Inspection on 25/02/09 for Newquay Nursing Home

This inspection was carried out on 25th February 2009.

CSCI found this care home to be providing an Good service.

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

Newquay Nursing Home 09/04/08

Newquay Nursing Home 11/10/07

Newquay Nursing Home 25/06/07

Newquay Nursing Home 10/01/07

Newquay Nursing Home 27/06/06

Newquay Nursing Home 07/03/06

Newquay Nursing Home 17/11/05

Newquay Nursing Home 22/03/05

Newquay Nursing Home 24/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Newquay Nursing Home 55 Pentire Avenue Newquay Cornwall TR7 1PD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Pitts     Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Newquay Nursing Home 55 Pentire Avenue Newquay Cornwall TR7 1PD 01637873314 01637877886 info@newquay7.freeserve.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Mary Elizabeth Roy care home 41 Number of places (if applicable): Under 65 Over 65 41 0 old age, not falling within any other category physical disability Additional conditions: 0 41 To admit one named service user under the age of 65 years for respite for a period of approximately three months. Total number of service users not to exceed a maximum of 41 Date of last inspection Brief description of the care home Newquay Nursing Home is registered to provide accommodation and nursing care for up to 41 Service Users who fall into the categories of Old Age (OP), Old Age nursing (OP (N)), Physical Disability (PD) and Terminally Ill (TI). The home is situated on Pentire Avenue in Newquay and the location offers some of the service users a scenic view over the beach and out to sea, others can enjoy distant countryside views. Service user rooms are situated on the ground floor and the first floor. The Registered Provider is Mrs M E Roy and Mr T Roy is the Registered Manager. There is a shaft lift, which can take wheelchair users to the first floor. There is a small Care Homes for Older People Page 4 of 25 Brief description of the care home patio area to the rear of the building where Service Users can sit with a pergola. There is a small parking area to the front and rear of the building. Fees range from 308.09 to 550 pounds per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over a period of approximately 5 hours. We looked at the homes documentation, their most recent self-assessment, and survey responses from residents. We looked at the premises; spoke with the registered manager, Mr Roy, and staff; residents; and visiting relatives. We also observed staff carrying out their duties, and their interactions with residents. Overall, the home has improved since the last inspection and now provides a good standard of care and accommodation. The care staff work hard and well providing personal care. Nursing needs and individual needs are met. The current fee range is 308.09 to 550 pounds per week. The fees do not include additional charges for: chiropody, optician, dentist, daily newspaper, dry-cleaning. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are properly assessed prior to admission. The home does not provide intermediate care. Evidence: There is a current and regularly reviewed Statement of Purpose and Service User Guide. These are provided in each room, and are sent out on request to enquirers. Both documents and a copy of the most recent inspection report are displayed in the entrance to the home. Each service user is provided with a statement of terms and conditions. This document includes the room to be occupied. The contracts include the breakdown of fees to show who is making what contribution. We inspected the file belonging to a resident who had moved into the home recently. This showed good evidence of assessment prior to admission, which had been done by the registered manager. Care Homes for Older People Page 10 of 25 Evidence: The registered manager was observed to discuss with a relative the likely future care needs of a resident. The registered manager arranged to do a care needs assessment, and also discussed the likely equipment necessary and available to meet the care needs. Intermediate care is not provided at this home. There are no designated rehabilitation facilities and staff are not received rehabilitative training. Respite care is offered. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care needs are accurately described in care plans, and residents health care needs are met. Medicines are stored and administered safely. Residents said that staff were kind and respectful. Evidence: Care plans are in place for each resident, and provide an accurate picture of the residents care needs. The care plans did show resident involvement in reviewing their care plans, where possible. District Nurses regularly visit. Nutritional screening is a part of the homes admission procedure. Assessments are dated and signed. All the residents are registered with a local GP, and have access to opticians, dentists, and similar services. Residents and a visitor to the home confirmed that their (or their relatives) needs were met. All the comments received were complimentary of the care and the staff. All medication is administered by qualified nurses and a Monitored Dosage System is Care Homes for Older People Page 12 of 25 Evidence: used, though not everything comes in blister packs. The trained nurse on duty administers all medication, and these are