Inspection on 07/07/05 for Northfield Manor Nursing And Residential Home

This inspection was carried out on 7th July 2005.

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.

Other inspections for this house

Northfield Manor Nursing And... 14/03/07

Northfield Manor Nursing And... 05/12/05

Northfield Manor Nursing And... 01/02/05

Northfield Manor Nursing And... 27/09/04

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

CARE HOMES FOR OLDER PEOPLE Northfield Manor Nursing & Residential Home Long Lane Driffield East Yorkshire YO25 7UT Lead Inspector David White Unannounced 7 July 2005 09:30 th 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. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 3 SERVICE INFORMATION Name of service Northfield Manor Nursing & Residential Home Address Long Lane, Driffield, East Yorkshire, YO25 7UT 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) 01377 257288 01377 241253 northfieldmanor@aol.com Silverfield Care Management Mrs Melanie Louise Missin Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45), of places Physical disability over 65 years of age (45), Terminally ill over 65 years of age (45) Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 01/02/05 Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 5 Brief Description of the Service: Northfield Manor provides care (including nursing care) and accommodation for up to 45 elderly people. The home is situated on the outskirts of the market town of Driffield. Accommodation at the home is available in single or companion rooms which are decorated and furnished to a high standard. Residents are able to use a choice of lounges or a conservatory to relax in and a wide range of activities are available. The grounds are well maintained and accessible to wheelchair users. Seating areas are provided and plans are in hand to develop raised beds planted to appeal to those with sensory impairment. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection over 7 hours which involved a check of the records, discussion with two residents, a visitor, two members of the care team, a member of the catering staff, the handyman and the manager. I also made a tour of the environment. What the service does well: What has improved since the last inspection? What they could do better: Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 7 Not all the problems that were identified in the last inspection report have been dealt with. There must be an up to date electrical wiring certificate to say the home is safe for residents. There must be written documentation to say that the asbestos in the home does not pose a threat to the residents. Residents must have heating systems in their bedroom which they can control. Chemical cleaning agents must not be left unattended to in resident bedrooms. Razor blades must not be left in bathrooms. Sliding skip holders must not be left in corridors. The complaints procedure must be amended so that people are aware that they can refer their complaint to the Commission for Social Care Inspection or other relevant agencies at any stage of the complaints process. Personal information about residents must not be held in files which contain information about other residents. 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. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc 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 Standards Statutory Requirements Identified During the Inspection Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5 There are good assessments of residents before their admission to the home and residents receive clear information about the services which will be provided. EVIDENCE: Each resident has an individual file which includes admission details, assessments, care plan programmes and daily records of care. The manager or her deputy usually carries out the pre admission assessments. Pre admission information includes an assessment and initial care plan from the placing or funding authority where applicable. One resident who has recently moved into the home said that she was able to visit the home before making a decision to move there. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc 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 and 10 Residents are treated in a dignified and respectful manner, and there are care plans in place to reflect that resident needs are being met. EVIDENCE: The residents looked clean and tidy and well cared for. The records of three residents were looked at and all had care plans in place although one care plan of a new resident was incomplete as the assessment of the resident’s needs was still ongoing. The care plans contain information about how the resident is to be cared for and this information is updated on a regular basis. The personal interests of residents are recorded and residents said that staff encourage them to be able to pursue their hobbies and interests. Particular attention is given to food likes and dislikes and residents could confirm that the information within the care plans is relevant. Risk assessments are in place regarding the prevention of pressure sores, to reduce the risk of a resident falling, to assess nutritional needs and to help residents with their mobility. The care plan records show that referrals to health specialists are made as and when necessary. Care plan reviews involving Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 11 relevant agencies and family members take place annually. It is recommended that reviews are carried out at least six monthly. All the residents said that staff treat them with respect” and one said “staff can not do enough for you”. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 Residents have opportunity for social activities both in and outside of the home and flexible visiting arrangements mean that residents can see family and friends whenever they wish. The meals provided are both nutritious and varied. EVIDENCE: The home has an activities organiser who offers residents the chance to join in activities at the home and day outings are arranged. Residents said that they do not have to join in with the activities if they choose not to. The home produces a monthly newsletter and the planned activity programme is included in this. Resident interests are recorded in their care plans and residents said that staff are supportive in helping them to carry on with their interests and hobbies. The residents could confirm that they were able to live their lives in the way they chose given certain limitations. One resident enjoys a bath and said “I am able to have a bath whenever I want”. Visiting time is flexible and some family and friends were seeing residents whilst I was at the home. One visitor said “staff are very good and always keep me informed about my mother’s care” also saying that she is always made to feel welcome when visiting. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 13 Residents were complimentary about the quality of the meals provided. There are choices for each mealtime and other meals are offered if a resident does not like anything on the menu. Special diets are catered for and advice is sought from dieticians when needed. One resident said that the meals are “lovely” and others said “the meals are excellent”. The manager asked the residents about the quality of the meals using a questionnaire and the records show that resident views about the meals have been acted upon. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc 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 and 18 Residents concerns are acted on although part of the complaints procedure needs changing so that accurate information is provided to people raising concerns. Staff have a good understanding of abuse procedures and this safeguards the interests of residents. EVIDENCE: There are written policies and procedures in place to deal with complaints and the complaints procedure is on display within the home. However the procedure states that people making a complaint can only refer the matter to the Care Standards Commission or any other relevant agency if they are not satisfied with the organisation’s investigation. Records are kept of all complaints and the actions taken and outcomes. Residents and the visitor spoken with knew who to see if they had a complaint There are adult protection policies and procedures in place and adult protection training is in place for all staff. Awareness of abuse is included in the induction training for new staff. Staff were knowledgeable about how to recognise abuse and the actions to be taken if abuse was suspected. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24, 25 and 26. The environment is pleasant and comfortable for residents but a number of unsafe working practices within the environment put residents at risk of harm. EVIDENCE: The home was clean and free from odours. I looked at four residents bedrooms and these were tidy and comfortable. One resident said that her bedroom was “marvellous” and enjoys sharing the bedroom with another resident as this gave her “some companionship”. The home has a number of residents who need nursing care, however there are only two adjustable height beds in the home. The lounges and dining room are all on the ground floor and are spacious and well furnished. There is a lift on every floor and there is access to the gardens for wheelchair users. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 16 The home has washing and sluicing facilities. A laundry assistant is employed to look after residents clothing and domestic staff assist with the laundry as part of their duties. The home is due to undergo refurbishment later this year at which stage all bedroom doors will be fitted with locks and heating systems in bedrooms will be able to be individually controlled by residents. Advice has been sought about the safety of the asbestos in the home but there was no written evidence to show that the asbestos poses no risk to the residents. A check of the electrical wiring was made in June 2005 but the home has not received the certificate as yet. I looked around the environment and found that on the first floor of the home sliding skip holders were being left on the corridors. In a ground floor communal bathroom there was a used razor blade on the bath. In bedroom 21 a cleaning trolley carrying chemical cleaning agents was unattended to whilst the domestic staff took a break. The manager dealt with these matters immediately. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30 Residents receive a good standard of care from an enthusiastic, well-prepared and motivated staff team. Recruitment procedures are followed to safeguard residents from abuse. EVIDENCE: The atmosphere in the home was pleasant with humour between residents and staff. There are nursing and care staff and the majority of care staff are trained to National Vocational Qualification (NVQ) level 2 or above. There is a wide range of training on offer that includes training specific to the needs of the residents. I spoke to a new member of staff who had an induction programme when starting work at the home. As well as learning about the health and safety issues about the home she was also told about what to do in various situations such as a fire in the home or if she thought a resident may be being abused. She was working under the supervision of a senior member of staff to make sure she was competent to carry out the work required. I looked at the staff file of a new member of staff and all the pre-employment checks had been made as required. The staff files provide information about whether staff wish to work in excess of the European working time directive as per current employment legislation. Staff members have a good awareness and understanding of the needs of the residents in the home. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 36, 37 and 38. The manager provides clear leadership throughout the home. Residents, relatives and others are asked about their views of the home. The health and safety practices in the home do not fully protect residents. EVIDENCE: The registered manager is experienced in running the home and will shortly complete the NVQ level 4 in management. Both residents and staff said that the manager was “approachable and helpful”. The manager has carried out a recent survey of GP’s views about the home and there have also been relative and resident surveys. Resident, relative and staff meetings are held on a regular basis and I spoke to a visitor who could confirm that she is invited to relative meetings to discuss her views of the home. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 19 Staff are now receiving supervision on a regular basis and problems and training needs can be identified and dealt with. The home has a number of health and safety policies and procedures and staff regularly receive updated health and safety training. However as detailed earlier under the section in this report dealing with the home’s environment there are a number of practices which could affect residents safety: • • • • • Documentary evidence must be provided to show that residents are not at risk from the asbestos in the home. A satisfactory electrical wiring certificate must be obtained. Chemical cleaning agents must not be left unattended to in resident bedrooms. Razor blades must not be left in bathrooms. Sliding skip holders must not be left in corridors. Records about the food were accurate and kept up to date. Individual and home records are kept secure and confidential, however some personal information about individual residents was being held with information about other residents. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 1 x x x x 1 1 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 3 2 x 3 x x 3 1 1 Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 21 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 16 Regulation 22 Requirement Complainants must be made aware that they can refer complaints to the Commission or local authority at any stage of the complaints process. Bedroom doors must be fitted with locks unless risk assessments indicate otherwise (Previous timescale of 31/03/04 not met). The registered provider must provide documentary evidence that the asbestos within the home poses no threst to residents either in its current form or when being removed from the home (Previous timescale of 28/10/04 not met) The registered person must ensure that rooms are centrally heated and heating may be controlled in the residents own room (Previous timescale of 31/03/04 not met) Personal information about residents must be held within individual records in accordance with the Data Protection Act. Cleaning trolleys carrying chemical cleaning agents must not be left unattended to. Timescale for action 31/07/05 2. 24 16, 23 30/10/05 3. 24 12, 13 30/08/05 4. 25 16, 23 30/10/05 5. 37 17 As from 07/07/05 and after Immedaiet as from 07/07/05 Page 22 6. 38 13 Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc and after 7. 38 13 Razor blades must not be left in communal bathroom areas. Sliding skip holders must be stored appropriately and not be left lying in corridors of the home. The registered provider must have an electrical wiring certificate for the home (Previous timescale 01/05/05 not met). Immedaiet as from 07/07/05 and after Immedaiet as from 07/07/05 and after 30/10/05 8. 38 13 9. 38 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 24 31 Good Practice Recommendations It is recommended that care plan reviews are carried out at least six-monthly. It is suggested that additional adjustable height beds are provided. It is recommended that the registered manager completes the NVQ level 4bin management by the end of 2005. Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 23 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 Northfield Manor Nursing & Residential Home Version 1.30 J53_J04_S944_Northfield_V231140_070705_Stage 4.doc Page 24 - 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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