Inspection on 23/11/05 for Newlands Nursing Home

This inspection was carried out on 23rd November 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

Newlands Nursing Home 11/12/06

Newlands Nursing Home 31/05/05

Newlands Nursing Home 11/11/04

Newlands Nursing Home 10/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Newlands Nursing Care Centre Evesham Road Stow-on-the-wold Glos GL54 1EJ Lead Inspector Mrs Eleanor Fox Unannounced Inspection 23rd November 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 Newlands Nursing Care Centre DS0000016509.V266902.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. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Newlands Nursing Care Centre Address Evesham Road Stow-on-the-wold Glos GL54 1EJ 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) 01451 870077 01451 832373 Berkeley Healthcare Ltd Mrs Fatima Parker Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The manager is to complete NVQ level 4 in management or similar management qualification by 30th September 2005. 31st May 2005 Date of last inspection Brief Description of the Service: Newlands is a most attractive substantial house situated on the outskirts of Stow-on-the-Wold, within walking distance of the local shops. It has been sympathetically converted to provide comfortable accommodation for 22 elderly residents who require nursing care. All the bedrooms offer single accommodation for the service users; three may be converted into double rooms if required by couples. Each well proportioned room has en suite facilities and has been decorated and furnished to a very good standard. A shaft lift provides access to the upper floors. The communal areas on the ground floor consist of a spacious lounge, dining room and conservatory. The property is surrounded by extensive well-maintained gardens and has the benefit of delightful views of the surrounding countryside. Fifteen freehold properties have been built on land adjoining the Home. Residents living in these houses do not require nursing care from the home but may use the dining facilities by prior arrangement. Plans are currently being considered to provide additional accommodation next to the Nursing Home. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection over a period of 6.5 hours. During the day she talked to eight of the residents, read their care records, visited their bedrooms and observed the service of the lunchtime meals. The inspector also spoke with members of staff, and looked at a selection of recruitment records and other documents, which were available in the home on that day. Finally, although the Registered Manager was not on duty, the inspector was able to talk with the General Manager who is responsible for administrative duties and to the nurse in charge, both of whom were most cooperative in providing information as requested. What the service does well: What has improved since the last inspection? Members of staff at the Home are to be commended once more for addressing and rectifying all the requirements identified at the previous inspection. There have now been improvements in the standard of record keeping and in the provision of information to prospective residents. There have also been significant developments in the provision of appropriate diversionary activities to suit the individual needs of each of the residents. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 6 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. Newlands Nursing Care Centre DS0000016509.V266902.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 Newlands Nursing Care Centre DS0000016509.V266902.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): 1,2,3 and 5 The provision of detailed information, a thorough assessment process, and a visit to see the facilities enables residents to make an informed decision regarding their admission and gives them assurance that their needs will be met. EVIDENCE: The Statement of Purpose and Service User’s Guide have been reviewed and updated to contain full information about the Home. These documents are provided to prospective residents but are also included in an ‘Information File’, which is kept in the front hall of the Home. This file also contains additional details about the Home. One visitor commented that she enjoyed reading about many of the events that had occurred at Newlands throughout the year. Each person is provided with a fully detailed copy of the terms and conditions for admission to the Home. The completed documentation for a resident who had recently been admitted was seen on this occasion. If appropriate, the documentation also includes details about the levels of any ‘RNCC’ financial contribution to which the resident may be entitled. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 9 The Registered Manager undertakes a full assessment of any person who wishes to be admitted to Newlands. A comprehensive document is completed during this process and retained to form a basis for the care planning processes when the resident comes into the Home. Prospective residents are encouraged to visit Newlands, meet the other residents and to sample the food served. Some people come into the Home for at least one respite stay before deciding on a permanent admission. One person did mention that a lunch party had been arranged to welcome a new resident to the home. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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 and 9 The care planning and medication administration systems in place need some further improvement in order to ensure that residents are not put at any risk of potential errors. EVIDENCE: Full and well-detailed specific care plans are provided for each resident. These are normally signed by the resident or close relative to signify involvement in the processes. However, although an initial assessment is completed prior to arrival at Newlands, any further reviews of these assessments are no longer recorded. This good practice must be reinstated at the home. Appropriate risk assessments continue to be completed for each person and, where necessary specific care plans are prepared to address any identified issues. The Home has a fully detailed drug administration policy developed by the Company. Medications including controlled drugs, are ordered, stored, and administered correctly. Some of the handwritten medications in the drug records seen on this occasion had not been signed correctly. The secure mobile drug trolley was used during the process of medication administration on each Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 11 drug round on this day. It was confirmed by the nurse in charge that this is normal practice at this home. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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, 13 and 15 Active encouragement to maintain links with family and friends helps enrich the residents’ social opportunities. The consistently excellent choice and variety of meals ensures residents receive a nutritious and balanced diet. EVIDENCE: Although not inspected in detail, it was impressive to see the significant improvement in the variety of diversionary activities, which are now arranged to suit the needs of individual residents. Visitors are welcome in the Home at any time and are invited to have a meal with a resident if they wish. A daughter and her husband enjoyed lunch with her father on this day. Families also receive copies of the Home’s newsletter and details of any planned events, which they are welcome to attend. Relatives and friends were seen talking to residents in one of the comfortable communal areas or in the privacy of their bedrooms. The recently appointed chef is now well established in the Home. He already has a good knowledge of the personal preferences of each of the residents. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 13 The chef has developed menus containing an excellent choice and variety of food. Lunch on this day was served in the attractive dining room although some people preferred to remain in their bedrooms. Only one person required any assistance with the meal and she was helped in a considerate and unhurried fashion. No special diets are required at the current time although two people have a soft diet prepared. Residents described the food as, “excellent”, “I can usually choose something I like” and “It suits me”. Only one person described the vegetables as “sometimes tasteless” otherwise all the remarks were complimentary. Although the kitchen was clean and well organised, it was observed that some members of staff came in and out of the kitchen without wearing protective clothing, even when food was being served. This issue is now being addressed. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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): Not Applicable EVIDENCE: These points were not addressed on this occasion as the Home met these standards at the previous inspection. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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 and 26 Some improvements to the environment are required to ensure that residents are provided with a safe standard of accommodation. EVIDENCE: The majority of the home was attractively decorated, well maintained and furnished with comfortable furniture to meet the needs of the residents living at Newlands Nursing Care Centre. One room was being completely redecorated prior to the admission of a new resident. Carpeting in some of the corridor areas is worn and is scheduled for replacement shortly, as is the carpet in the dining room. There were vases of fresh flowers throughout the communal rooms on the ground floor, enhancing the general appearance of the home in these areas. Work is progressing well to ensure that the remaining radiators in the Home are fully covered and do not pose a risk to the residents. On this occasion, all the machines in the laundry were in use. It was a cold day and it was observed that the ceiling was damp and flaking and there appeared Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 16 to be mould growing in one part of the room. The recently washed clothes had been folded tidily but had been left uncovered and exposed to the flaking ceiling. It was mentioned that a window is usually opened to provide some ventilation to the area. Care staff who were questioned about infection control processes in the laundry had only minimal knowledge on the subject. The sluice facility is very small and has no obvious means to disinfect infected equipment. It was confirmed by two members of staff that commodes are usually emptied into the resident’s en suite toilet and washed out in the bath. This is not acceptable practice. The whole home appeared reasonably clean and there was no evidence of offensive odours in any area. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Skill mix and staffing numbers continue to be adequate to meet the majority of the needs of the residents living in the Home. EVIDENCE: There were twenty-two people living in the home on this occasion; the majority had low dependency needs. Observation of the duty rosters showed that there is always at least one qualified nurse on duty with four carers each morning; a nurse and three carers each evening and a nurse with one carer overnight. Additional ancillary staff are employed to address catering, cleaning and general maintenance duties. The General Manager looks after the administrative functions in the home. At present the care staff take responsibility for the laundry. It was mentioned that this does cause difficulties, especially on night duty when staff have reduced time to look after the residents. It is recommended that consideration be given to providing a dedicated laundry assistant. Residents spoken to on this visit made comments such as, “ The staff are kind but are so very busy” and “the staff do not have time to talk to us any more.” Others, however, were quite satisfied with the care they received in the home. Scrutiny of the personnel records relating to staff employed since the last inspection showed that careful recruitment processes continue to be observed in the home. All the required employment checks are undertaken before the Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 18 member of staff joins the team and each person is fully inducted and supervised in their new roles. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 37 Through the implementation of effective management policies and procedures, residents are protected and their rights are upheld. EVIDENCE: The Registered Manager, a qualified nurse experienced in the care of the elderly, is currently undertaking the Registered Manager’s Award. She was attending a study session on this day. There was also documentation to show that the Manager has attended ‘update training’ during the year to ensure she keeps abreast with current practice. The senior members of staff continue to take responsibility for the personal monies for some of the residents; four were randomly selected for inspection. The money is maintained in individual secure storage and accurate records documented; these are audited on a monthly basis. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 20 Clear and appropriate records are maintained in the home, both electronically and in paper form. Data Protection requirements are observed although the Manager is reminded that ‘CRB’ screening results for any members of staff employed before 23/11/05 may now be shredded. Any screening results received after this date must be retained for the next inspection. Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x x x x x 1 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x 3 x Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 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. 1 2 Standard OP7 OP9 Regulation Requirement 14(2a & The assessments of service b) users’ needs must be kept under review and revised as necessary 13(2) The person making the record in the drug administration documentation must sign any handwritten amendments 16(2j) & Any person entering the kitchen 13(4a) must wear adequate protective clothing to maintain satisfactory standards of hygiene. 13(4), Deficiencies in the carpets in the 23(2b) corridor areas and in the dining room must be addressed. 23(2b) The maintenance and decorative requirements in the laundry room must be addressed 18(1a and All appropriate staff must receive c) training in infection control processes, particularly in relation to laundry and sluicing processes 23(2k) The home must provide adequate sluicing facilities 31/01/06 31/01/06 31/12/05 3 OP15 31/12/05 4 5 6 OP19 OP26 OP26 28/02/06 31/03/06 31/01/06 7 OP26 31/03/06 Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 23 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 OP27 Good Practice Recommendations It is recommended that consideration should be given to providing a dedicated laundry assistant Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Newlands Nursing Care Centre DS0000016509.V266902.R01.S.doc Version 5.0 Page 25 - 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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