Comment cards had been received from the GP, Care Manager and two relatives – one with an accompanying letter. All comments have been included in this report together with comments received on the day of inspection. Not all of the standards were examined at this visit but those scoring less than 3 or not assessed at the previous inspection were examined. There have been some requirements and one recommendation made as a result of this inspection and verbal feedback was given to the registered manager and management company at the end of the inspection. The inspector was made to feel very welcome by the residents and staff in the home. What the service does well: This was a positive inspection and the home continues to fully meet almost all of the minimum standards and excelling in some. Those standards scored at 2 were almost met and a requirement has been made in order to improve in this area. The home provides a safe and comfortable environment for the residents who live there. Residents feel very well cared for and these were also the feelings of the relatives spoken to at the time of the inspection. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 6 The medical and nursing care provided to individuals is excellent and comments from the GP who has patients accommodated at the home read – “I feel that the home has an excellent nursing team. They are very professional and the standard of care is second to none. I highly commend this home.” The quality assurance carried out at the home is very good with both internal and external auditing in operation. What has improved since the last inspection? What they could do better: Individual residents must be offered an alternative at each mealtime and personal preferences upheld wherever possible. Observation of residents whilst they are sitting in the lounges is needed. The residents have limited access to nurse call bells in the communal areas and are in need of staff attention in order to access drinks and toilets as required. The environment is now looking tired and in need of redecoration and refurbishment. The providers have plans in place to start the redecoration programme and a copy of this now needs to be forwarded to the CSCI. Throughout the report there are some concerns and issues documented. These have been brought to the inspector’s attention from a letter and telephone call and it must be noted that these concerns are all from the same family. Please contact the provider for advice of actions taken in response to this Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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 the following standard(s): 1, 2 and 5 Prospective residents and their families are able to make an informed decision before coming into the home. EVIDENCE: The Statement Of Purpose had been recently amended to include the details of the new operational management structure. This document was available to prospective residents and placement officers. Each resident is issued with a statement of terms and conditions when entering the home and a sample of these were seen. Whether entering through Social Services or self-funding, the first six weeks are regarded as a trial period at the end of which a review of the needs assessment is carried out. The contracts specify what is and what is not included in the terms. The manager stated that residents and families are encouraged to come and visit the home prior to admission and meet the staff and other residents before making a decision on whether to come into the home. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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): 7, 8, 10 and 11 The standard of care planning, nursing and medical care at the home is very good. Staff will need to ensure that individual residents are able to communicate their needs at all times. EVIDENCE: Care plans are kept in resident’s own bedrooms where they are accessible to them and/or their representatives. Care plans were not looked at in great detail as these had been assessed at the previous inspection. A letter had been received by the CSCI following the inspection from the family of a resident in the home. The inspector followed the letter up by telephone discussion following the inspection, with one of the relatives. The relatives felt that the nursing and medical care which their relative had received since she had been residing in the home had been very good and were very happy with her overall progress. They did feel, however, that in the past, communication had not been as good as it could have been but that, following discussions with the staff and manager, this had now improved. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 11 Very positive comments were received from the GP in relation to the standard of care and nursing care provided at the home and these have been included in the summary of this report. Some issues raised included the following – until recently residents were served hot drinks in cups without saucers, and these had been provided the day before the inspection. The presentation of drinks is important to individuals and staff must ensure that dignity is promoted in this area. It had been noted that some of the residents were unable to access a call bell whilst sitting in the lounge to ask for drinks and had resorted to shouting on occasions. Staff must ensure that if residents do not have direct access to a call bell whilst sitting in the lounges then these areas are supervised. It was identified that the home had a policy in place in relation to death and care of the dying. There was no statement in place in relation to the procedure for the event of sudden or unexpected death. This must be developed and made available for the staff. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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): 12 and 15 The home continues to provide an extensive programme of therapeutic activities and entertainment for the residents who live there. However the provision of this will need to be monitored in order to ensure that the cut in coordinator hours does not have a detrimental effect. The provision of choice in relation to meals will need to be addressed with an alternative displayed. EVIDENCE: Discussions with the activities co-ordinator, the manager and the operations manager revealed that the number of activity co-ordinator hours provided had been reduced at the home and there was now one co-ordinator instead of two employed. Discussions with the co-ordinator revealed that she was continuing with the extensive programme of therapeutic activities and entertainment as much as she was able but that she had concerns about who would cover this during her holidays. This was discussed with the manager and operations manager who stated that arrangements would be made to cover the activities programme when required. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 13 The residents were observed eating lunch, most were dining in the main dining room whilst some preferred to stay in their own bedrooms to dine. The main meal was a lamb dinner and this looked appetising. Care staff were observed helping residents who could not manage themselves. The nurse in charge was also observed helping to feed residents and supervising over lunch. Examination of the menu revealed that this is based on a six-week rota. The menu did not specify an alternative at lunchtime and this was discussed with the cook. She showed the inspector a list of residents’ names and food dislikes which was displayed on the kitchen wall. She stated that if individual residents did not like the main menu then they are offered an alternative and that she would cook whatever they would like. Residents spoken to at the dining tables stated that they were enjoying their meal but were unaware that there was an alternative. Written comments received from the same family identified that they had been dissatisfied with the meals provided for their relative and that requests for changes to these meals had not always been addressed. A customer satisfaction questionnaire completed recently identified that the relative of the family (resident) is now satisfied with the meals served to her and that she does choose her meals. The family were also concerned that, when fish and chips are on the menu this is served as fish fingers and not proper fish. This must be addressed. