Inspection on 29/11/05 for Nicholas Rothwell House

This inspection was carried out on 29th November 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.

Other inspections for this house

Nicholas Rothwell House 23/02/10

Nicholas Rothwell House 27/06/07

Nicholas Rothwell House 28/06/05

Nicholas Rothwell House 08/11/04

Nicholas Rothwell House 29/04/04

Nicholas Rothwell House 26/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Nicholas Rothwell House 290 Harborough Road Kingsthorpe Northampton Northants NN2 8LR Lead Inspector Mrs Pat Harte Unannounced Inspection 29th November 2005 11:00 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 Nicholas Rothwell House DS0000012872.V266386.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. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Nicholas Rothwell House Address 290 Harborough Road Kingsthorpe Northampton Northants NN2 8LR 01604 841882 01604 850845 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) Charity of St Giles Mrs Margaret Rafferty Care Home 21 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (2), Old age, of places not falling within any other category (21), Physical disability over 65 years of age (2) Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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. 28th June 2005 Date of last inspection Brief Description of the Service: Nicholas Rothwell House is a Residential Care Home owned by the St. Giles Charity Estates. The Charity, founded in the 15th Century, is non-profit making. The running of the Home is overseen by a Board of Trustees who meets regularly at the premises to monitor practice, plan and develop services and to consult with Residents on their overall satisfaction of the service. The Manager is Mrs. M. Rafferty. The Home provides care for Residents over the age of 65 and includes two places for People with Physical Disabilities. The premises are situated in quiet and pleasant surroundings on the north side of Northampton and are easily accessible by public transport being just off the main A508 Harborough Road. The Home is near to the suburb of Kingsthorpe and its local amenities The accommodation provided to Residents is solely on the ground floor and the facilities include a large comfortable lounge/dining room and a conservatory/lounge overlooking the patio garden. Residents are provided, in the main, with single bedrooms, there is one double bedroom. There is a central kitchen supplying all meals and the home has its own laundry. Currently there are up to twelve permanent places with the rest of the places offering short-term care. 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 DS0000012872.V266386.R01.S.doc Version 5.0 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. Inspection planning took one hour and consisted of a review of the last inspection report, requirements and recommendations made together with a review of the Home’s service history including notifications and events. The primary method of inspection used was through discussions with seven Residents and four staff members to obtain their views and opinions on the service. In addition discussions were held with two members of the Board of Trustees including the Responsible Individual and also the Manager. 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 early afternoon over a period of three hours. What the service does well: The Home has a committed staff group. Residents spoken to felt that their relationships with staff were very good and that staff provided them with good care and support and valued and respected as individuals. The Board of Trustees meets regularly at the Home and is dedicated in overseeing the service and its development. Members offer good support to the staff group and seek the views of the Residents on their satisfaction with the service. Routines are relaxed and flexible and Residents confirmed that they are enabled to continue the routines they have followed through their lives and maintain their independence as much as is possible. The Home manages the many Short Stay admissions well. Residents confirmed that they were made welcome and that their stays at the Home were enjoyable. A Resident who had been admitted from Hospital commented on how staff had assisted her to regain her independence and find ways of managing her disability in order to return home. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 6 Staff ensure that Residents Health Care needs are closely monitored with prompt referral made to Medical Professionals where necessary. Meals are varied, well balanced, of good quality and nicely presented. Residents stated that they are given a good choice of options in the daily menu and account is taken of their likes and dislikes and special diets. 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 DS0000012872.V266386.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 Nicholas Rothwell House DS0000012872.V266386.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, 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 can be met. EVIDENCE: Residents are provided with written information on the Home’s services and facilities in order that they can make informed choices concerning a possible placement. The Manager is currently reviewing the Home’s Statement of Purpose, which is to be made available to all Residents. It is anticipated that the reviewed and updated documentation viewed on this Inspection will be available in the New Year and will offer comprehensive information on the services and the Home’s Philosophy of care. Senior staff from the Home visit all prospective Residents to carry through an assessment of their needs. Discussions with the Manager showed that the dependency levels of prospective Residents, whether short or long-term placements, were carefully assessed and balanced with the dependency levels Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 9 of existing Residents. The careful process of assessment ensures that Residents are only admitted to Home where their needs can be met in full. Dependent on circumstances Residents and their Relatives are encouraged, where possible, to visit the Home and discuss their requirements, meet staff and other Residents and view the accommodation and facilities. The use of specific and recognised assessment tools to identify risk factors, such as nutritional or skin care risks, were discussed with the Manager. These tools are not currently used but the Manager agreed to research available tools as a good practice development. Residents stated that they had been provided with written contracts and were aware of the terms and conditions of residency whether this was short or long stay. It was evident, through discussions with staff that they were well prepared to receive new residents and had been given information on their needs, preferred routines and the tasks to be carried out. Nicholas Rothwell House DS0000012872.V266386.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, 8, 9 & 10 Residents are consulted and involved in the development of their care plans with agreement reached on how the care is to be provided. Residents are encouraged to maintain or develop their independence as much as is possible. EVIDENCE: Residents felt that staff kept their care needs under constant review and made changes where necessary and in consultation with them. They confirmed that they felt respected, valued and treated as individuals and dependent on their circumstances were encouraged to maintain or develop their independence as much as possible and allowed to do things for themselves. In one instance a Resident commented on how staff had helped her to regain her independence following a fractured arm. She stated that staff had initially supported her with her personal care needs and then helped her to develop management strategies and regain her independence in preparation for her discharge home. All Residents spoken with stated that staff took care to ensure the protection of their privacy and dignity when personal care tasks were carried through. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 11 The development of Residents care plans was discussed. The Manager confirmed that she had not as yet revised the short-term care plans, which were found, on the last Inspection, to be lacking in detailed instructions for staff on how the care is to be provided. This is an area for on going development. Residents felt that staff closely monitored their health care needs and took prompt action to make arrangements for them to see their General Practitioners and other health care professionals. 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 inspected. Because of the high number of short stay admissions medication storage was problematic and some blister packed medication was stored in a locked filing cabinet. Following discussions the Manager agreed to take immediate action to review the arrangements and ensure all excess medication was appropriately stored in the locked medication cupboards in the Treatment room. The Medication records were generally in good order. All incoming medication is carefully checked on receipt and a full disposal record was maintained. The administration records did not always show appropriate coding to indicate why a medication had not been administered. For example a prescribed medication with instructions to administer at night showed that this had not been given, as the Resident was asleep or the medication was “not required”. Discussions with the Manager and Senior staff showed that the medication was not needed on a regular basis. The Manager agreed to refer back to the General Practitioner to consider a change in prescription to “when required”. Nicholas Rothwell House DS0000012872.V266386.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, 14 & 15 Residents are enabled to continue with their preferred lifestyle routines and exercise control over their lives, they are provided 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 where and 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. The Home has an open visiting policy and Residents stated they were free to receive their visitors in private if they wished. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 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 choice 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 DS0000012872.V266386.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): 16 & 18 Systems are in place to protect Residents from abuse and to ensure that complaints are listened to and acted upon. 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. A complaints record is maintained. No complaints have been made to either the Home or the Commission in the last year. Procedures are in place to protect Residents from abuse. A notification was made to the Commission and the relevant Authorities recently concerning abusive practice. The matter was fully investigated by the Manager and appropriate action taken. Nicholas Rothwell House DS0000012872.V266386.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, 20, 21, 22, 23, 24, 25 & 26 The Home is well maintained, safe, warm, clean and comfortable and provides Residents with an attractive and homely environment. EVIDENCE: The Home has programmes for ongoing maintenance and refurbishment. Physical standards were viewed as good and Residents felt their surroundings were both comfortable and homely. They are enabled to personalise their bedrooms as they wish and arrange their furniture to their liking. They are enabled and encouraged to have their own possessions around them. Residents stated that domestic routines were flexible and not disruptive to their lifestyles. Standards of domestic and hygiene maintenance were viewed as good. Observations and Residents comments confirmed that appropriate aids were obtained for them where necessary such as walking aids. Nicholas Rothwell House DS0000012872.V266386.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 Sufficient numbers of care staff are deployed to meet the needs of current Residents. EVIDENCE: Residents spoken with said that all the staff, including ancillary staff, were very kind, committed and caring. They felt and observations confirmed that staff responded promptly to their needs. It is acknowledged that there has been a high level of long term staff sickness during the last six months but the staffing rotas have been maintained by extra hours undertaken by regular staff, most of whom are part time and able to increase their hours. Residents were aware of the difficulties but confirmed that their care had not been affected. Discussions with staff showed that they knew their Residents well and had knowledge and understanding of their needs and conditions. Two care staff are normally on duty on daytime shifts. One waking and one sleeping night carers provide night care. In addition the Manager or Deputy are on duty on day time shifts and ancillary staff including catering and domestic staff are employed to ensure care staff are not detracted from their care duties. As Residents generally have low to medium dependency levels these numbers are sufficient to meet their needs. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 The Management of the Home is effective and efficient and the home is run in the best interests of the Residents. EVIDENCE: Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support and supervision. Residents felt the Manager was readily available to them. They commented that she met regularly with them to seek their individual views and opinions of the service always seeking to improve the service. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 18 Residents felt that they had trust and confidence in both the Manager and the staff group as a whole and that the Home was run in their best interests. The systems for the safekeeping Residents’ moneys were safely maintained and records showed that Residents signed for withdrawals and receipts were maintained for items or services, such as hairdressing, paid for by staff on their behalf. Due attention was paid to Health and Safety and no hazards were observed. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 19 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 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13 (2) Requirement Medication must be administered according to prescription instructions or the relevant General Practitioner contacted to consider a change in prescription where necessary. Timescale for action 10/12/05 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 OP3 Good Practice Recommendations Recognised assessment tools should be utilised and reviewed to identify risk levels. E.g. Nutritional and Pressure Care Risk Assessments. Nicholas Rothwell House DS0000012872.V266386.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House 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 DS0000012872.V266386.R01.S.doc Version 5.0 Page 22 - 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. 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