Inspection on 10/04/06 for Northfield Nursing Home

This inspection was carried out on 10th April 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Northfield Nursing Home 22/12/09

Northfield Nursing Home 30/09/09

Northfield Nursing Home 05/08/09

Northfield Nursing Home 01/04/08

Northfield Nursing Home 10/04/07

Northfield Nursing Home 03/02/06

Northfield Nursing Home 08/06/05

Northfield Nursing Home 01/03/05

Northfield Nursing Home 02/08/04

Northfield Nursing Home 12/02/04

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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 Northfield Nursing Home 2a Roebuck Road Sheffield South Yorkshire S6 3GP Lead Inspector Michael O’Neil Unannounced Key Inspection 10th April 2006 09:20 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 Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 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. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Northfield Nursing Home Address 2a Roebuck Road Sheffield South Yorkshire S6 3GP 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) 0114 268 7827 0114 267 9591 lynne@palmsrow.co.uk www.palmsrow.co.uk Palms Row Health Care Limited Mrs Lynne Neil Care Home 63 Category(ies) of Old age, not falling within any other category registration, with number (63) of places Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may admit persons between the ages of 60 to 65 years. Date of last inspection 3rd February 2006 Brief Description of the Service: Northfield is a care home providing personal and nursing care. Accommodation is provided for 63 people. The home is owned by Palms Row Health Care and is situated in the residential area of Crookesmoor. It is close to the main bus route and is a short walk away from the Upperthorpe shopping area. The home is purpose built with accommodation provided on two floors, which are accessed, by a lift. Since the last inspection the service user category has been varied. There is no longer capacity for 31 people that suffer from various forms of dementia to be accommodated. There is a garden area that is safe and private for residents to enjoy. The grounds are accessible and well laid out, the garden sitting areas are attractive and well maintained. The manager confirmed that from 10.04.06 the weekly range of fees charged for accommodation and care varied from £368-£513. Additional charges are made for services such as chiropody and hairdressing. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection carried out by Mike O’Neil and Stuart Hannay, regulation inspectors. This inspection took place between the hours of 9.20 am and 3:40 pm. Lynne Neil, registered manager was present during the inspection. Opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home, check the homes policies and procedures and talk to 7 staff, 2 relatives and 17 residents. The inspectors wish to thank the staff, relatives and residents for their time, friendliness and co-operation throughout the inspection process. What the service does well: What has improved since the last inspection? The provider was now providing residents with terms and conditions of residence. The admission and care needs assessment policy and assessment procedures had improved. The way that staff assisted residents to eat was more dignified for the residents. Staff were sitting next to residents assisting them to eat rather than standing up over the residents. Some new dining room furniture had been purchased. Residents said that staff answered the nurse call system more promptly. There had been a notable improvement in recruitment practices since the last inspection. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 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. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3,4 and 5. Standard 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives receive information they need to make an informed choice about where they wish to live. This information includes the fees charged and a contract of residence. Residents’ needs are assessed prior to admission but the assessments have not always been completed when their needs change whilst resident in the home. Specialist medical and nursing staff were regularly consulting with the staff at the home and advising good practice. EVIDENCE: Contracts and terms and conditions of residence were seen in two resident files checked. (Previous requirement met) The manager said that no residents were admitted to the home without an assessment. An assessment was faxed through to the home before residents Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 9 were admitted to the home on an “emergency” basis. A copy of this assessment was seen in a residents care plan. (Previous requirement met) The manager said that there were now only 4 residents at Northfield who were waiting for reassessment, to be led by Sheffield Social Services, to see if the residents were appropriately placed at the home and not “out of category”. There had been good progress made to meet this previous requirement. Three resident files were checked and each contained a copy of their full needs assessments. The information from the full needs assessment had been incorporated into two of the three resident care plans. Details of medical/nurse specialists who had been consulted with regard to the residents care were recorded in the care plans. This will assist in ensuring residents needs are met. Staff said that they had undertaken various types of training needed to assist them in caring for the client group who are resident at Northfield. This training will assist them to meet the needs of the residents at Northfield. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The information in one care plan was inadequate to ensure that the resident’s health needs could be met. Two other care plans checked were of a good standard and the residents’ health; social and personal care needs were well documented. Residents themselves said that the care they were receiving was good and that the staff were helpful, friendly and nice. Some medication documentation practices provide a risk to the residents’ health and welfare. Residents said their privacy was upheld at the home. EVIDENCE: Three resident plans of care were checked. Two plans checked set out individual needs and the action required by staff to ensure those needs were met. However staff had failed to develop a care plan for one resident despite the resident being admitted to the home one month ago. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 11 Two care plans were of a good standard and identified that a range of health professionals visited the home to assist in maintaining the residents health care needs. Residents or their relatives were involved in drawing up the care plans. Updated risk assessments were recorded in the care plans. Staff, when writing the residents daily notes, need to be more reflective of the information actually recorded in the residents care plan. There was evidence to show that the manager has been using an auditing system to monitor the quality of care plans. (Previous requirement met) Residents said that they were happy and that the staff were friendly and nice. The inspectors observed that residents were well dressed in clean clothes and had received a good standard of personal care. Medicines were securely stored around the home in locked cupboards. Residents’ health and safety, however, was not maintained because not all Medicine Administration Records (MAR) were adequate. The MAR sheets contained hand written instructions and/or alterations with no signature as to the prescriber. Whilst waiting for a label to arrive from pharmacy two staff members, who check that the correct information is documented, or ideally the General Practitioner must sign any handwritten instructions on the MAR sheets. Staff were observed to be assisting residents in a positive and friendly manner, doors were closed where staff were helping with personal care. Residents said that staff “respected our privacy”. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a choice of lifestyle within the home and are able to maintain contact with family and friends. Meals served at the home were of a good quality and offered choice to ensure residents receive a healthy balanced diet. EVIDENCE: Residents were able to spend their day as they wished and move freely around the home. Residents said that they were able to maintain contact with their family and friends. Relatives said that they were always made to feel welcome when they visited and they were able to visit at any reasonable time of the day or evening. Throughout the day friends and family were seen visiting freely and being offered hospitality, which creates a home that people want to visit. A friendly and welcoming feel was evident in Northfield. Residents spoke positively about the amount of activities available both within the home and on trips outside the home. These were advertised around the home. Activities were occurring during this inspection. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 13 Residents said they chose when they got up and went to bed. Residents said that they had a choice of food and that the quality of food served was good. Lunch was served in a pleasant relaxed manner with staff sat with some residents helping them to eat. (Previous requirement met) Residents said that they enjoyed their lunch. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure residents are protected from abuse. Complaints procedures are in place to enable residents and relatives to feel confident that any concerns they voice will be listened to. EVIDENCE: Complaints procedures were displayed around the home. Relatives and residents said that if they had any concerns that they would feel comfortable in talking to the staff or the manager. Staff had received information on adult abuse and some staff had received formal training. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,22,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment within the home was well maintained and clean providing a comfortable, safe environment for residents. Staff confirmed that there were enough hoists available to ensure that residents could be safely moved. EVIDENCE: The grounds around the home were very welcoming and residents said that they could easily access them should they wish. All areas of the home were clean and tidy. (Previous requirement met) Three bedrooms were checked in detail and many others seen, all were comfortable and homely. The home was clean, with no unpleasant odours noticeable. Relatives and residents said that the home was always kept clean. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 16 The inspectors observed that the ‘nurse-call’ system was answered within acceptable timescales after it was activated. Residents said staff answered the nurse call system promptly. (Previous requirement met) The home was warm in all areas. Window restrictors were fitted to all windows checked. The hot water temperature in bathrooms and residents rooms measured safe temperatures below 45 degrees centigrade. This will assist in maintaining resident safety. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff were employed in sufficient numbers to meet the residents needs. The recruitment information obtained for new staff was sufficient to adequately protect the welfare of residents who lived at the home. Staff were not receiving adequate training on their induction, so may not have the required skills to meet the residents needs. However a proportion of staff have completed training that ensures these staff have the competences to meet the residents needs. EVIDENCE: The manager stated that agreed staffing levels were being maintained and the staff rota identified agreed staffing levels had been met. Staff said staffing levels were adequate. Residents said there was always a member of staff available when they needed them. The required 50 of care staff had not achieved their level 2/3 NVQ qualification, although the manager said a number of staff had enrolled or were undertaking their NVQ training. One member of staff interviewed said they had completed their NVQ training. Two staff recruitment files were checked. There had been a notable improvement in recruitment practices since the last inspection. Previous requirements made at the last inspection had all been met. The staff files contained references from the staff’s last employer, Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 18 information to verify identity and Criminal Record Bureau (CRB) and Protection Of Vulnerable Adults (POVA) checks. The manager confirmed that all staff working at the home had completed an enhanced CRB/POVA check. There was a training and development plan for the staff. Staff said they were encouraged to attend training on various care topics but in recent months this training was on an adhoc basis. A staff file checked identified that the member of staff had not received adequate or in depth induction training when they commenced work at Northfield, only basic health and safety training was provided. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,35,36,37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There was a positive style of management in the home. Further staff fire and moving and handling training is needed to protect the safety of the residents and staff. Residents’ confidentiality was safeguarded, as their records were securely stored in the home. Staff were not being adequately supervised, so they may not have the required skills to meet the residents needs. Some of the homes policies and financial procedures did not fully promote the health, safety and welfare of residents and staff. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 20 EVIDENCE: The manager was very positive about the inspection process and was committed to improve the service of Northfield and meet the National Minimum Standards and Care Home Regulations. The manager said she had nearly completed her level 4 NVQ management qualification. Residents said that they met regularly with the manager and spoke positively about her approachability and helpfulness. Staff interviewed said they enjoyed working at the home. The home had an active quality assurance system. There was evidence of internal auditing of the homes environment, services and records. The manager had recently sent questionnaires to the relatives and residents to ask for their views of the home. These had been returned and contained positive comments about Northfield, however, recorded visits by the registered provider had not been carried out. The residents’ personal money accounts were up to date and a receipting system and statement sheets were seen for each resident. However, residents’ financial interests were not fully safeguarded because staff were not requesting that the resident or relative countersign the records when money is deposited or withdrawn from the account. One resident’s record suggested that a large sum of money was being held at the home when in actual fact it was deposited with an advocacy agency. This must be made clear on the record. Staff said they were not receiving supervision on a regular basis. Records were securely stored around the home, which protected the residents’ best interests and confidentiality. The health and welfare of residents could not be fully protected, as two members of staff had not received recent moving and handling training or fire safety training. Practice fire drills had been conducted in the home, however the records did not identify the length of the drill, any corrective action needed after the drill and the drills were not conducted at different times of the day. Fire records stated that weekly testing of the fire alarm system had occurred. A sample of records showed servicing of the homes utility systems had occurred. At the time of inspection fire exits were clear and window restraints were in situ at first floor windows checked to prevent falls. Hazardous products were safely stored in the home. This will promote the safety and welfare of the service users. Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X 3 X 3 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 2 3 2 X 2 1 3 2 Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP4 Regulation Care Standards Act 24 15 15 Requirement Service users who are ‘out of category’ must be reassessed to see if their needs can continue to be met at the home. Each resident must have an up to date care plan. The residents daily notes must reflect the information actually recorded in the residents care plan. The Medication Administration Records must contain General Practitioners or two members of staffs’ signatures alongside any directions regarding the dosage of the medication or the time the medication is to be dispensed. 50 of care staff must be trained to NVQ level 2 or equivalent. Staff must receive induction training within 6 weeks of appointment to their posts. The manager must be trained to NVQ level 4 or equivalent in management. DS0000021798.V288317.R01.S.doc Timescale for action 01/06/06 2 3 OP7 OP7 01/05/06 01/07/06 4 OP9 13 01/05/06 5 6 7 OP28 OP30 OP31 18 19 9,18 01/01/07 01/07/06 01/01/07 Northfield Nursing Home Version 5.1 Page 23 8 OP33 26 9 OP35 16,17 10 OP36 18 11 12 13 OP38 OP38 OP38 23 18 23 The registered provider must visit the home and produce a report. The report must contain the information as highlighted in regulation 26. Increased procedures must be put in place to ensure that residents financial interests are safeguarded. Formal staff supervision must occur at least six times a year. This supervision must be documented. Staff must receive fire instruction training at least once a year. Staff must receive annual moving and handling training. Fire Drills must be conducted at different times of the day/night so as to ensure that all staff working at the home are aware of the procedures to follow in the event of fire.Fire Drills records must indicate the time of the drill and any corrective action taken after the drill. 01/07/06 01/06/06 01/07/06 01/06/06 01/08/06 01/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Northfield Nursing Home DS0000021798.V288317.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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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