dispensed directly from individual named packets or blister packs within the medication trolley to the resident. Medication Administration Records (MAR) are completed in an appropriate manner. The Medication Administration records are pre-printed by the pharmacist. When they are handwritten care should be taken to ensure they are checked and signed by a second person. Each resident has a photograph held on their medication sheet to ensure their correct identification during the administration of medicines. Records of medication received into the home and disposed of are kept. Medicines are stored securely. Residents informed the inspectors that they are treated with respect and their right to privacy is respected. There are Policies and Procedures relating to privacy, dignity, and choice. The double rooms are usually only occupied by two persons who express a wish to do so. Screening is provided in double rooms. The individuals preferred names is recorded. Residents all said that staff are polite and respectful. Staff were observed to interact well with the people in their care. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities provided are sufficient to meet the individual and collective needs of all the residents. Visitors are welcomed to the home. Residents enjoy the variety and quality of the meals that are provided. Evidence: There is an activities coordinator employed Monday to Friday for a period of approximately three hours per day. The weekly activity plan and record of activities reflects almost daily activities. There is an activity record but this should be amended so that there is one for each resident. Activities are varied and include gardening, crafts, and music. Residents personal choices, likes and dislikes, and wishes are ascertained and recorded. Several people visited the home throughout the inspection. The visitors book confirms that there are regular and frequent visitors to the home. The home has several seating areas and these are available to residents and visitors, including residents own rooms. There is evidence of choice and autonomy from residents comments and records, two residents confirming that they determined how they spend their day. Two residents Care Homes for Older People Page 14 of 25 Evidence: have their own telephone, and a cordless telephone is available to the other residents. There are regular visits and services provided by church clergy. Residents monies are handled by themselves or a family member, small amounts are available via the administration office. Residents are able to bring in personal possessions and furniture with them. Rooms are personalised to varying degrees. The home provides three varied, nutritious meals each day and a snack supper. The menu is regularly reviewed and operates on a four-week rotation. Food records are kept and show that residents have a choice. The residents confirmed that they are offered a choice at every meal. A member of staff goes round all the residents every day to get their meal choices. The daily menu is displayed in the reception hall and staff discuss daily choices with the residents. Fresh fruit and vegetables are available. There is always a waitress on duty at lunchtime. At teatime, the care staff serve the meals to residents in their rooms. The homes chef has completed the Chartered Institute of Environmental Health Level 3 Award in Supervising Food Safety in Catering. The residents comments on the quality of the food ranged from good overall to excellent. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes complaints procedure and safeguarding procedure. Evidence: There is a current complaints procedure included in the homes Statement of Purpose and Service User Guide, both of which are displayed in the reception and are provided to each resident. These documents are regularly reviewed. There have been no complaints received since the last inspection. The home maintains a complaints record and the registered manager understands that this is to be used to record any complaints and any subsequent action taken as a result. Residents said that they would feel able to make a complaint. Safeguarding training is included in the homes induction training for new staff. Nine staff have completed safeguarding training provided by the local authority, and the registered manager said that staff would continue to be going on this. There is a relevant and appropriate procedure in place, which staff have signed to say they have read. Safeguarding is included in the homes training handbook, which is given to all staff. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment meets the needs of the residents in a homely and comfortable way. Individual accommodation is personalised to varying degrees. Residents stated that they liked their rooms. Evidence: The home is accessible, the location being on the edge of Newquay and the layout of the home is suitable for its stated purpose. Many rooms have excellent sea views and others enjoy far reaching countryside views. Residents said that they liked their accommodation. There is a maintenance record book and a person is employed to do the maintenance in the home. Alarms are fitted on external doors. There is parking to the front and rear of the home, the former for approximately 6 vehicles. The home provides a range of shared facilities. These comprise the dining room, a large main lounge and a sea