Inspection on 25/01/06 for Northlands

This inspection was carried out on 25th January 2006.

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

Northlands 30/01/09

Northlands 25/01/07

Northlands 01/07/05

Northlands 24/01/05

Northlands 05/08/04

Northlands 19/02/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Northlands 21 Kings Avenue Morpeth Northumberland NE61 1HX Lead Inspector Mrs Irene Bowater Unannounced Inspection 09: 25 January 2006 th 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 DS0000000509.V258345.R01.S.doc Version 5.0 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. DS0000000509.V258345.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Northlands Address 21 Kings Avenue Morpeth Northumberland NE61 1HX 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) 01670 - 512485 01670 512317 Autumn Care Group Mrs Margaret Aird Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places DS0000000509.V258345.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named service users under pensionable age category PD may be admitted to the home. No further admissions in this category may take place without agreement of CSCI. 1st July 2005 Date of last inspection Brief Description of the Service: Northlands Nursing Home is a large, three storey building, compromising of a converted house and a purpose built extension. The home is located within a residential area near the centre of Morpeth and is within walking distance of the town centre facilities. The home has 35 bedrooms which all have en suite facilities. There are specialist bathrooms, toilets and shower rooms on each floor. The ground floor has a large lounge with access to a pleasant garden and patio area. The middle and top floors have lounges, dining rooms and a conservatory. Smoking is permitted in the conservatory. The home has separate kitchen and laundry facilities. A passenger lift accesses the middle and top floor. There is limited car parking at the rear and front of the building and on street parking is also available on Kings Avenue. A sloping pathway gives access from the main parking area to the front of the building. DS0000000509.V258345.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the home, which took place over four hours. The manager was available and assisted throughout the inspection. Five residents and seven staff were spoken to throughout the inspection. The majority of the time was spent touring the premises and talking to residents and staff and time was taken examining records. What the service does well: What has improved since the last inspection? The requirements from the last inspection have been actioned or are in the process of being resolved. The redecoration and refurbishment of the home has continued. The care planning and communication with other health care professionals has improved which ensures the staff know how to care for each resident. The staff training has continued with 82.3 of care staff being trained to at least NVQ level 2.This exceeds the standard of 50 required by 2005. DS0000000509.V258345.R01.S.doc Version 5.0 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. DS0000000509.V258345.R01.S.doc Version 5.0 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 DS0000000509.V258345.R01.S.doc Version 5.0 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): 3, The admission procedures are comprehensive and ensure that the residents assessed needs are met. EVIDENCE: There are comprehensive preadmission and admission assessments in the care plans. The home ensures the care managers’ assessment is available prior to admission and the manager also completes an assessment to ensure the home can meet the resident’s needs. These assessments then form the basis of the initial individual care plan. DS0000000509.V258345.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 The care planning is clear and consistent to provide staff with the information they need to meet residents’ needs. Health care needs are met with multidisciplinary working taking place. Medication systems are satisfactory although the storage systems have the potential to place residents at risk. EVIDENCE: The qualified nursing staff have worked hard since the last inspection to improve the residents care plans. The plans inspected showed risk assessments such as nutrition, pressure area prevention, continence, mental health, dependency, falls and moving and handling are in place. The guidance is clear and these are evaluated each month. All of the residents have access to NHS services. The GP visits on a regular basis and there is evidence that opticians, chiropodist and dentists are sourced as necessary. DS0000000509.V258345.R01.S.doc Version 5.0 Page 10 Advice from other professionals for wound care and nutrition is sought and their recommendations actioned. The documentation regarding pressure sore care was detailed and clear. The home has sufficient pressure relieving mattresses and these were being appropriately used. The home has policies and procedures in place for staff to follow to ensure the safe administration of medicines. The requirements from the last inspection have been met. The recording of medicines coming into the home and being disposed of was satisfactory. A brief audit of the medicines and controlled drugs was satisfactory. The home is in the process of changing supplier and therefore an extra two weeks supply of all medicines was in stock. This has caused some short-term storage problems. Given that there are three floors there are only two medicine trolleys. One of the trolleys was full of medicines, which made it disorganised and possibly extended the medicine round. DS0000000509.V258345.R01.S.doc Version 5.0 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 the following standard(s): 14,15 The residents are supported to maintain control over all aspects of their daily lives for as long as they are able to do so. The dietary needs of residents are well catered for with a balanced and varied selection of food available that meets their taste and choices. EVIDENCE: Relatives and other visitors are welcome at any time and they can visit in the communal areas or in the resident’s rooms. The home has contact with the local churches and the locally community in general. There was a “flow” of visitors throughout the inspection who were all known by name by the staff. The staff encourages the residents to maintain control over their lives for as long as possible. Information about advocacy is available and the manager is always available to offer advice if necessary. All of the residents have brought small items of furniture and other belongings with them making the bedrooms highly individualised and homely. The home has separate dining rooms on two floors of the home. The dining rooms were nicely decorated and the tables appropriately set for both breakfast and lunch. Residents were observed having lunch either in the dining room or in their own room as they wished. DS0000000509.V258345.R01.S.doc Version 5.0 Page 12 The meal consisted of three courses. The food was hot and nicely presented and the residents were given choices of hot and cold drinks with their meal. The daily menu is readily displayed in the dining rooms and the residents confirmed that there are always choices for each meal. All of the residents spoken to said the “food is good” and “there is always plenty to eat”. The staff were quietly organised and give assistance in a discreet sensitive manner. DS0000000509.V258345.R01.S.doc Version 5.0 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 the following standard(s): 16,18 The complaints systems are satisfactory with residents’ views being listened to and acted upon. Arrangements are in place to protect residents from harm and abuse. EVIDENCE: The complaints procedure is displayed on notice boards in the home. The residents said they would be able to use the procedure should they need to do so. The complaints are recorded with actions and outcomes documented in a complaints file. There have been no complaints reported to the Commission since the last inspection. There are policies and procedures in place for staff to follow should there be any allegation or suspicion of abuse. The manager has completed a two-day investigation training course and the staff have received Adult Protection training in the last year. DS0000000509.V258345.