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Inspection on 03/04/07 for Norman Hudson Nursing Home

Also see our care home review for Norman Hudson Nursing Home for more information

This inspection was carried out on 3rd April 2007.

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.

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

The inspectors spoke with the community psychiatric nurse who visits one of the service users who has dementia. She spoke positively about the home and explained how the staff contact her for help and advice in ensuring they are meeting the nursing needs of the service user. She also said that staff do act on the advice given.The survey sent to relatives/ advocates/ friends asked the question, "Does the care home give the support or care to your relative that you expect or agreed?" One of the relatives commented, "I feel that the care plans agreed are not always adhered to." Whilst a second relative commented that the home always gives the support or care that was expected or agreed. One relative commented in their questionnaire that their family found that communication was good, and that they were kept informed by telephone or through discussion when they visited. Staff were seen treating people respectfully, knocking on doors before entering bedrooms and toilets and providing discreet support when assisting people with feeding. People commented on how they had enjoyed their meal, and a visitor who has his meals with his relative said that the food was delicious and very good. The meal on offer was chicken, potatoes and vegetables, followed by treacle sponge and custard. Some people had chosen an alternative such as jacket potato and a filling. Cultural needs had been catered for, including a hot and spicy Caribbean dish, and specialist diets were available.

What has improved since the last inspection?

The lounge and the two small dining room carpets have been replaced, and a damaged chair and table were no longer in use. The ground floor communal toilet area had also been re decorated. The Kirklees adult protection procedure is now used to report suspected incidents of abuse.

What the care home could do better:

The care records of people must contain information relating to their health, welfare, social, and behavioural needs and guidelines. Staff must also record visits/ contacts by doctors, nurses, chiropodist or any other health care professionals to show that people are receiving the appropriate treatment and advice. The social care needs of people must be recorded, and details of any individual activities that they take part in on a daily basis. This will show that their lifestyle experienced in the home, matches their expectations and recreational interests and needs. When the review of peoples` care plans take place the information should show that the care has been fully evaluated and their needs met.Care should be taken when recording the medication that has come into the home to ensure that the it is correct. The list of staff who are authorised to administer medication should be updated, as the current list was out of date. Eight staff have had two half days training on "Person Centred Care," and a further training date has been booked for 15 staff. The registered person must ensure that staff are trained and competent to care for people with dementia. All staff should have up to date training, which includes, care of people with dementia, adult protection, fire, and where appropriate basic food hygiene. People who use the service can be confident that their complaints will be listened to and taken seriously, however only 50% were responded to within the 28 days as stated in the procedure. In a couple of bedrooms the carpets had a strong odour and the provider has been requested to replace the carpets. Three questionnaires received from people who use the service stated that the home was always clean and two stated usually. One relative`s questionnaire stated that the cleaning of the rooms and lounges could improve. All staff should receive induction training within 6 weeks of appointment, and foundation training within the first 6 months to ensure that staff are trained and competent to do their jobs.

