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Inspection on 08/06/05 for Northfield Nursing Home

Also see our care home review for Northfield Nursing Home for more information

This inspection was carried out on 8th June 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

At present the home has applied for a variation to the registration to include the provision of a service for 25 people over 65 years who have dementia. The manager has shown commitment by accessing information and putting in place plans for the specialist training for staff on dementia. Alterations are taking place in the home to enable people with dementia to be cared for in an appropriate safe environment. Residents who are at present in the area highlighted for the care of people with dementia had been consulted with a view to moving rooms. One resident told the inspector that they had been offered a choice of three rooms to choose from.

What has improved since the last inspection?

All residents now have a lockable facility in their rooms and their bedroom doors have been fitted with locks. Some bedrooms have been decorated and some furniture replaced. Good progress has been made in registering staff on NVQ training. Domestic staff are also undertaking NVQ training. A training matrix had been produced which gives a clear view of what training has been completed and who needs further training. Staff identified for further training in the administration of medications had received this. The staff rota now identifies staff by their full names and includes agency staff employed.

What the care home could do better:

Thorough management audits should be carried out of the quality of care provided, staff training and supervision. Systems should be put in place and monitored regularly to ensure that residents are happy with the care and attention they receive. Residents must be given easy access to the complaints process and the appropriate staff to ensure they have the confidence in making a complaint and to know they will not be penalised for doing so. Commitment is needed and action taken to reduce the number of outstanding requirements for the home to provide a quality service as set out in their Statement of Purpose and Service User Guide.

