Inspection on 25/01/07 for Northlands

This inspection was carried out on 25th January 2007.

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 25/01/06

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 Suzanne McKean Key Unannounced Inspection 25 January 2007 09:30 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 Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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 nicola@autumncare.co.uk 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 Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. 25th January 2006 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. The home charges fees of between £483.47 and £521.47 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide. A copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was carried out over six hours by one inspector, Suzanne McKean. The manager was on duty during the visit and assisted the inspector with the process. Twelve residents and four relatives were spoken to individually during the visit; although the inspector also spoke to six of the staff in process of the inspection visit and was involved in the residents and relatives meeting. Records examined included, six care plans, training records and the records for complaints as well as the health and safety, accident and maintenance records. There was one requirement identified as a result of this inspection. The three requirements from the last inspection had been met. There are two recommendations in place from the last remain in place. What the service does well: What has improved since the last inspection? Since the last inspection the home has provided an additional medicine trolley and improved the storage for all controlled medicines. The vinyl flooring in bathrooms, toilets and en-suite areas are almost all replaced as part of the refurbishment programme, this has been removed as a requirement. The home must replaced grimy light cords and covered them with a non-pervious covering, which can be easily cleaned. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 6 The waste bins are now foot operated and have suitable lids. 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. The summary of this inspection report can be made available in other formats on request. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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 Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a full and detailed pre admission assessment prior to admission and this forms the basis of the care plan. Intermediate care is not provided. EVIDENCE: Four resident care files were checked and on each there was a copy of a needs assessment carried out by the referring Care manager. The care home also carries out a detailed pre-admission assessment for all prospective residents including those who are self funding. Two residents confirmed on the site visit that they had spoken to a member of the home staff prior to them coming to the home. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good individual care plans, which are comprehensive, and the care is being delivered in line with these plans. The residents are having their health care needs met. Staff treat residents with respect and maintain their privacy when they are caring for them and throughout their daily life. There is a good procedure in place for administering medication, which is followed. EVIDENCE: Four care plans were examined, they are up to date and in good detail to allow the staff to used them to plan the care they provide. A variety of assessment tools are used, and the care plans are reviewed at least monthly. The manager monitors the care plans to ensure the standards are maintained. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 10 The home is registered to provide Nursing care and the home has the necessary equipment to provide for the needs of the current residents. This included a number of intermittent pressure-relieving mattresses and patient hoists. A skin integrity assessment tool is used and all service users are assessed formally for their nutritional status. Residents access the wider community for chiropody, dentistry and other therapeutic services according to assessed need. They are weighed regularly and staff make changes in the care provided to take into account of any changes. Individual care plans include information regarding the cultural and religious needs of residents. This is evident in both the social and health care needs. Dietary needs are identified and met for those residents who have requirements specific to their beliefs or preferences. The medicine records and systems were complete and staff were aware of the need to manage the medication systems effectively. Staff were seen knocking on bedroom doors prior to entering and residents interviewed confirmed that this was usual practice. They also said that they felt that they were offered privacy during personal care. Any examinations by medical or nursing staff are carried on in the resident room. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines for daily living and activities, which are appropriate to meet their cultural, social, religious and recreational interests and needs. Arrangements for residents to maintain contact with their family and friends and the local community are good and are suited to each individual’s needs varying according to need. The food being served is being prepared safely by knowledgeable staff and offers choice to the residents. The home offers the resident a balanced diet and there is sufficient quantity of both food and fluids to meet their needs. EVIDENCE: The home currently does not have an activities co-ordinator and the new one, although recruited, does not start work until February. In the interim the staff are providing social activities as time and opportunity presents. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 12 All service users are supported to maintain close links with their families. During the site visit some relatives were visiting the home and all of those spoken to were positive about the way they are welcomed and made to feel comfortable. All residents choose who they want to see and when. Residents were observed participating in different activities. A number remained in their bedrooms and occupied their time reading or watching television or attending to personal correspondence. Daily routines encourage independence, choice and freedom of movement although some of the activities of daily living results in being in particular place at certain times of the day. Regular service users meetings take place and there was one arranged for the day of the unannounced site visit. This was well attended and the relatives and residents participated in the meeting comfortably. All residents spoken to could identify the Manager, Mrs Aird and said that they would approach her if they had any concerns. The staff team were interacting in a sensitive and respectful manner with service users during the visit and the residents confirmed when asked that the staff respect their dignity. The Home’s menus are arranged on a four week rotation and are based on the known likes and dislikes of the residents. At least two hot meals are provided on a daily basis. The menus appeared varied and nutritional, special diets are provided as needed. The residents said that the food was good and they confirmed that a choice is always available. Two said that the food was better on some days than others but felt that this would always be the case in shared accommodation as “everyone likes different things”. They confirmed that they could have something that was not on the menu if they asked. The kitchen was found to be well-organised, clean, and tidy with ample stock levels including fresh vegetables and a good selection of fruit. The catering staff maintain appropriate checks as required. There was an extensive supply of good quality food available. There was no chef/cook on duty on the day of the site visit however the food was presented well and the residents enjoyed what was being served. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good information to the residents and relatives about the complaints policy. The records show that complaints that are logged by the home have been investigated. Where it is not clear that a complaint has been made the home should respond to correspondence to clarify the issues. The home protects the residents from abuse by having a policy in place and by training staff in how to recognise and react if abuse is suspected. EVIDENCE: The complaints policy is in the service user guide and is displayed in the home. Three residents were asked specifically about how they would make a complaint if they wished to do so. They were all clear about the complaints procedure and said that they would not be worried about speaking to a member of staff if they had any concerns. Records of recent complaints were examined and competed in detail. One complaint has been made to the home since the last key inspection. It was investigated well and in line with the company policies and procedures. The outcome is identified and the complainant’s level of satisfaction was recorded. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 14 There has also been a letter of complaint, which was made directly to the proprietor. This letter was not logged by the home as a complaint. No response or acknowledgement was sent to the complainant. The responsible individual for the company was interviewed about this. She said that she had received the letter but had understood that the complainant was planning to take further advice regarding the issue. She said that she believed this because the complainant had said it at the last meeting held at the home. She felt that the letter was expressing dissatisfaction with the way that she had communicated with the complainant but that it did not contain the elements of the complaint itself. Mrs Cartwright-Lax had taken legal advice and was advised that as the complainant had suggested that the home would be contacted by the complainant’s legal representative then they should not to respond at this stage. The home has policies and procedures in relation to the prevention of abuse and whistle blowing; the staff are trained in these areas of practice, which is included in the induction programme and the ongoing in house training programmes. There has been one Adult Protection investigation in the last twelve months. The home participated in the process in a professional way. The issue did not involve the quality of the care being delivered. No action was necessary as a result of the process. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24, & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides good facilities and is decorated to a high standard. It is suitable to meet the collective needs of the service users. The decoration and furnishings are of a good standard resulting in the home being a pleasant environment. The bedrooms are particularly personalised and well decorated and furnished to give the residents a pleasant personal space. The home has policies and procedures for the maintaining of a clean and hygienic environment, and the control of infection, which are known by the staff. EVIDENCE: Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 16 The building is of a high standard; it was odour free and was tidy and well organised. The decoration is good and the home has a feeling of spaciousness and has good natural light. The service users interviewed said it was homely and comfortable. The grounds were tidy, safe, and attractive. Ongoing work is going on with the replacement of the flooring in the bathrooms, which is almost complete. Service users can see visitors in private in their own rooms and the dining areas are large enough to cater for all service users. There are smoke-free sitting rooms. Furnishings and fittings were domestic in design and in good condition. The lighting was sufficiently bright and also domestic in design. The home has sufficient numbers of baths, showers and toilets. These were close to bedrooms, lounges and dining areas and the doors had privacy locks. Room dimensions were such there was space on either side of the bed when necessary to enable access for carers and specialist equipment. Service users’ bedrooms checked all had opening windows. The rooms were centrally heated. Lighting levels were sufficient and there was emergency lighting throughout the home. Water is stored at over 60°C. Valves are in situ at water outlets to ensure water is provided close to 43°C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities appeared to be well organised. The washing machines have the specified programme to meet disinfection standards. Only personal clothing and small items are laundered on site as the home has a contract for bedding and larger items. The home only has a sluice disinfector on one floor so that the staff have to carry potentially contaminated equipment to the floor with the steriliser using either the staircase or the lift, which has inherent control of infection risks. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is staffed with appropriate numbers of staff and there are qualified nurses on duty in sufficient numbers to meet the needs of the residents. The staff are recruited and selected using a system, which ensures that they are able to care for the residents safely and well. Training is provided to the staff covering both statutory and clinical issues and is up to date. EVIDENCE: Staff records examined were completed in line with the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. Training records maintained by the Manager to allow her to plan for training. It is clearly maintained and offered a good system. Staff have received both practical and theoretical moving and assisting training as part of the induction process and updates have been given. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 18 Staffing rotas showed that the Manager is ensuring that enough staff are on duty to meet the staffing levels necessary to meet the needs of the current residents in the home. She is able to adjust the staff if she feels that there is a change in the resident’s level of dependency or if a situation arises that makes it necessary. It was noted that when sickness and staff holidays occur home staff usually covers it. Late reporting of sickness does occasionally result in fewer staff being on duty for short periods. On the day of the site visit the Manager was on duty and there were two qualified nurses and four carers on duty. In addition to the care staff there were two domestic staff, one kitchen assistant and a handyman. There was no cook/chef on duty on the day and the deputy manager was covering this with assistance from the Manager. The home has two nurses undertaking their Nursing and Midwifery Council adaptation training. This allows them to convert the nursing qualification from another country to the registration, which allows them to practice in the United Kingdom. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed; service users heath and welfare are promoted and protected. The environment is maintained and was safe and well organised. Resident’s personal finances are managed appropriately by the home as necessary. Staff supervision is up to date and in line with the homes policies. The Manager uses a variety of ways of considering Quality assurance in the home, which assists in the development of the annual development plan. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 20 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. Staff interviewed were clear about the their responsibilities. Those spoken to be positive about the management systems saying they were encouraged to contribute to the development of the service. The organisation has a range of appropriate policies and procedures, which have been linked to the National Minimum Standards. The records inspected were completed appropriately, these included the fire logbook, accident book, personal allowance records, Health and Safety, and there was information, which verified that appropriate maintenance contracts for the home are in place. Water storage tanks, gas and electrics are checked annually. Individual records are kept of the equipment being used for the residents for example bed rails and the records of them being examined were up to date and well kept. Accident records are kept however they are not the HMSO Accident Recording Book usually used. The information is detailed and meets the necessary requirements for content it relies upon the person completing it to ensure that all of the areas are included. It also makes the information more difficult to audit. The use of the HMSO book is recommended. The records of the residents personal finances were examined and were being kept in detail with records of money spent being signed by either the resident their representative or by two staff. The receipts and the recordings were present as necessary. The home has recently undertaken a quality assurance questionnaire exercise and the results of this are being analysed. It covered a broad spectrum of issues including laundry, food, staff, activities and complaints. Audits are carried out in the home and are analysed by the company so that they can form part of the annual improvement plan. Staff meetings are held regularly and the records show that they give the staff an opportunity to give their views about the home as well as giving the Manager the chance to keep them informed. Resident and relative meetings are organised by the Manager, records are available for the last one on 01.11.06. There was a meeting on the day of the Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 21 site visit which had been planned for some time (the visit was unannounced) and it was well attended. There were visiting representatives from one of the local churches at the meeting as the home is hoping to take part in a befriending service. Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 22 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 3 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 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP38 OP16 Good Practice Recommendations It is recommended that the HMSO Accident Recording Book be implemented. The home should ensure that it always clarifies the intention of a complainant before taking a decision about the use of the complaint process. It is highly recommended that sluice disinfectors be fitted on each floor. 3. OP26 Northlands DS0000000509.V327524.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Northlands DS0000000509.V327524.R01.S.doc Version 5.2 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. 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