Inspection on 26/09/05 for Newford Nursing Home

This inspection was carried out on 26th September 2005.

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

Newford Nursing Home 12/12/08

Newford Nursing Home 14/12/07

Newford Nursing Home 07/02/07

Newford Nursing Home 24/01/06

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 Unannounced Inspection 26th September 2005 10:00 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.V253834.R01.S.doc Version 5.0 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.V253834.R01.S.doc Version 5.0 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.V253834.R01.S.doc Version 5.0 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 23/02/05 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.V253834.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over four hours by two inspectors. A tour of the home was conducted where inspectors met and chatted with residents, visitors and staff. The inspector met with a group of staff and discussions were held. Relevant records and documentation were examined. Discussions were held with the manager and deputy manager of the home. Inspectors were unable to give verbal feedback at the end of the inspection as the manager and her deputy had had to leave to attend a Care Managers’ meeting. What the service does well: Staff engaged in conversation made some very complimentary comments about the service. ‘Our staff team are very friendly and we help each other’ ‘It helps having good management, the way the home is run improves team work’ ‘We provide excellent care to residents, we work very hard and are very committed to our job’ Staff commented very positively about the food offered in the home. ‘ We provide good honest home baking’ ‘ residents can pretty much have what they want’ ‘ we know their likes and dislikes well’ The standard of care planning throughout the home is consistently high. Plans are thorough and effective with regular reviews. The health care needs of individual residents are very well monitored and promoted. The inspector received positive comments from visiting relatives in relation to the standard of personal and nursing care provided at the home. The residents spoken to stated that they felt very well cared for by the staff and that the staff were always polite and respectful toward them. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 6 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. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 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 Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 Residents and their families could be assured that the home they were entering would be able to meet the resident’s assessed needs. EVIDENCE: Through examination of care plans it was identified that residents are only admitted to the home following an assessment of their needs. There was written evidence that these assessments had been done by the manager of the home. Social workers had also carried out assessments on residents funded by social services. A review was held six weeks following admission to the home to ensure that individual needs were being met. Two of the residents spoken to were able to recall that they had been visited by the manager of the home prior to their admission. Through direct observation of care being carried out, examination of care plans and discussions with residents and relatives it was identified that the assessed needs of the residents were being met by the staff at the home. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 9 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, and 10 There was a clear and consistent care planning system in place, which provided staff with the information they need to satisfactorily meet residents’ needs. Individual health care needs were well met and personal care was delivered in a respectful and dignified manner. EVIDENCE: A random selection of care plans was examined. Care plans were stored in residents’ bedrooms. The standard of care planning was very good. Extensive individual risk assessments had been developed along with the corresponding plans of care, both long and short term. Plans were informative and residents spoken to were aware of their named nurse and team carer. The plans had been evaluated on a monthly basis. There was evidence of multidisciplinary working. There was good GP support and evidence of regular contact, advice and support by other healthcare professionals as and when needed. The daughter of one resident stated how happy she was with the nursing care provided and how the home had helped her father recover from a nasty infection and that he was now eating and Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 10 starting to gain weight. Another visitor stated that the GP support was good. Another visitor told the inspector that her husband had been seen by the optician, chiropodist and GP and that, because her husband was PEG fed, he had been seen by the dietician. Care was carried out in a dignified and respectful manner. Staff were observed to knock before entering bedrooms and, when the inspector entered a room with a member of care staff she was introduced to the resident and permission was obtained before entering the bedroom. Care plans contained instructions on how to uphold privacy and dignity whilst carrying out personal care. Residents spoken to confirmed that staff were respectful towards them. