Inspection on 04/05/05 for Norman Hudson Nursing Home

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Norman Hudson Nursing Home 16/10/07

Norman Hudson Nursing Home 03/04/07

Norman Hudson Nursing Home 16/05/06

Norman Hudson Nursing Home 11/10/05

Norman Hudson Nursing Home 14/10/04

Norman Hudson Nursing Home 05/05/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Norman Hudson Nursing Home Meltham Road Lockwood Huddersfield HD1 3XH Lead Inspector Sally McSharry Jacinta Lockwood Unannounced 4 May 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. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Norman Hudson Nursing Home Address Meltham Road Lockwood Huddersfield HD1 3XH 01484 451669 01484 426960 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) Mrs Fatima Shahid Park Homes UK Ltd Position Vacant CRHN 42 Category(ies) of OP 42 registration, with number of places Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14/10/04 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 to forty two older people. All the bedrooms have ensuite 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. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced visit carried out on 4 May 2005 by two inspectors. The inspectors looked at a selection of the core National Minimum Standards. During the visit inspectors spoke to some service users and staff, looked at care and recruitment records and briefly toured the building. A line manager, Maria Palmer has been supporting a new manager Ms Amanda Bromley through her induction period. Ms Bromley is an experienced manager, but has yet to submit an application to CSCI to be registered as the manager at Norman Hudson Nursing Home. A statutory requirement notice was issued to the company in November 2004. The action was taken to ensure the home provided sufficient numbers of trained and experienced staff and that staff recruited had had the required checks and references obtained before they started work at the home. These requirements were met by the registered provider. However during this inspection the inspectors found that staff records failed to provide evidence that rigorous checks had been carried out on staff and that some staff are not yet trained to a level of competence. Further requirements and recommendations have been made in this report to ensure standards improve. Failure to resolve and sustain an improvement may lead to the CSCI taking further enforcement action. What the service does well: What has improved since the last inspection? There have been improvements in the management support for staff in the home. Since the last inspection a choice of menu has been introduced at lunchtime. Staffing levels are now being maintained to a level suitable to the number and needs of the service users. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.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 Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.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) 3 Service users are assessed prior to admission to the home. EVIDENCE: A selection of service users’ care records was audited. Prior to admission to the home, prospective service users are assessed to ensure the staff are able to meet their needs and to ensure the home is able to accommodate the prospective service user. Copies of the service user’s Community Care assessment are also available. The manager of the home also writes to the prospective service user to confirm that their needs can be met at Norman Hudson Nursing Home. The acting manager Ms Maria Palmer also advised that the manager also arranges a placement review meeting when the service user has been resident in the home for six weeks. Norman Hudson Nursing home is not providing any intermediate care at the moment. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 9 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 and 10. Care plans fail to set out the health, personal and social care needs of service users. Service users’ health care needs are not being fully met in the home. There are safe systems for administering medications, but one recording issue was identified. The service users are treated with respect and their privacy is maintained. EVIDENCE: During the last inspection carried out on 14 October 2004 the inspectors noted that care plans failed to identify all the service users’ health and welfare needs or advise staff how these were to be met in the home. Some staff have received care plan training and some new documentation is being introduced. Despite these actions care plans still fail to identify all the service users’ needs or clearly advise staff how these needs are to be met whilst at Norman Hudson Nursing Home. Some documentation has not been completed; some entries are not dated or signed. Where risk assessments have been carried out, such as nutritional assessments and the assessment score indicates the service user is at risk of poor nutrition, a care plan has been produced which indicated the service user be weighed monthly and referred to the dietician; the service user was not Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 10 being weighed monthly, nor had the service user been referred to the dietician as indicated in the risk assessment. Some assessments have not been reviewed; for example, an assessment in relation to the service user falling out of bed had not been reviewed since November 2004. Some assessments, such as movement and handling, failed to take into account service users’ recent falls, as indicated in the accident record and therefore the assessment carried out is inaccurate. Further training and supervision must be provided to staff regarding care planning and all care plans must be signed dated and accurately reflect the service users’ health and welfare needs and how these are to be met in the home. Each service user’s individual plan should provide specific and detailed information to enable staff to deliver the agreed care safely. Not all the service users’ health care needs are being fully met. One service user’s plan failed to identify how the service user’s continence needs were to be met. The same service user clearly had some anxiety and agitation at night. There was no care plan advising staff how to manage this behaviour and no evidence that this need was being addressed in the home. Medications are generally managed well. There is a photograph of each service user with their medication administration sheet. A sample of medications were audited and found to be correct. There was one discrepancy noted where a variable dose had been prescribed, (give one to two tablets when required) staff had not noted whether one or two tablets had been given. Accurate records must be maintained. At the last inspection it was noted that some service users were not appropriately dressed for the time of year. On this occasion the inspectors arrived at the home at 9am. All the service users seen were smartly and appropriately dressed. Service users were clear in their opinions, when asked, that the staff at the home respect their choices and help maintain their privacy and dignity. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 11 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 and 15. The cultural needs of some service users are not being met. Service users are able to maintain contact with their family, friends and the community. Service users confirmed they are offered choice in the home. Mealtimes are flexible and the food served is wholesome and appetising. EVIDENCE: There was little evidence that a service user with a differing culture and language was having their cultural needs met. Service users advised that there is a religious service held at the home regularly and they are able to receive visitors whenever they wish. Service users advised that activities are offered and that they have a choice as to whether to take part in activities or not, although there was no evidence of any activities at the time of the inspection. Service users also confirmed that they are able to choose what time they go to bed at night and get up in a morning, also that choices are available at each mealtime. Following recommendations made at the last inspection there is now a choice of menu at each mealtime. All the service users who spoke to the inspectors felt that the meals provided at the home were good. One service user said, “ I eat it all, I love it all”. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 12 The cook said that she regularly speaks to service users to obtain their opinion about the menus and that menus are reviewed. The cook also prepares special diets when required. A record of meals prepared and individual service user’s choices is maintained, however this is destroyed after 3-6 months. These records must be retained for a period of three years from the date of the last entry. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 13 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 and 18 There is a complaints procedure but some staff in the home are not responding appropriately to concerns raised by relatives. Staff need further training and guidance in adult protection to make sure service users are safe. EVIDENCE: The most recent complaint made to the home was reported as being made in January 2005. The CSCI is currently investigating a complaint made directly to the CSCI. When one of the inspectors was reading a service user’s care plan it was clear in the daily record that the family of the service user had made a complaint. The member of staff on duty recorded this, but no action had been taken to bring this to the attention of the acting manager, or to follow the complaints procedure. All staff must receive training to enable them to recognise a complaint and then act appropriately. Some adult protection training has been given in the home; however during a recent complaints investigation some staff were unsure of the correct procedure to follow when potential abuse was identified. All staff must receive adult protection training to enable them to recognise potential abuse and then take appropriate action. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 14 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 and 26 The furnishings in the home were not well maintained and there were an unacceptable number of bedrooms with unpleasant odours. EVIDENCE: Most of the home was clean and tidy but there were three recommendations made in the last report relating to furnishings in the home have not been addressed. The lounge carpet continues to split at a join; tape has been applied, the carpet still should be replaced. There are still old and worn chairs in the first floor sitting areas; these should be replaced. There were nine bedrooms, which had a strong unpleasant odour; action must be taken to eliminate these odours. Some footstools in the lounge area also smelled of urine. Apart from the areas identified the home was clean and tidy. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 15 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, and 30 Sufficient staff were on duty to meet the needs of the current service users. Further staff training is required to ensure service users are in safe hands at all times. Service users are not being protected by safe recruitment practice, as the provider’s recruitment processes have not been followed consistently. EVIDENCE: At the time of the visit there were thirty one service users resident in the home. There are sufficient care and ancillary staff provided to meet the needs of those service users. At the last inspection some staff were found to be working excessive hours. There was no evidence of this during this visit. Staff recruitment files failed to contain the required information or evidence that appropriate references and checks had been received. Some staff training has taken place. However, induction records were not available and none of the staff at the home hold a valid certificate in first aid. Work is still required to ensure that all staff receive movement and handling, health and safety, fire safety, first aid and adult protection training as required in the last inspection report. Staff must also receive training to enable them to manage and maintain accurate and detailed care plans and respond appropriately to complaints as identified earlier in this report. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 16 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) 38 The health, safety and welfare of service users and staff are not always promoted or protected in the home, when moving and handling service users. EVIDENCE: Some service users were seen sat in and transferred in wheelchairs without footplates. This is not safe practice. Staff must be trained to ensure service users are moved and handled safely. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 17 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 x x x x x x x 1 Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 18 yes 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 7 Regulation 15 Requirement All service users must have a care plan which identifies all their health and welfare needs and details clearly how those needs are to be met in the home. Timescale of 31.12.04 not met. Where risk assessments have been carried out and have identified that there is a risk, action must be taken to ensure the service user receives where necessary, treatment, advice and other services from any health care professional. The registered person shall make suitable arrangements to ensure that the care home is conducted - b) with due regard to the sex, religious persuasion, racial origin, and cultural and linguistic background and any disability of service users. All complaints made must be acted upon, investigated and a record made of the complaints process and the outcome reached. All staff must receive training in relation to abuse awareness and the protection of vulnerable J51J01_s45225_Norman Hudson_v220524_040505.doc Timescale for action 31.07.05 2. 8 13 31.07.05 3. 12 12 31.07.05 4. 16 22 31.05.05 5. 18 13 31.08.05 Norman Hudson Nursing Home Version 1.30 Page 19 adults. 6. 29 7,9,19 & Schedule 2. Staff records must be 31.07.05 complete.There must be evidence avaiable at the home to show that a POVA first and CRB check have been carried out and a satisfactory result returned to the home. All staff in the home must be 30.09.05 skilled and competent to care for the service users. Training must be provided on care planning, managing complaints, movement and handling, health and safety, first aid and adult protection. Time scale of 15.01.05 not met. 7. 30 18 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. 4. 5. 6. 7. Refer to Standard 7 7 7 7 9 15 19 Good Practice Recommendations All care plan documentation should be completed, dated and signed. Staff should be trained to complete and maintain care records correctly. All care plans and risk assessments should be reviewed at least monthly and if there are any changes in the service users condition. Information provided in care plans should be clear, detailed and specific to the individual service user. Where a variable dose is prescribed, for example one to two tablets may be given, staff should accurately record what dose has been given. Records relating to the choices service users have made in relation to the menus and their diet should be retained for inspection. The lounge carpet should be repaired/replaced. The carpet on the first floor corridor should be replaced. The chairs in the first and second floor sitting areas should be replaced. Action should be taken to address the unpleasant odour noted in at least 9 bedrooms in the home. J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 20 8. 26 Norman Hudson Nursing Home 9. 30 Documented evidence of staff induction training should be available in the home. Norman Hudson Nursing Home J51J01_s45225_Norman Hudson_v220524_040505.doc Version 1.30 Page 21 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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