view lounge. The entrance hall is spacious and also provides a small seating area. Residents were observed choosing to sit in this area during the day. The furniture in communal areas is of a good standard and domestic in nature. There is plenty of natural lighting and adequate ventilation. There are no gardens but there is a small patio area to the rear of the home with a pergola. There are two bathrooms with assisted baths on the ground floor. On the first floor Care Homes for Older People Page 17 of 25 Evidence: there is a bathroom with assisted bath and a level entry shower. There is a shower chair for this facility. Most of the rooms have a toilet and wash hand basin. Additional toilets are located near the communal areas of the home. The rooms are individualised by their different shapes, sizes and decor. Rooms on the first floor have attractive sea or countryside views. There are a number of double rooms within the home, not all double rooms are occupied by two residents and suitable screening is in place in these rooms to afford privacy to both. Individual rooms are personalised and residents stated they were able to bring what they wished into the home depending on the space available. All rooms have a lockable space. A call bell system is in place. The laundry is located within the home, suitably placed away from where food is prepared or served. Laundry staff are on duty daily. Two industrial washing machines and one large dryer are available. There are sluice facilities on the ground and first floor. Liquid soap and paper towels were available to staff throughout the building. The building was seen to be clean, and there were no undue odours noted. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by the numbers and skill mix of staff. Residents are protected by the homes recruitment practices, and staff are trained to do their jobs. Evidence: At the time of the inspection there were 25 residents served by 2 nurses (including the registered manager) and 4 care staff. There were additional ancillary staff on duty also. The duty rota is accurate, and clearly shows who is actually on duty and in what capacity. The duty rota does show the registered managers hours. Shifts are generally: 7am-2:30pm (1 nurse plus 4 carers) - not including the registered manager. 2:30pm-10pm (1 nurse plus 3 carers) 10pm- 8am (1 nurse plus 2 carers) There are additional staff that work at peak times. There were sufficient staff at the time of the inspection. There are 14 care staff, of which 10 have achieved NVQ Level 2 or above. There is a rolling programme for training in 1st Aid, Safeguarding, Food Hygiene, Diet and Nutrition, Health and Safety, and Infection Control. Certificates of training are obtained and a copy kept. One staff personnel file was inspected and showed that the home adheres to a robust Care Homes for Older People Page 19 of 25 Evidence: employment procedure. A National Training Organisation compliant induction programme was seen to be in use for all new staff. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. The health and welfare of residents is promoted and protected. Evidence: The Registered Manager is a registered nurse and has completed the Registered Managers Award. There has been significant improvement since the last inspection in many areas. Staff and residents said that they had confidence in the registered manager. Residents said that they would feel able to express any concerns should they have any. Regular staff meetings are held and minutes are recorded. Regulation 26 reports are available for inspection. The home has received responses from an annual quality assurance survey carried out in 2007, and the registered manager has prepared a summary of the findings. The registered manager undertook to include an annual summary in the Service User Guide. This has not changed since the last inspection. Care Homes for Older People Page 21 of 25 Evidence: The home has no involvement with residents money, operating a system where funds can be drawn from the homes resources and subsequently invoiced to the individual. Receipts are kept and provided with invoices. Supervision records were seen to be kept in individual personnel files. Supervision is happening at least six times a year. The registered manager has recently sought the advice of the Information Commissioner to ensure that people requesting information were given all that they had a right to receive. There are comprehensive policies and procedures developed in conjunction with external consultants, which are regularly reviewed. There are individual and environmental risk-assessments in place, which are regularly reviewed. There is appropriate insurance in place and contracts for repair and maintenance of equipment and systems. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 The registered manager should ensure that staff provide two intitials on hand written MAR to show the entry has been checked as correct. The registered manager should change the collective activity records so that each resident has their own record. The registered manager should continue to ascertain the views of people that use the service and other stakeholders, summarising any findings and publishing these. 2 3 12 33 Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 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. 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!