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 11 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): 14 and 15 The meals in the home were good offering both choice and variety and catering for special dietary needs. Although there was written evidence of choices and preferences, staff will need to be mindful of this and refer to them in order to promote personal autonomy for residents accommodated in the home. EVIDENCE: Examination of individual care plans identified that personal choices were documented and promoted wherever possible. In relation to the routines of the day it was documented what time residents preferred to rise in the morning, where they preferred to take their meals, food likes and dislikes were noted. Preferences for baths or showers were documented including what time of day individuals liked to take these. One of the residents spoken to confirmed that he was given choices but that sometimes “it depended on the number of staff on duty” as to whether these were upheld. He stated that he liked to stay up longer in the evening but that “if the home was short staffed they would put him to bed earlier.” He also stated that he could walk short distances but that if they were short staffed Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 12 they transferred him in a wheelchair. He didn’t mind as he commented that “the staff were very good but were often run off their feet.” Examination of the staffing rota identified that there had been no staffing shortages within the periods immediately leading up to and following the inspection. Very positive comments were received from residents in relation to the meals provided at the home. Examination of the menus identified that these were six weekly rotational. They were varied and well balanced. There was a choice at every mealtime and special diets and preferences were documented and catered for. Mealtimes were flexible and some residents were observed to be eating at different times to suit their care plan, on the day of the inspection. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 13 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 18 The home provided a safe environment where residents were protected from abuse. Residents and their families could be assured that any concerns or complaints they had would be listened to, taken seriously and acted upon. EVIDENCE: There was a complaints procedure displayed within the home, which contained the contact details of the CSCI. The manager kept records of complaints and investigations together with any action taken. The CSCI had not received any complaints directly in relation to the home since the last inspection. The families of residents spoken to at the time of the inspection knew who to raise concerns with should they have any. Staff were given training on the recognition and reporting of abuse. This also formed part of the induction process for new staff. The systems in place at the home helped to ensure that residents were protected from harm or abuse. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 14 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, 21, 24 and 26 The home was accessible, well adapted and generally clean and hygienic throughout. Attention is required to maintenance of the environment. EVIDENCE: All rooms are single and all ensuite. The home had been adapted to meet the needs of individual service users. There was evidence that bedrooms had been personalised by the residents. An audit of replacement bedroom carpets and furniture is identified and incorporated into the homes redecoration/upgrade programme. There are no lockable facilities on the bedroom doors but this would be facilitated should any resident require their own key. Lockable facilities in the bedrooms are available on request. There are very limited garden areas accessible to residents and one area in particular gave cause for concern regarding the safety of residents. A double Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 15 fire door at the end of a corridor, which overlooks a caravan park leads onto a steep bank followed by some sloping bush land, which then drops on to the caravan park below. Garden fencing has fallen short of this area and a requirement has been made to ensure this area is made safe and secure. The carpeting in the reception area and corridors in the north and west wing are in need of replacement. The corridor carpets are at least 10 years old and the reception area at least five years old. This is a very busy nursing home and the wear and tear of those carpet areas is very apparent. They are stained and all attempts of removing these stains have failed. Discussions took place on this and the care manager explained that quotes have been undertaken to replace these areas with good quality non-slip vinyl flooring. There were adequate amount of baths and one shower available in the home. However, two bathroom floors (one in the North corridor and one in the west corridor) were split and were not impervious and need to be either made good or replaced. Requirements have been made to replace these floor areas further in the report. The domestic staff explained how the laundry and domestic rota works and their duties in relation to this. A discussion was held with the care staff regarding the general cleaning schedule of the home, all staff thought the home was well kept. Clinical waste category A and E was disposed of in line with infection control regulations. Red disposable bags were used for foul linen. The laundry was inspected and although small was fully functional with two washers and one dryer. The kitchen was inspected and as expected a little untidy just following the main meal of the day. All machinery was in good working order; fridges were clean and well stocked. Food was labelled appropriately and stocks and supplies were plentiful. Staff reported a full supply of incontinent equipment, crockery, flat linen and all the necessary stocks needed in their working environment. Any shortfalls noted were replaced promptly. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 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, 29 and 30 Staffing numbers and skill mix was appropriate to the needs of the residents at the time of the inspection. Recruitment procedures were not in line with current requirements and this could be detrimental to resident’s welfare. Staff training, and care staff supervision was ongoing. EVIDENCE: At the time of the inspection there were 38 residents accommodated in the home all with nursing needs. (One nursing resident was in hospital at the time of the inspection). There was one vacancy. The care manager has two supernumerary days a week and the deputy care manager has one-day supernumerary. Through discussions with staff members, it was identified that the home was staffed as follows. From 7.30am-2pm there were two Registered Nurses and six care staff and from 2pm-9pm there were two Registered Nurses and four care staff. At nighttimes, from 9pm-7.30am there was one Registered Nurse and four care staff. Additionally, there was an extra member of care staff employed in the home seven days a week on the early shift to help with bathing and feeding of residents. The home is also registered to take some day Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 17 care residents. At the time of the inspection only one gentleman was receiving day care but due to illness had not been attending the home regularly. The two activity staff generally worked Monday to Friday 8.00am – 4.00pm, but these hours would be changed in order to meet the activities programme organised within the home. There were sufficient domestic, laundry and catering staff working in the home. The home provides seven-day cover. Additionally, on a Wednesday and a Thursday there are two extra domestics to undertake weekly ‘spring cleaning’ tasks. There were two staff in the laundry on a Monday and the night staff also laundered flat linen. There was one part time handyman/gardeners who worked 16 hours but would be on call to respond to any unforeseen maintenance duties. There was one administrator who works 9.30 – 2.10, five days a week. Recruitment procedures were determined and some shortfalls were noted. Two personnel files were examined in detail for those members of staff who had most recently been employed in the home. CRB and POVA first checks had been not been undertaken; two written references had not been obtained. This was discussed at length and requirements have been made in this regard. Induction programmes were in place with all new starters receiving up to 12 weeks to familiarise themselves with their duties and surroundings. However, for those two induction programmes viewed neither had been completed within the 12-week timescale laid down by the homes policy. A requirement was left in this regard. Discussions with various staff members identified that mandatory staff training had taken place on a regular basis including moving and handling and fire safety. The deputy care manager holds a current manual handling trainers award and with the assistance of an external trainer, manual-handling training is delivered to all disciplines of staff. NVQ training was on going throughout the home, six staff were undertaking Level 2 in direct care and two staff members were undertaking Level 3. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 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): 32,36, 37 and 38 Staff and residents felt supported by the management structure of the home and their safety and welfare was promoted and protected. EVIDENCE: The home was running well at the time of the inspection. Staff stated that they felt well supported by the management at the home. They stated that the manager was approachable and ran an open door policy. Staff meetings were held and documented; there had been a senior care meeting followed by a general staff meeting last month. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 19 Care staff supervision was ongoing but did not occur every two months in line with National Minimum Standards. A recommendation has been made to this effect All three mobile hoists in the home and the nurse call systems were fully operational. Window restrictors are on all windows in the ground floor building. Accidents had been recorded and audited on a regular basis. Regular checks had been carried out and documented on hot water temperatures, Emergency lighting, Fire Alarms, PAT testing and all the required servicing and maintenance of equipment had been carried out. Records and documentation were kept securely and in accordance with Data Protection requirements. Individual care plans were kept in resident’s own bedrooms. Following discussions with management it was determined that night staff have yet to receive a minimum of four fire drills a year. A recommendation was left in regard to this shortfall. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 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 x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 3 x x x 3 3 3 Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 19 Regulation 23(2)(o) Requirement All unnecessary risks to the health and safety of residents are identified and eliminated. All areas in the grounds accessible to residents must be made safe. Carpets in the corridors of the North and West wing and reception area need replacing. Timescale for action 20/12/05 2 19 23(2)(b) 20/03/06 3 4 19 29 23(2)(b) 19(2)(b) Schedule 2 5 30 18(1)(c)(i ) Bathroom flooring needs to be 20/01/06 made good or replaced in the North and West wings. All prospective employees must 20/10/05 undergo a current POVA and CRB check, supply two satisfactory written references, prior to commencing duties within the home. To ensure that all new staff 20/10/05 undertake and complete an induction programme within 12 weeks of appointment to their posts. Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 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 2 Refer to Standard 36 38 Good Practice Recommendations All care staff should receive supervision every two months Night staff should receive four fire drills annually as a minimum Newford Nursing Home DS0000026954.V253834.R01.S.doc Version 5.0 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. 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