CARE HOMES FOR OLDER PEOPLE Norman Hudson Nursing Home Meltham Road Lockwood Huddersfield West Yorkshire HD1 3XH Lead Inspector Karen Summers Key Unannounced Inspection 08:15 3rd & 4th April 2007 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 Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 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. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norman Hudson Nursing Home Address Meltham Road Lockwood Huddersfield West Yorkshire HD1 3XH 01484 451669 01484 426960 normhuds@aol.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Park Homes (UK) Ltd Care Home 42 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (42) of places Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Can provide accommodation and nursing care for one named service user under 65 years. Can provide accommodation and care for one named service user, category DE(E). No more than 21 beds can be used for the category DE(E) Date of last inspection 26th January 2007 Brief Description of the Service: Norman Hudson Care Home is a stone, purpose built home set back from the main road in the Lockwood area of Huddersfield. The home provides care and nursing for up twenty people; twenty-one of the places are registered to provide care and nursing for people with dementia care needs. All the bedrooms have en suite facilities. Thirty-four of the places in the home are in single rooms, with the remaining beds provided in four double rooms. Bedroom accommodation is provided on the first and second floor, with lounge and dining areas on the ground floor. All floors are accessed via a passenger lift. The home is within a few minutes’ walk of the local amenities, including the bus route. There is a garden to the rear of the building, which service users can use. There is ample parking at the front of the home. The provider informed the Commission for Social Care Inspection on 03/04/07 that fees range from £460.58 to £507.15 NHS contribution per week. Additional charges include hairdressing, private chiropody, newspapers and some selected activities. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to a key inspection, which included an unannounced site visit on the 3rd & 4th April 2007. Two inspectors carried out the visit and the length of the inspection was 10.5 hours. There were 30 people living at the home at the time of the visit. Mrs Bev Hogan acting manager, and Mr Jason Sykes Operations Director were present throughout the inspection visit. Since the last key inspection the home has been registered for 21 people with dementia care need. The lounge and dining areas has been divided into two separate areas, one for those who have dementia care needs, and those who are have general nursing care needs. There are also future plans for the bedroom accommodation to be divided into the two areas. Staff training to care for people with dementia has commenced, and until all staff reach the standard, Mr Sykes has voluntarily taken the decision not to admit any more service users needing dementia care until this is complete. The following were looked at and have been used in the production of this report; a sample of records, care plans, recruitment, staff training, medication, individual discussion with service users, relatives, members of staff, tour of the premises and document reading. To reflect the views of those who use the service, satisfaction questionnaires were sent to: 10 service users, 5 were returned; and 10 relatives/ advocate/ friends, 2 were returned. The inspectors also met with the community psychiatric nurse. In writing this report, information and evidence was not only obtained by way of visiting the home, but also from notifications of events sent by the company to the Commission for Social Care Inspection. The last random and key inspection reports were also consulted. The inspectors would like to thank those who contributed to the inspection process, and also thank Mrs Hogan, Mr Sykes, the staff and service users, for their time and hospitality on the day of inspection visit. What the service does well: The inspectors spoke with the community psychiatric nurse who visits one of the service users who has dementia. She spoke positively about the home and explained how the staff contact her for help and advice in ensuring they are meeting the nursing needs of the service user. She also said that staff do act on the advice given. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 6 The survey sent to relatives/ advocates/ friends asked the question, “Does the care home give the support or care to your relative that you expect or agreed?” One of the relatives commented, “I feel that the care plans agreed are not always adhered to.” Whilst a second relative commented that the home always gives the support or care that was expected or agreed. One relative commented in their questionnaire that their family found that communication was good, and that they were kept informed by telephone or through discussion when they visited. Staff were seen treating people respectfully, knocking on doors before entering bedrooms and toilets and providing discreet support when assisting people with feeding. People commented on how they had enjoyed their meal, and a visitor who has his meals with his relative said that the food was delicious and very good. The meal on offer was chicken, potatoes and vegetables, followed by treacle sponge and custard. Some people had chosen an alternative such as jacket potato and a filling. Cultural needs had been catered for, including a hot and spicy Caribbean dish, and specialist diets were available. What has improved since the last inspection? What they could do better: The care records of people must contain information relating to their health, welfare, social, and behavioural needs and guidelines. Staff must also record visits/ contacts by doctors, nurses, chiropodist or any other health care professionals to show that people are receiving the appropriate treatment and advice. The social care needs of people must be recorded, and details of any individual activities that they take part in on a daily basis. This will show that their lifestyle experienced in the home, matches their expectations and recreational interests and needs. When the review of peoples’ care plans take place the information should show that the care has been fully evaluated and their needs met. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 7 Care should be taken when recording the medication that has come into the home to ensure that the it is correct. The list of staff who are authorised to administer medication should be updated, as the current list was out of date. Eight staff have had two half days training on “Person Centred Care,” and a further training date has been booked for 15 staff. The registered person must ensure that staff are trained and competent to care for people with dementia. All staff should have up to date training, which includes, care of people with dementia, adult protection, fire, and where appropriate basic food hygiene. People who use the service can be confident that their complaints will be listened to and taken seriously, however only 50 were responded to within the 28 days as stated in the procedure. In a couple of bedrooms the carpets had a strong odour and the provider has been requested to replace the carpets. Three questionnaires received from people who use the service stated that the home was always clean and two stated usually. One relative’s questionnaire stated that the cleaning of the rooms and lounges could improve. All staff should receive induction training within 6 weeks of appointment, and foundation training within the first 6 months to ensure that staff are trained and competent to do their jobs. 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. The summary of this inspection report can be made available in other formats on request. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 8 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 Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, & 5. Standard 6 does not apply. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Prospective people to use the service are assessed prior to moving into the home and are able to visit the home to establish whether or not it is the right place for them. EVIDENCE: The care records of three new people were examined, all of which contained a pre-admission assessment carried out by the funding local authority. Each assessment contained detailed information about the person’s current needs. In addition to this the home had also carried out a pre-assessment with the prospective person. The acting manager explained that prospective people are welcome to visit the home prior to them moving in, and that some people prefer to spend a day or two at the home before making their decision to move in or not. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 10 Four out of five surveys of people who live at the home said that they received enough information about the home before they moved in, and four out of five people said that they had received a contract. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Care plans and records need to be developed further to ensure they include people’s specific needs and enable staff to monitor health care. Medication systems are generally good. EVIDENCE: Three people’s care plans were examined in detail. Whilst the care plans are generally satisfactory there is room for improvement in respect of recording specific information about individual’s needs. For example some sections in the care plan are written in a general manner rather than what is relevant to that particular individual. One person’s specific needs’ relating to behaviour management was a major omission in their care plan, and important information about a persons contact with their spouse had not been included. The acting manager explained that service users have access to health care services. The Community Psychiatric Team offer support to those people with mental health problems including dementia related illnesses. It was difficult to establish when health care professionals such as their GP or chiropodist had seen service users because staff are not recording such visits in the relevant Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 12 place. This needs to be addressed to ensure staff are able to monitor people’s health care needs. The inspectors spoke with the community psychiatric nurse who visits one of the people who has dementia. She spoke positively about the home and explained how the staff contact her for help and advice in ensuring they are meeting the nursing needs of the service user. She also said that staff do act on the advice given. The survey sent to relatives/ advocates/ friends asked the question, “Does the care home give the support or care to your relative that you expect or agreed?” One of the relatives commented, “I feel that the care plans agreed are not always adhered to.” Whilst a second relative commented that the home always gives the support or care that was expected or agreed. A number of health care assessments are completed, these include, moving and handling, the risk of falls, oral hygiene (mouth and teeth) as well as nutritional assessments (any risks about eating and drinking, e.g. poor appetite, swallowing problems). As part of the nutritional assessment, service users are weighed on a regular basis and although weights are being recorded, there was very little written evidence of any action taken in respect of weight loss and weight gain. The acting manager explained there are procedures in place for monitoring weight loss/gain, which ultimately result in referral to the GP. However there was no evidence of this in two of the three files examined and therefore staff must make sure they are vigilant in their recording of any action they have taken. Three peoples’ medication and records were examined, and there were discrepancies in respect of two service users’ medication. Staff must take more care when booking in medication received in the home to ensure that the records are correct. Medication brought forward from one month to the next must be clearly identified on the medication record. The list of staff who are authorised to administer medication needs to be updated, as it is currently out of date. Staff were observed treating people respectfully, knocking on doors before entering bedrooms and toilets and providing discreet support when assisting people with feeding. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Written evidence does not show that people’s social needs are met, but the home has arrangements for activities and promoting contact with relatives and friends. People receive a wholesome appealing and balanced diet. EVIDENCE: A dedicated activities person works Monday to Friday, 10am – 4pm, and occasionally at weekends. The home’s activities programme is displayed on the notice board at the entrance of the home, and visitors are able to see for themselves the different types of activities that take place on a daily basis. Activities include, arts & crafts, sing a long, board games, movies and baking. For the Easter weekend the home had arranged a buffet for family and friends, and a singer had been arranged for the event. The surveys from people who use the service asked if there are activities arranged by the home that they can take part in. Two indicated that there are always activities they can take part in. One commented, “I have two friends that take part in the activities with me.” And two people said that there are usually activities that they can take part in. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 14 Three care plans were looked at and there was very little information about people’s social care needs. The activities person has a file divided into separate pages to record the daily activities however; there was very little evidence of people taking part. The majority of records referred to the person by name, and the statement, “refused any activities today when asked.” Through discussion with Mr Sykes and Mrs Hogan, staff are involved in individual activities with service users, but are not recording their involvement. The social care needs of people should be recorded, and also details of the individual activities that people take part in on a daily basis. This will show that their lifestyle experienced in the home matches their expectations and recreational interests and needs. A minister from the local church visits every two weeks, and also another minister visits twice weekly and provides a communion service for those people who wish to take part. One of the people who uses the service likes to have her bible read to her, and a member of staff was sat with that person reading her bible at the time of the visit. The home provides a daily, and Sunday paper. Visitors are welcome at the home at any time. The visitors’ book showed that the home receives a number of visitors throughout the day and evening time. A mealtime was observed, and staff were assisting people with feeding in an unhurried and dignified manner. The meal on offer was chicken, potatoes and vegetables, with treacle sponge and custard. Some people had chosen an alternative such as jacket potato and a filling. Cultural needs had been catered for, including a hot and spicy Caribbean dish, and also specialist diets. People commented on how they had enjoyed their meal, and a visitor who has his meals with his relative said that the food was delicious and very good. The cooks and assistants white clothing looked heavily stained. confirmed that new clothing had been ordered. Mr Sykes Not all staff who prepare food have had an up to date basic food hygiene certificate. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who use the service can be confident that their complaints will be listened to and taken seriously. Until all the staff has had adult protection training, people are potentially at risk of abuse. EVIDENCE: The home has a complaints leaflet that is given to each person when they are admitted to the home. Four out of five peoples’ surveys said that they knew how to make a complaint, and the relatives surveys also said that they knew how to complaint. When asked, “Has the care service responded appropriately if you or the person using the service has raised concerns about their care.” One relative commented, “sometimes”, and a second person said, “As far as I am aware, yes.” One relative commented in their questionnaire that their family found that communication was good, and that they were kept informed by telephone or through discussion when they visited. The home keeps a log of complaints, and Mr Sykes stated in the pre inspection questionnaire that there had been six complaints during the last twelve months. One had been substantiated and two partially substantiated. He also stated that 50 of complaints had been responded to within 28 days. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 16 The registered person must ensure that all complaints are responded to within the 28 day period as outlined in the home’s policy. Six out of thirty one staff have not had adult protection training. A further training date has been booked for later this month. Those staff spoken with were aware of the procedure to follow if they suspected that an incident of abuse had occurred. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People who use the service live in a homely, clean and well-maintained environment. EVIDENCE: Since the last key inspection the home has been registered for 21 service users with dementia care needs. The lounge, dining areas and toilets has been divided into two separate areas, one for those who have dementia care needs, and those who are over the age of 65. There are also future plans for the bedroom accommodation to be divided into the two areas. Carpets have also been replaced in the communal ground floor areas, and the toilets have been redecorated. Mr Sykes confirmed that there are plans to replace the dining room furniture. The maintenance book was inspected and there was evidence that repairs are done quickly. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 18 Generally the home is clean and there are systems in place to prevent the spread of infection. A couple of bedrooms had a strong odour. The cleaner confirmed that although the rooms are cleaned daily, and the carpets shampooed the odour remains. In the interest of infection control and people who use the service comfort and dignity, the registered person is requested to replace the carpets in the rooms with the odour. Three questionnaires received from people who use the service stated that the home was always clean and two stated usually. One relative commented on their questionnaire that the cleaning of the rooms and lounges could improve. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The staffing levels are sufficient to meet the number of people living in the home. Service users are supported and protected by the home’s recruitment practices. EVIDENCE: There were 30 people in residence, 7 of which have dementia care needs, and there was a sufficient number of staff on duty to care for the number of service users in the home. One of the two questionnaires received from relatives, carers and advocates, stated that through their observations, there were not enough dedicated staff. When asked, “How do you think the care home can improve?” the person wrote,” By improving on the staff and training they receive.” Eight staff have had two half days training on “Person Centred Care,” and further training has been booked for 15 staff. The registered person must ensure that staff are trained and competent to care for people with dementia. The home is still working towards the standard of 50 of staff having an NVQ 2 qualification in care. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 20 The registered person operates a thorough recruitment process, ensuring the protection of service users. Staff confirmed that they had had induction training within 6 weeks of their employment, and were able to say what the induction included. The information was also recorded in the staff training files. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is run in the best interests of people who live there. Peoples’ financial interests are safeguarded. Until all staff have had a fire lecture, the health and safety of staff and people who live at the home could potentially be at risk. EVIDENCE: Mrs Bev. Hogan who is the training manager for the company is also acting manager, and the home is currently advertising for a permanent manager. Mrs Hogan has been working with the staff over the last few months, and having meetings with relatives to improve the care and standards for the people living at the home. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 22 Mr Sykes carries out a quality assurance audit of systems within the home every 3 months. In addition to this, quality assurance questionnaires are sent out to people who live at the home and their relatives. Mr Sykes said that the questionnaires are returned to the company’s head office, and then are passed back to the home where they are discussed at the residents/ relatives meetings, which take place approximately every 8 weeks. There had recently been a meeting prior to this inspection, where the layout of the building was discussed in relation to people’s safety. The people at the meeting gave some suggestions and these were used when changing the layout of the building. Small amounts of personal monies are kept on behalf of people living at the home, and the three records and monies that were checked were correct. Accident reports were looked at, and suggestions were made to carryout monthly audits and monitor any recurring issues. Information provided by the home prior to this inspection indicates that the servicing of equipment takes place on a regular basis. Fire alarm and emergency lighting are tested weekly, and staff receive regular fire drills. According to the training matrix provided by Mr Sykes the majority of staff have not had a formal fire lecture since March 2006, and 5 staff have not had a fire lecture. Mrs Hogan is a fire training facilitator, and dates for the training of staff were arranged to take place in the next few weeks. The inspectors were assured that those staff that had not had a fire lecture had been shown the procedure to follow at induction. There was also evidence to suggest that all staff have had movement and handling training within the last fourteen months, and further training dates have been identified. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 2 Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 24 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 OP7 Regulation 15(1) Requirement The registered person shall write a written plan as to how the service user’s individual needs in respect of his health and welfare, including guidelines for behaviour management, and social care needs are to be met, and to ensure that all the needs of the service user are cared for. The registered person is requested to confirm in writing by 21/05/07 the action you have taken. All staff must receive adult protection training. In the interest of infection control and people’s comfort and dignity, the carpets in the rooms with the odour must be replaced. Timescale for action 21/05/07 2. 3. OP18 OP26 13(6) 16 (2)(k) 25/05/07 21/05/07 4. OP38 23 (4) To protect the health & safety of 14/05/07 staff and people living at the home the registered person must make arrangements for persons working at the home to receive suitable training in fire prevention. Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 25 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 OP7 Good Practice Recommendations The care plan monthly reviews should include information to show that the care has been fully evaluated and their needs met. Visits & contacts with health care professionals should be recorded. The medication should be regularly audited to ensure that any discrepancies are identified and traced, and safe practices are maintained. The list of staff who are authorised to administer medication should be updated, as the current list is out of date. All staff that prepare food should receive food hygiene training. A minimum of 50 of care staff should have an NVQ 2 in care. All staff should receive induction training within 12 weeks of appointment, and foundation training within the first 6 months to ensure that staff are trained and competent to do their jobs. For the protection of staff and people who live at the home, all staff should have two fire lectures and two fire drills each year. Accident reports should be audited monthly to monitor any reoccurring issues, and therefore protect people and staff. 2. OP9 3. 4. 5. OP15 OP28 OP30 6. 7. OP38 OP38 Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: 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 © 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 Norman Hudson Nursing Home DS0000045225.V334720.R01.S.doc Version 5.2 Page 27 - 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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