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,24,26 The standard of the environment is generally good, providing residents with an attractive, comfortable place to live. There are some premise and infection issues that have the potential to place residents at risk. EVIDENCE: The location and layout of the home is suitable for the residents. The home continues to redecorate and refurbish the home as part of an ongoing plan and the manager audits the environment on a regular basis. All of the communal areas are nicely decorated and furnished to a good standard. There has been some carpet replacement which has enhanced the areas, including the conservatory. All of the bedrooms have an en-suite facility and there is a good range of specialist bathing, shower and toilet facilities throughout the home. The vinyl flooring in many of these areas is now showing signs of wear and tear. DS0000000509.V258345.R01.S.doc Version 5.0 Page 15 All of the rooms inspected were nicely decorated and furnished. The residents have brought small items of furniture and other personal possessions with them making the rooms highly individualised and homely. On the day of inspection the home was clean, bright and free from any offensive odours. The laundry is small, however the home contracts out for laundry services apart from personal items. The home has sluice facilities on each floor, however there is only one disinfector, which is located on the first floor. Many of the light cords were grimy and not all of the bins had suitable lids. DS0000000509.V258345.R01.S.doc Version 5.0 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 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): 27,28,29,30 The staffing levels are adequate to meet residents assessed needs. The staff are enthusiastic, well trained and keen to improve residents quality of life. The recruitment and selection processes are robust and protect resident living in the home. EVIDENCE: The home benefits from a core staff team who have worked at the home for some time. The recruitment of both qualified nurses and care staff has been successful and agency staff are rarely used. The records in the home confirm that there is an ongoing training programme. Eleven staff have completed NVQ level 2 and four staff are in the process of completing the course. Three staff have completed NVQ level 3 and four staff are completing the course. The staff have received training in safe working practices and further specialist training has been sourced. All staff have a training and development file. The staffing levels for the current number of residents are: 2 qualified nurses and 4 care staff during the day 1 qualified nurse and 3 care staff overnight DS0000000509.V258345.R01.S.doc Version 5.0 Page 17 The home has an activities organiser, cook, kitchen assistant, laundry and domestic staff. Administrative support is sourced from the homes head office. A random selection of personal files showed that the home follows the procedures for the selection of staff. Evidence was available regarding two references, Criminal Record Bureau checks and proof of identity. Qualified nurses have their registration and Personal Identification number (PIN) confirmed to ensure they are able to practice. The home has undergone audit by the University and is able to have student nurses on placement. The student nurse was positive about her placement at the home. DS0000000509.V258345.R01.S.doc Version 5.0 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 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): 31,35,36,38 The current management of the home is satisfactory and run in the best interests of the residents who are safeguarded by the financial procedures. Staff supervision is satisfactory and ensures they have a good understanding of their roles and responsibilities. The staff follow the health and safety procedures, which protects residents, and visitors from harm as far as reasonably practicable. EVIDENCE: The registered manager is a duel qualified first level nurse with considerable experience in the care of older people. She has completed the Registered Managers Award and is awaiting accreditation. The home has limited access to residents’ personal allowances. The manager confirmed that generally the residents or their representatives’ deals with the DS0000000509.V258345.R01.S.doc Version 5.0 Page 19 finances. All financial transactions are individually recorded with details of expenditure and witness signatures. The staff receive supervision on a regular basis. The records examined show that supervision covers all areas of practice and any development needs. The staff also have regular appraisals. The home has policies and procedures for staff to follow to minimise any health and safety risk to residents, staff and visitors to the home. The records show that staff receive training in safe working practices. The accident reporting is satisfactory with good monthly analysis recorded. Fire training is carried out with records kept. A fire risk assessment is available which is reviewed yearly. On the day of the inspection there were no concerns raised about the health safety and welfare of the residents. DS0000000509.V258345.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 2 3 X 3 X 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 3 X 3 DS0000000509.V258345.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 12,13 Requirement The home must provide a further medicine trolley. The home must provide suitable storage for all controlled medicines. The vinyl flooring in bathrooms, toilets and en-suite areas must be replaced as part of the refurbishment programme The home must clean and replace grimy light cords to enable regular cleaning. All of the bins must be foot operated and have suitable lids. Timescale for action 01/07/06 1 OP21 23 01/12/06 2 OP26 13 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard OP26 OP38 Good Practice Recommendations It is highly recommended that sluice disinfectors be fitted on each floor. It is recommended that the HMSO Accident Recording Book be implemented. DS0000000509.V258345.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000000509.V258345.R01.S.doc Version 5.0 Page 23 - 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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