Inspection on 17/05/05 for Northcott House Nursing & Residential Care Home

This inspection was carried out on 17th May 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

Northcott House Nursing &... 28/10/08

Northcott House Nursing &... 06/11/06

Northcott House Nursing &... 04/10/05

Northcott House Nursing &... 12/10/04

Northcott House Nursing &... 13/05/04

Northcott House Nursing &... 30/07/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Northcott House Nursing & Residential Care Home Northcott Close Bury Hall Lane Alverstoke Gosport Lead Inspector Gina Pickering Unannounced 17/5/05 09:30am 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. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Northcott House Address Northcott Close, Bury Hall Lane, Alverstoke, Gosport, Hampshire, PO12 2PP 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) 02392 510016 02392 513110 Gods Port Housing Society Limited Mrs Christine Mirner CRH 55 Category(ies) of OP- Old Age registration, with number TI- Terminally ill of places TI(E)- Terminally ill Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1- No service users are to be admitted under the age of 55. 2- Only a total of 5 service users in the categories TI(E) and TI can be accomodated at any one time. Date of last inspection 12/10/2004 Brief Description of the Service: Northcott House is a care home providing nursing and personal care for up to 55 service users over the age of 55. The registered provider is a Gods Port Housing Association, a charitable organistaion , who also manage flats and bungalows on the same site as the care home. The manager, Mrs Christine Mirner, has been in post for ten months during which time there have been substantial improvments in the management of the home and staff morale. The home is situated in a residential area of Alverstoke in Gosport, with easy to local amenities, health care providers and the coastal area of Stokes Bay. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a two-day period and was performed by one inspector. The inspector was able to have conversations with many staff members, residents and several visitors to the home. Discussions with the manager revealed that the service users at the home like to be called residents; this shall be reflected throughout the inspection report. The manager, Mrs Christine Mirner and many staff members assisted the inspector throughout the inspection process. The inspector would like to take this opportunity to thank all staff, residents and visitors that assisted in the inspection process. Throughout the inspection it was noted that the atmosphere at the home continues to improve under the new leadership. Staff and residents are welcoming to all who enter the home and there was a happy friendly atmosphere at the home throughout the inspection. What the service does well: What has improved since the last inspection? The home, under the leadership of the manager, continues to improve in many areas. The care planning process is vastly improved with assessments and monitoring of health care needs now in place. The residents continue to become more vocal, the atmosphere at the home enabling them to be confident in exercising their choice and being able to speak up about their Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 6 needs and wishes. Staff at the home have also been enabled to speak out regarding their needs and the management of the home. The training needs of staff are being addressed, with many staff reporting an increase in receiving relevant training. 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. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.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 Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 3 Prospective residents receive information regarding the service provided by the home prior to admission, however this information has yet to be published in a revised form to accurately reflect the service provided and thus enable prospective residents to make a fully informed choice. Residents enter the home with the assurance that the home will be able to meet their holistic needs following a thorough assessment of their needs. EVIDENCE: The statement of purpose is made available for all to view as well as being supplied to all who enquire regarding the home. However despite a requirement following the previous inspection a revised statement of purpose has not yet been published that accurately reflects the service provided at the home as well as including service users views of the service provided. This shall be the third time this requirement has been made. All prospective residents undergo an assessment of their needs performed by two members of the care homes staff. This was confirmed during conversations that the inspector had with several residents and their relatives. Care workers at the home stated that they have information to enable them to meet the resident’s needs on admission to the home. The inspector viewed a Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 9 sample of pre admission assessments for residents evidencing that the information gathered is of a nature that enables a decision to be made as to whether the home is going to be able to meet that individual’s needs. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Huge improvements have been made regarding the care planning systems thus enabling the care staff meet the holistic needs of the residents at the home. The practice of regular assessments ensures that the health care needs of the residents are met. The administration of medications to the residents is handled in a safe manner thus further ensuring that the health care needs of the residents are met as well as ensuring their safety. EVIDENCE: The inspector viewed a sample of residents care plans. Detailed information is recorded to enable the health, personal and social needs of the residents be met. Care plans are reviewed monthly or as needs change. Residents and/or their relatives are consulted regarding care plans three monthly. During the course of the inspection the inspector noted consultation with residents and their relatives regarding changes in plans of care. Discussions with care staff indicated that the development of the care planning process at the home is enabling them to have immediate information regarding the care of residents. The manager discussed that the staff at the home as a team are still in the process of developing and improving the care planning process. The inspector Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 11 commends the work and improvements that have been made with regard to the care planning process. Within the care plans is documentary evidence regarding the monitoring and assessment of resident’s nutrition, psychological health, tissue viability, and moving and handling needs as well as risk assessments regarding falls. Discussions with residents and their relatives indicated that the staff at the home request medical attention if residents or their relatives voice concerns regarding health along with the staff’s own judgements. Residents have full access to the full multidisciplinary health care team, all contacts of which are documented within the resident’s records. Medication polices and procedures are in place. Observation of the administration of medications indicated that the polices and procedures are being adhered to. The home has the service of a community link pharmacist. The manager discussed that the link pharmacist is being utilised to address the issue of overstocking of medications that was noted during the course of the inspection. Following an inspection of the records of controlled medication it is recommended that a regular stock count of controlled medication is performed. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 & 15 The ethos, philosophy and management of the home create an environment in which residents are encouraged to retain their independence in the exercise of choice and control over their life. The provision of a varied and healthy diet enables residents to exercise choice regarding their diet whilst maintaining a healthy nutritional intake. EVIDENCE: Following recommendations after the previous inspection details regarding advocacy services are available for all to access within the home. At the time of the inspection no resident required the use of an advocate. Discussions with staff suggested that residents are able to exercise choice regarding daily routines and activities. This was confirmed in conversations that the inspector had with residents and relatives visiting the home. Residents are able to voice their concerns and wishes regarding any aspect of the home during regular resident meetings. Action is taken regarding their concerns some of which have resulted in the change of meat and dairy supplier to meet the requests of the residents. All residents that the inspector spoke with spoke highly of the meals received at Northcott House. Inspection of the menu evidenced that residents are offered a varied nutritional diet that is amended to reflect the wishes of residents. The catering team continue to strive to improve their service and are to attend further training regarding meeting the nutritional needs of the elderly population. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 13 Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Residents and their relatives are confident in the knowledge that any concerns complaints they have can be aired and acted upon promptly. All staff are aware of issues regarding the protection of vulnerable adults thus ensuring that all residents are protected from the effects of abuse. EVIDENCE: A complaints policy is displayed with the entrance area of the home for all residents and visitors to the home to view. Discussion with residents and visitors indicated that they are aware of the complaints procedure and they know who to approach if they have any concerns or complaints. All indicated that any concerns or complaints are acted upon and resolved promptly by the management of the home. Policies and procedures are in place regarding the protection of vulnerable adults including the Hampshire procedure in this situation. The manager has received accredited training regarding this subject, the information of which has been cascaded to the other staff during supervision sessions. Further members of staff have been allocated to attend formal training to enhance the awareness of this subject. Discussions with care staff indicate that they are aware of the action to be taken should they suspect an incident of abuse has occurred. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Improvements have been made in the prompt response to call bells and the access to care staff for those utilising the large communal areas. EVIDENCE: Following the requirement made in the previous report further call bells have been positioned in the communal areas. Throughout the inspection process the inspector observed that there was always one member of staff located in the communal areas to assist the residents if required. Residents were attended to promptly and none exhibited any signs of agitation to suggest that they were seeking attention. Residents utilising the communal areas confirmed that there were always staff located around the communal areas to attend to their needs if required. The inspector observed that call bells were being answered promptly; this was confirmed in conversations held with several residents. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 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 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) 29 & 30 The resident’s well-being is partially protected by the recruitment practice at the present time. Training programmes are being developed to ensure a competent workforce is in place to ensure residents wellbeing and safety are protected at all times. EVIDENCE: Recruitment polices and procedures are in place. However on viewing a sample of staff files the manager had not received two written references prior to members of staff commencing work. This was discussed with the manager. Details regarding previous employment and experience, relevant training and CRB and POVA checks had been obtained prior to staff commencing employment. Following the previous inspection much work had been done by the manager responding to the training needs of staff members at the home. All new staff members now receive an induction programme that meets national training objectives. All care staff are being encouraged to undertake relevant NVQ training. Discussion with care staff revealed that they feel they are receiving appropriate training to enable them to meet the needs of the residents at the home, and that they are receiving more training now than they have in the past. Residents that the inspector spoke with suggested that they believe that the care staff have the knowledge and skills to enable their needs be met. The manager acknowledges that more work is required in developing an assessment of each staff members training needs. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 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 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) 32, 33 & 36 The management of the home creates a supportive atmosphere for all staff and residents to be able to take choice and responsibility for their own actions, and to be able to voice concerns with the knowledge that they will be acted upon. The service provided is regularly reviewed ensuring that it is run in the best interests of the residents. Resident’s well-being is upheld with the process of regular supervision of care staff. EVIDENCE: The manager discussed the support she receives from the management committee and other staff members to enable her to perform the role of registered manager effectively. Her enthusiasm for ensuring the well being of the residents at the home was apparent throughout the inspection process. She continues to access various trainings for her self and for all staff members to enhance the quality for life for residents at the home and the quality of working life for the staff members. She is due to commence the registered Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 18 managers award in the near future. Discussions with staff at the home evidenced that the manager can be approached if they have any concerns. Residents meetings are held six weekly to which there is a 75 – 80 attendance. Viewing records of residents meetings and speaking to several residents evidenced that issues raised by the residents in these meetings are acted upon. During these meetings the residents are also kept informed of home management issues. The manager has developed an internal auditing programme for assessing the environment of the home. Since the previous inspection all polices and procedures have been reviewed and updated to reflect current practice. Resident surveys results have been collated and have been acted upon. Reviewing of care plans monthly enhance the quality auditing of the service provided by the home. At the time of the inspection the required monthly visits to the home to report on the conduct of the service are not being performed. This was discussed with the manager that this can be utilised as part of the auditing of the service provided at the home. Regular supervision of care staff has commenced. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION x x x 3 x x x x STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 3 2 x x 3 x x Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 20 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 OP1 Regulation 4 Requirement Timescale for action 30/06/05 2. OP29.2 17(2) & 18 26 3. OP33 A revised of purpose of that accurately refects the service provided at the home must be available. This is the third time this requirement has been made. Two satisfactory written 30/06/06 references must be obtained for each prospective employer prior to commencing employment. Monthly audits of the service 30/06/06 provided at the care home must be carried out, these must be documented and a copy provided to CSCI . 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 OP9 Good Practice Recommendations A regular stock count of the controlled medications held with in the home be peformed. Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 Page 21 Commission for Social Care Inspection 4th Floor-Overline House Blechynden Terrace Southampton Hampshire 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 Northcott House Nursing & Residential Care Home H54 S 11513 Northcott House V226600 170505.doc Version 1.30 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. 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