CARE HOMES FOR OLDER PEOPLE Northfield Nursing Home 2a Roebuck Road Sheffield South Yorkshire S6 3GP Lead Inspector Carol Makin Unannounced 8 June 2005 09:00am 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 Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Northfield Nursing Home Address 2a Roebuck Road Sheffield South Yorkshire S6 3GP 0114 2687827 0114 2679591 None Palms Row Healthcare Limited 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 Lynne Neil N Care Home with Nursing 63 Category(ies) of OP Old age (63) registration, with number of places Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26 April 2005 Brief Description of the Service: Northfield is a care home providing personal and nursing care. Accommodation is provided for 63 service users. 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. The home provides nursing and personal care, service users accommodation is provided in 49 single rooms and 7 shared. There is a garden area that is safe and private for service users to enjoy. The grounds are accessible and well laid out, the garden sitting areas are attractive and well maintained. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted over seven hours; the person in charge on the day was Hilly Rockliff. The inspector would like to thank her and the residents spoken to for their help in the inspection process. Staff were not interviewed during this inspection. A complaint was received by the CSCI regarding the care of a resident who is no longer at the home. This was investigated as part of this inspection. The complaint was not upheld; records checked contained evidence that the appropriate care had been provided. What the service does well: What has improved since the last inspection? All residents now have a lockable facility in their rooms and their bedroom doors have been fitted with locks. Some bedrooms have been decorated and some furniture replaced. Good progress has been made in registering staff on NVQ training. Domestic staff are also undertaking NVQ training. A training matrix had been produced which gives a clear view of what training has been completed and who needs further training. Staff identified for further training in the administration of medications had received this. The staff rota now identifies staff by their full names and includes agency staff employed. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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 Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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, 4 Insufficient information is given to prospective residents or their relatives before admission. An informed decision to move into the home cannot be made as the information to assist in the decision making process is not provided. A full needs assessment completed by a professional is obtained before a resident is admitted to the home. However the resident themselves are not consulted by staff at the home about their needs to give them the confidence that the home can meet their needs. EVIDENCE: Two relatives spoken to stated that they were not given any information on the home before their relative was admitted there. They had not received the homes Statement of Purpose or Service User Guide. One resident interviewed said that they were not asked about what their needs were or what they wanted from the home before they moved in. One resident’s plan of care that was checked as part of a complaint made to the CSCI about the home contained a full needs assessment completed before admission. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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, 10. Residents care plans do not contain the information in sufficient detail to meet this standard. This could result in the staff not having the information required to meet the full needs of the residents they care for. Continuing health care is provided and health care professionals are consulted when the changing health needs of a resident deteriorates. Residents care needs are not met resulting with them feeling very unhappy about their personal hygiene needs and their dignity not being maintained. Residents are not always treated with respect and their privacy was not maintained. It is every resident’s right to be treated as a person whose rights to privacy are maintained thus maintaining his or her dignity. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 10 EVIDENCE: One-deceased residents care plan was checked as a result of a complaint made to the CSCI about the care received at the home. Although the details recorded were not sufficient to meet the standards there were sufficient records that indicated that health care and attention that was provided was appropriate. Other health professionals were consulted when health needs changed and the medical care was reviewed and changed at these times. A tissue viability nurse was consulted and appropriate aids and equipment was provided for the comfort of the resident. Medication was stored securely on this inspection and the person in charge said that extra training on the safe keeping of medication had been provided for staff after problems during the last inspection were highlighted. One resident spoken to said that they were not treated with respect by the staff and they had no privacy. The resident spoke of bad practices, which distressed them and made them very unhappy. With the residents permission the inspector repeated the concerns in the resident presence to the person in charge. The person in charge gave assurances that their complaints would be taken seriously and action taken. A system for communicating between the people in charge and the resident was established. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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, 15. Activities are provided and an activity worker is employed. Not all residents are given the opportunity to be involved in activities, which results in a lack of stimulation and motivation. Relatives and visitors to the home are made welcome and can visit their relative in their own room to maintain their privacy at this time. Residents can personalise their rooms with their own possessions to make it feel familiar and homely to them. A choice is offered from a menu each day and sufficient quantities are provided which is to the residents liking. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 12 EVIDENCE: Some residents were sat outside enjoying the fine weather. The homes activities coordinator was present and involving the residents in a craft session. One resident spoken to said the gardens were beautiful and they enjoyed sitting out. Two relatives were concerned that their relative spent a great deal of time alone in their room which resulted in them sleeping for most of the day. The two relatives spoken to said they were always made welcome by the staff when they visited. Residents are allowed to bring some of their own personal possessions into the home so they have familiar things around them. Two residents spoken to about the food said that they enjoyed their meals, they were given a choice and there was always sufficient quantity. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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, 17, 18 Resident’s are not given the opportunity to complain and be listened to and where needed appropriate action taken. Abusive practices could go undetected if residents don’t feel that any action would be taken if they complained or that they could be penalised for doing so. Residents are given the opportunity to vote using the postal system thus ensuring they maintain their rights to be part of the community and civic processes. Residents feel safe at the home however the attitude and behaviour of some of the staff is not acceptable to some of the residents resulting in them feeling uncomfortable when certain staff are on duty. EVIDENCE: One resident spoken to said that they knew whom to go to if they had a complaint, however they would have to ask the staff to take them to this person, this put them off they said as staff would know who had complained All had received a postal vote for the recent general election. One resident made comments about some of the staff’s attitudes that gave them cause for concern. Comments the resident made to describe some of the staff were “one is nasty”, “staff boss you around”, “they will make it worse for us if they know we have told you anything”, “they cover things up and tell us not to say anything to you” Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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, 26 The furniture, furnishings and decorations in the home are in the main in reasonable condition making it a pleasant environment for the resident, visitors and staff. Some refurbishment was taking place. Residents said that they liked their rooms and they were comfortable. They contained their personal possessions, which made them look homely and personalised. There is a call system for residents to summon help however resident said that not all staff answers the call system promptly causing discomfort and distress to the residents when they are in need of care and attention. The home was free from unpleasant odours. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 15 EVIDENCE: A brief tour was carried out of the building. At the present time alteration were being carried out for the proposed new service for people with dementia. A new dining area had been provided and the lounge area on one floor moved with an additional small lounge provided. Some bedroom furniture had been replaced however not all that is in need of replacing had been. A maintenance person is employed at the home for routine repairs and decorations. The home was clean with no unpleasant odours. Residents spoken to said they liked their rooms and they had what they needed to make them comfortable. One problem identified by residents was that the ongoing problem of staff not answering the call system promptly. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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) 27, 30. The home needs to look at the deployment of staff to ensure that there are more staff on duty at peak times in the day so that residents feel they are well cared for and not told “you will have to wait” when they call for assistance. There is a programme for staff training and some had recently undergone training in COSHH (Control of Substances Hazardous to Heath) and food hygiene thus maintaining residents and staff safety. More training is booked to ensure that all staff has attended statutory training. EVIDENCE: There was mixed views given by two of the residents on if the staff do their jobs well. They said some were good however they also gave negative comments when asked their opinions of if staff did their jobs well. They said that they did not think there was sufficient staff on duty at all times as they were told they would have to wait when they needed assistance. Some staff had recently undergone training in COSHH and fire safety this included taking part in a fire drill. Some staff are in the process of completing their NVQ qualification and the home employs a training officer. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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) 33, 36, 38. Quality systems are in place for monitoring that the home is meeting the aims and objectives of the Statement of Purpose. With comments received during this inspection about the quality if care there appears to be a major amount of development needed to meet the objectives to the satisfaction of the residents. Further comments are contained in other sections of this report on this. No hazards were found relating to safety issues in the homes environment ensuring that residents live in a safe environment. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 18 EVIDENCE: The home has a quality assurance system and the findings are published and displayed at the homes reception area. A responsible individual of the operating company does carry out a monthly-unannounced visit and produces a report. A selection of records the home is required to keep was checked these did not contain all details as is required and further comments are contained in other sections of this report. On the day of the inspection no hazardous substances were seen insecurely stored and fire exits were clear. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.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 1 x 3 1 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 1 x 1 x 3 STAFFING Standard No Score 27 1 28 2 29 x 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 3 1 2 x 1 x x 1 1 1 Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 20 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 1 Regulation 5, 43 Requirement The homes Service User Guide must be updated to include the names of the current manager and cook. Prospective residents must be given sufficient information on the home and be consulted about their needs before they make the decision to move into the home. Action must be taken, as identified in the homes care plan audit, to ensure all individual plans are accurate and up to date. Care plans must be completed in full. Previous timescale of 31.5.05 has not been met. Personal health care needs must be maintained with regular person hygeine care following incidents of incontinence. Timescale for action 1.Sept.05 2. 1, 4 5, 43 1.Sept.05 3. 7, 37 15, 43, Shedule 3 1.Sept.05 4. 8 12, 43 The person in charge was informed of this immediatel y The person in charge Page 21 5. 10 12, 43 The manager must investigate and take appropriate action regarding the comments from a Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 resident that they are not treated with respect and their privacy and dignity is not maintained. 6. 10 12, 43 The homes pay phone must be fully accessible to service users. A chair must be provided. Previous timescale of 31.5.05 has not been met. Residents must be given the choice to participate in activities provided in the home. Staff must assist residents that are not mobile to join in. was informed of this immediatel y 1.Sept.05 7. 12 12, 43 1.Sept.05 8. 16 12, 13, 22, 43 9. 18 There must be a simple, clear and accessible complaints procedure which the residents can access and do so privately. Residents must be assured that if they complain they will be protected from reprisals. 18, 24, 43 The comments that some staffs attitude and behaviour is not acceptable must be thoroughly investigated and clear plan of action taken to ensure these practices cease. 10. 18 11. 22 12. 22, 27 13, 18, 43 All staff must receive training on adult protection issues. Previous timescale of 31 May 05 was not met. 23, 43 Bathrooms must not be used, as 1 Sept 05 storage areas for aids and equipment and a suitable safe area must be provided for the hoists that need to be electrically recharged. Previous timescale of 31.5.05 has not been met. 12, 43 The manager must undertake 1 Sept 05 further unannounced audits of response times to call systems at varying times of the day. If service users needs are high J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 22 The person in charge was informed of this immediatel y The person in charge was informed of this immediatel y 1 Sept 05 Northfield Nursing Home 13. 24 14. 24 15. 30 16. 33 17. 36 18. 37 19. 38 then the staffing levels must be increased to reflect these needs. Previous timescale of 31.5.05 has not been met. 23, 43 An audit of bedroom furniture must take place. Where furniture is showing signs of age, this must be identified within the homes refurbishment programme for replacement. Previous timescale of 31.5.05 has not been met. 23, 43 How ventilation is safely provided in the identified service users room without opening windows must be demonstrated. Previous timescale of 31.5.05 has not been met. 13, 18, 43 Staff must receive all statutory training including COSHH. Previous timescale of 1.6.05 has not been met. 21, 43 An annual development plan for the home must be produced taking into account the findings of the quality assurance surveys. Previous timescale of 31 May 05 was not met. 18, 43 All staff must receive supervision at least six times a year that covers all aspects of care, philosophy of care in the home and their career development needs. Previous timescale of 31 May 05 was not met. 17, 43 Records required by regulation for the protection of service users must be maintained, up to date and accurate. Previous timescale of 31 May 05 was not met. 16, 18, 43 All staff must undertake training in food hygiene. Previous timescale of 31 May 05 was not met. 1 Sept 05 1 Sept 05 1 Sept 05 1 Sept 05 1 Sept 05 1 Sept 05 1 Sept 05 20. 21. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 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. Refer to Standard 28 31 Good Practice Recommendations A ratio of 50 of all care staff must be qualified to NVQ level 2 or equivalent by 2005. The manager should ensure she has a management qualification equivalent to NVQ level 4 by 2005. Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Northfield Nursing Home J55 S21798 Northfield V223095 08.06.05 UI Stage 4.doc Version 1.30 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!