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Inspection on 28/06/05 for Nicholas Rothwell House

Also see our care home review for Nicholas Rothwell House for more information

This inspection was carried out on 28th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Senior staff from the Home carry out a through assessment of all prospective Residents and only those people who`s needs can be met in full are admitted to the Home. Care is taken to ensure Residents` needs are constantly monitored and reviewed and that staff are kept fully briefed on any changes. The Home has a committed and caring staff group who work together as a team. Staff turnover is low and this provides Residents with continuity and consistency of care. Residents spoken with felt that their relationships with staff were very good and that staff provided them with good care, support and encouragement. Residents are given choice in the daily menu and they felt that their likes and dislikes and special dietary needs were known and respected by the catering staff.Routines in the Home are relaxed and flexible and Residents confirmed that they were free to choose how and where they wished to spend their time. Residents are encouraged, supported and enabled to be as independent as possible and staff take care to protect their privacy and dignity when caring out personal care tasks. Relatives commented that they were kept well informed on the progress of their Residents. They felt welcome to visit the Home at anytime and stated that staff made time to talk with them. The Home`s medication system was safely and efficiently managed. The general and domestic maintenance of the Home was good providing the Residents with comfortable and homely surroundings.

What has improved since the last inspection?

Improvements have been made to the lighting in the lounge areas. A further en suite facility has been created in one room for the convenience of the Resident.

What the care home could do better:

Improvements to the lighting of the bedrooms can be made to create a more homely atmosphere. Care must be taken to obtain the necessary clearances for staff before they commence employment in order to protect Residents. Residents should be fully encouraged to be involved in the safekeeping systems for their moneys and receipts must be maintained where items are purchased on behalf of Residents by staff.