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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): 16 and 17 Residents could be assured that any concerns they had would be listened to and acted upon. The legal rights of residents are maintained by the home. EVIDENCE: There was a clear and accessible complaints procedure displayed in the home. The CSCI had not received any complaints in relation to the home since the last inspection. Written comments received by the CSCI from one family identified that they had had difficulties expressing their concerns in the past but that this had now improved. The legal rights of service users are upheld wherever possible. The manager stated that she completes the election role and that at election times residents are helped to vote – usually by postal voting or, if possible by visiting the local polling station. Advocacy services could be accessed if required and some residents used the services of a solicitor to deal with their affairs. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 22, 23 and 25 The environment, although pleasant, safe and homely, was in need of redecoration and refurbishment. EVIDENCE: A tour of the home was undertaken where it was identified that the home was now looking worn and in need of redecoration and refurbishment in many areas. The carpets in the lounges were in urgent need of replacement. The programme of redecoration/refurbishment was discussed with the operational managers and it was agreed that they would furnish the CSCI with an action plan in relation to this. It was also noted that some of the bedroom windows were covered in condensation and, in room 12 this was particularly bad with restricted viewing for the resident. The visitor stated that the window was very often like this. This problem was discussed with the operational manager at the time of the inspection and will need to be addressed. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 16 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): 27, 28 and 30 Staff were provided in sufficient numbers and had the necessary skills to care for the residents accommodated in the home. EVIDENCE: At the time of the inspection there were 39 residents accommodated in the home, all in receipt of nursing care. The manager was supernumery and the Deputy Manager was the second nurse on duty. There was a first level nurse in charge working on the floor together with seven care assistants. From 2pm– 8pm there was two nurses plus four care staff and from 8pm-8am there was one nurse plus three care staff. The number of night staff had recently been reduced by one carer but this was still in keeping with the existing staffing notice. The number of domestic assistants provided at the home had not changed, there were two domestics on duty daily each working six hours plus an assistant working in the laundry. There had been some changes made to the kitchen staff hours. From 7.30am until 2.30pm there was one cook and one assistant and from 2.30pm there was one assistant. As previously outlined, the number of activity hours had been reduced down to 18 at the home and there was now one co-ordinator as opposed to two. Maintenance and administration hours were unchanged. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 17 The inspector was informed that there was now 40 of all the care staff trained to NVQ level 2 and above in direct care and that there were more care staff registered on the training programme. There was also a staff training and development programme in place at the home. Staff stated that they felt supported with their training needs. The registered nurse on duty stated that she received regular updates in mandatory health and safety training including moving and handling, fire safety and infection control. She had also received training in enteral feeding. Three examples of where new staff had received induction training were seen. These had been completed by the inductee and signed off by the mentor. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 18 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): 31, 32, 33, 35 and 38 The management of the home has been consistent and effective over many years. EVIDENCE: Both the manager and deputy had commenced the RMA training course but had been having difficulties completing the course with the local college. It is recommended that they continue to try and address this problem and gain the award as soon as possible. All the staff spoken to stated that they felt very supported by the manager and the deputy. Both had played an important role in maintaining staff stability through the changes, which had occurred over the recent weeks. The visitors spoken to at the time stated that the manager was approachable and had dealt effectively with any concerns they had. One comment read – “We are always made most welcome and are invited to all of the social Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 19 evenings. A very pleasant and well run home”. Other comment cards, with the exception of one, had included indications that relatives were kept informed. The managers of the home carry out quality assurance on a regular basis and examples of these records were seen at the time. The manager and deputy carry out spot audits every three months and records of these were seen. All areas and services provided are audited at least on an annual basis, with records kept. The Home is also audited by external bodies – ISO and IIP. The new operations managers agreed to complete a Regulation 26 monthly report and send it through to the CSCI. The administration of residents’ pocket monies and finances was examined with the administrator and records had been maintained as per requirements. Records had been maintained in relation to formal staff supervision and this was well underway at the home. Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 20 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 3 x x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 2 3 x 3 3 x 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 3 3 3 x x Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? yes 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 19 Regulation 23(2)(b) Requirement Carpets in the corridors of the North and West wing and reception area need replacing. PREVIOUS REQUIREMENT An action plan must be forwarded to the CSCI outlining the redecoration and refurbishment programme for the home. This must include the plans for renewal of the windows identified. Where fish is on the menu then this must be presented in the form of true fish and not as fish fingers An alternative to the menu must be displayed to the residents at each mealtime. If individual residents do not have direct access or the ability to a call buzzer whilst seated in communal areas then these areas must be supervised by staff Timescale for action 30/05/06 2 19 23(2)(b) 10/03/06 3 15 16(2)(i) 20/02/06 4 5 15 10 and 4 16(2)(i) 13 (4) 20/02/06 28/02/06 Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 22 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 12 Good Practice Recommendations That the provision of dedicated activity hours is monitored by the home and increased if required Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Newford Nursing Home DS0000026954.V262993.R01.S.doc Version 5.1 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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