CARE HOMES FOR OLDER PEOPLE NICHOLAS ROTHWELL HOUSE 290 Harborough Road Kingsthorpe Northampton NN2 8LR Lead Inspector Pat Harte Unannounced 28th June 2005 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 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. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Nicholas Rothwell House Address 290 Harborough Road Kingsthorpe Northampton NN2 8LR 01604 841882 01604 850845 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Elizabeth Berrill, Charity of St Giles, Nicholas Rothwell House, 290 Harborough Road, Kingsthorpe, Northampton, NN2 8LR Mrs Margaret Rafferty CRH 21 Category(ies) of OP - Old Age - 21 places registration, with number PD(E) - Physical Disability over 65 yrs - 2 places of places MD(E) - Mental Disorder over 65yrs - 2 places NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within the category of PD (E) can be admitted where there are 2 persons in that category already in the Home. No person falling within the category of MD (E) can be admitted when there are 2 persons in that category already in the Home. Date of last inspection 8..11.2005 Brief Description of the Service: Nicholas Rothwell House is a Residential Care Home owned by the St. Giles Charity Estates and managed by Mrs. M. Raffety. The Charity, founded in the 15th Century, is non profit making. The Home provides care for Residents over the age of 65 and includes two places for People with Physcial Disabilities. The premises are situated in quiet and pleasant surroundings on the north side of Northampton and are easily accessible being just off the main A508 Harborough Road. Accomodation provided to Residents is soley on the ground flloor. There are up to twelve permanent places with the rest being short term care. Residents are provided in the main with single bedrooms, there is one double bedroom. There is a large comfortable lounge/dining room and a conservatory/lounge overlooking the patio garden. Residents come to the Home for a variety of different reasons, perhaps when their relatives or carers are on holiday; they have had a minor mishap at home, they have been discharged from hospital and unable to go straight home or they are unable to continue living in the community. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three Residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. In addition discussions were held with the Manager, four staff, seven other Residents and four visiting Relatives. Written comments were also received from fourteen Residents, eight Relatives and two visiting Professionals. Comments on the care provided by the Home were very positive. A partial tour of the premises took place and a selection of records was inspected. The Inspection was unannounced and took place during the late morning and afternoon over a period of four and a half hours. What the service does well: Senior staff from the Home carry out a through assessment of all prospective Residents and only those people who’s needs can be met in full are admitted to the Home. Care is taken to ensure Residents’ needs are constantly monitored and reviewed and that staff are kept fully briefed on any changes. The Home has a committed and caring staff group who work together as a team. Staff turnover is low and this provides Residents with continuity and consistency of care. Residents spoken with felt that their relationships with staff were very good and that staff provided them with good care, support and encouragement. Residents are given choice in the daily menu and they felt that their likes and dislikes and special dietary needs were known and respected by the catering staff. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 6 Routines in the Home are relaxed and flexible and Residents confirmed that they were free to choose how and where they wished to spend their time. Residents are encouraged, supported and enabled to be as independent as possible and staff take care to protect their privacy and dignity when caring out personal care tasks. Relatives commented that they were kept well informed on the progress of their Residents. They felt welcome to visit the Home at anytime and stated that staff made time to talk with them. The Home’s medication system was safely and efficiently managed. The general and domestic maintenance of the Home was good providing the Residents with comfortable and homely surroundings. 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. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4 & 5 Residents are provided with good information on the Home and it’s services. The Home has a thorough assessment process ensuring that Residents needs are met. EVIDENCE: The information given to prospective Residents and their relatives includes the Home’s Statement of Purpose and information on the services provided. The information is being reviewed at the present time to ensure prospective Residents are aware of the Home’s limitations, as care cannot be provided for People who need hoisting, and also to reflect the arrangements for Resident consultation on the running of the Home and activities, the number and size of rooms and the emergency procedures. Senior members of staff visit and complete an assessment of all prospective Residents needs. Records showed that the assessment process was thorough, took account of risk factors and individual Residents wishes and preferences. The Home only admits Residents where their needs can be fully met. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 9 Records showed that all residents are provided with a contract/Residents agreement, according to whether they are permanent or short stay Residents. New contracts are issued where changes have occurred. Where possible Residents and their Relatives may visit the Home prior to their admission, view the accommodation, meet with staff and other Residents and discuss their care needs. Residents spoken with stated that staff had been given information on their care needs prior to their admission and were aware of their routines and requirements. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10 & 11 Residents care needs are met and staff ensure careful monitoring of any changes with prompt referrals made, where necessary to relevant Professionals. EVIDENCE: Residents stated that care staff took account of their personal preferences for the timings of the care routines and how they wished the care to be carried out. They stated that they felt staff respected them as individuals and enabled them to retain or develop their independence as much as possible. They were fully satisfied in the way they were cared for and confirmed that staff protected their dignity and privacy when carrying out personal care tasks. Three care plans were inspected; one for a permanent resident and two for short stay residents. The plans identified Residents needs and provided guidance to staff on the how the care was to be provided. The timings for the routines were not always stated although it was clear that staff were fully aware of these. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 11 The plans for short stay Residents were less concise as they were combined within the assessment information and it was more difficult to quickly identify the care instructions. Records showed that staff monitor and record Residents health care needs carefully and are quick to refer any concerns to the Community Medical services. Arrangements are made for Residents to undertake routine screening and health checks. Procedures are in place for Residents to continue to manage their own medication, where possible. Lockable facilities are provided. The Home’s Medication system was safely managed and in good order with medication securely held. Two staff undertake the medication rounds and share the procedures for checking and giving medication to ensure no mistakes are made. Currently only one of the staff members signs the record. Discussions with the Manager and the review of records showed that care might be provided for Residents who are dying so long as needs can be met with the support of the Community Medical and Nursing services. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 Residents are enabled to control their own lives and continue to pursue their interests and hobbies. Care is taken to provide Residents with a good range of meals giving them choice and alternatives and ensuring that their likes and dislikes are respected. EVIDENCE: Residents stated that account was taken of their personal lifestyle preferences and that they could spend their time as they wished. They said that staff provided them with support and encouragement but respected their rights to exercise choice and control over their own lives. They stated that the Home had an activities programme with regular aerobics sessions and opportunities for trips out. They felt that they were supported in pursuing their individual interests and staff provided assistance to, for example, fresh supplies of library books and materials such as knitting wools. External entertainers regularly provide musical entertainment. The Home has an open visiting policy and four Relatives visiting the Home said they were always made most welcome and extended hospitality. They also stated that they could discuss any concerns with the staff and felt that staff kept them well informed on the progress of their Residents. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 13 Residents were positive in their comments on the food provision. They felt that their likes and dislikes were known to and respected by staff. They were provided with choices and further alternatives were made available if requested. The serving of the mid day meal was efficient and the food was nicely presented. Residents are encouraged to eat in the dining room to promote social interaction but may take their meals in the lounges or their rooms. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 standard(s) 16, 17 & 18 Systems are in place to protect Residents from abuse and to ensure that complaints are listened to and acted upon. Resident’s rights are protected. EVIDENCE: Residents confirmed that they have received information on how to complain and felt that they were able to raise any issues with the staff or Manager. The Commission has not received any complaints in the last year and none were shown in the Home’s own record. Procedures are in place to protect Residents from abuse. Staff demonstrated their understanding of the reporting procedures. One allegation has been made in the last year; the matter was reported promptly, fully investigated with the appropriate action taken. Staff ensure that Resident legal rights are protected and arrangements are made for them to exercise their civil rights to vote. Advocacy services have been obtained in the past to ensure Residents wishes are established and acted upon. Information on Independent Advocacy Services is made available to all Residents. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25 & 26 The Home was safely maintained, clean and comfortable and suitable for the needs of the Residents. EVIDENCE: Standards of domestic and hygiene maintenance were viewed as good. Residents stated that domestic routines were carefully carried through to prevent any disruption to them. The general upkeep of the building was viewed as good. Systems are in place to ensure replacement of furnishings and equipment and routine re-decoration. Improvements have been made to make the lighting in the lounges more homely. Further work is planned for Residents bedrooms where the lighting is sufficient but somewhat clinical, in that strip lighting is provided. Residents confirmed that their rooms were suitable for their needs and they were enabled to personalise them and have their belongings around them. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 16 Residents have access to a safe and well-maintained patio garden area. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 29. Procedures for the clearance of new staff were not robust and did not provide safeguards to offer protection to people living in the Home. The Home was sufficiently staffed to meet the needs of the Residents. EVIDENCE: Residents praised the staff group highly finding them sensitive and caring. They stated that staff responded promptly to their needs. . Discussions with three staff members, the Manager and Residents confirmed that current staffing levels are sufficient to meet Residents needs as the dependency levels of Residents admitted are generally low. There are 2 care staff on each day time shift and 2, 1 waking plus 1 sleeping in, carers at night. Managerial staff are on duty during office hours. The dependency levels of Residents are closely monitored and adjustments can be made if necessary. The records relating to 2 staff members were inspected. In one instance the required POVA 1st clearance had not been obtained and the Criminal Records Bureau check was still outstanding. The Domestic Assistant concerned had been working in the home without the appropriate clearance. The Manager agreed to ensure full supervision and the resolution of the clearances. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36 & 38 The Management of the Home is overall effective, accessible and responsive to the needs of both the Residents and staff. The recording systems for the safekeeping of Residents moneys do not provide a clear audit trail. EVIDENCE: Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues and guide them in practice. Supervisions systems were in place to ensure that staff receive guidance and support. Residents felt the Manager was readily available to them. They commented that regular Residents meetings were held and that the Manager also sought their individual views. Residents felt that their opinions were listened to, valued and acted upon and that they had trust and confidence in the staff group as a whole. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 19 The Trustees of the Charity maintain a close interest in the Home. They provide support to the Manager and monitor the overall service seeking Residents views as part of the Home’s overall Quality Assurance systems. The system for safekeeping of Residents moneys should be reviewed. Currently when withdrawals are made staff sign the record, Residents are not currently involved in this process. The Manager must ensure that where staff have made a purchase on behalf of a Resident or where payment has been made for a service, such as hairdressing, a receipt is maintained as part of the records, Currently all receipts are given to the Residents concerned and not maintained with the records. The Trustees and Manager have reviewed the homes policies and procedures to ensure that staff are provided with clear guidance and instruction and that the Home is run in the best interests of the Residents. NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x 2 3 3 3 NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? 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 29 Regulation 19 Requirement The Manager must ensure that the required POVA 1st check is undertaken prior to any new staff taking up employment at the Home. Staff starting work with this clearance only must be supervised at all times and not undertake personal care tasks until a satisfactory CRB clearance has been obtained. Timescale for action 28.6.2005 & Henceforth 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. 3. Refer to Standard 7 9 35 Good Practice Recommendations Consideration should be given to the development of a clear care plan section on the existing assessment documentation for short stay users. Both staff members involved in the process for the administration of medication should sign the MAR sheet. The systems for the safekeeping of Residents moneys should be reviewed to ensure Residents are fully involved in signing for withdrawals and that receipts are maintained with the records where items or services are purchased on a Residents behalf by staff. D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 22 NICHOLAS ROTHWELL HOUSE Commission for Social Care Inspection Newland House, First Floor Campbell Square Northampton NN1 3EB 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 NICHOLAS ROTHWELL HOUSE D C51 S12872 Nicholas Rothwell House V229352 280605 stage 4.doc Version 1.30 Page 23 - 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!