Inspection on 15/03/07 for Northview Lodge Nursing Home

This inspection was carried out on 15th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Northview Lodge Nursing Home 24/12/09

Northview Lodge Nursing Home 17/11/08

Northview Lodge Nursing Home 11/10/05

Northview Lodge Nursing Home 23/05/05

Northview Lodge Nursing Home 16/11/04

Northview Lodge Nursing Home 08/07/04

Northview Lodge Nursing Home 19/03/04

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

CARE HOMES FOR OLDER PEOPLE Northview Lodge Nursing Home Northview Road Castletown Sunderland SR5 3AF Lead Inspector Mrs Katie Tucker Key Unannounced Inspection 15th March 2007 9:00 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 Northview Lodge Nursing Home DS0000018202.V333427.R02.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. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Northview Lodge Nursing Home Address Northview Road Castletown Sunderland SR5 3AF 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) 0191 516 8605 0191 516 8601 www.schealthcare.co.uk Southern Cross Healthcare Services Limited Mrs Lynn Bell Care Home 45 Category(ies) of Dementia (8), Dementia - over 65 years of age registration, with number (15), Mental disorder, excluding learning of places disability or dementia (30), Physical disability (10), Physical disability over 65 years of age (7) Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th October 2005 Brief Description of the Service: Northview Lodge is a two-storey purpose built nursing home, which was originally designed to provide care for older people with dementia-type illnesses. At the beginning of 2002 the ground floor was converted to provide care for younger adults with acquired brain injury and mental health needs. In July 2004 the upstairs unit was converted to provide a smaller higher staffed unit for older people with a dementia-type illness and a small unit for younger adults with very complex mental health needs. The fees charged at the home range from £449 to £2212 per week. The amount of the fee people will pay depends on the financial assessment the social service department has completes. There is a car park and main entrance to Northview Lodge at the front of the building. Access to this entrance is level. Both floors have dining rooms, lounges, bathrooms, toilets and bedrooms. A passenger lift serves both floors. The administration office is located on the first floor with an additional office area on the ground floor. The home is off the Western Way at the Castletown junction. A short walk from the home is an industrial/business estate with food retailers and a range of stores. The local bus routes provide transport to the local estates and the city centre. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced visit. They spent the day speaking to people using the service and staff. The inspector also looked around the houses and checked the standard of the record keeping. Prior to the visit the inspector looked at comment forms from people living at the home. Several residents’ care was tracked through what people said and looking at the service user plans and other records. Staff practice, attitude and approach were also watched and judgements made on how well staff worked with people. During this inspection all of the key standards were checked. What the service does well: Northview Lodge has been successfully caring for younger adults who have had brain injuries or have mental health needs for the last 5 years. The home is designed to provide long term nursing care for people. However, the manager and staff have been able to help people come to terms with many of the difficulties they face every day because of their health needs. The staff have always made sure that the work they do is in the best interests of the people. Thus the service is very much person-led and the residents play an active part in not only their care but also how the service is developed. For a large number of people this skilled support and help has meant are have able to make dramatic changes to the way they cope with things. All of the residents on the younger adult units are encouraged to take control of their lives and become more independent. Staff are very skilled at finding out people’s strengths, what they are able to achieve and where they need a bit more help. Residents said ‘ the staff are fantastic, I can talk to them about anything and they really help’ and ‘its bril here I get to do so much – I’ve been on holiday aboard a good few times now, I go out when I want and on trips plus go to college, my life is so much better in fact the best it ever has been’. Other residents said ‘Sometimes when I’m anxious I want to do things that would not be sensible and staff have been there to make sure I’m alright’ and ‘I have had a few strokes and one really recently staff were there when I needed them and no one can believe how well I am now’. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 6 Northview Lodge also has a small 10-place unit for people with dementia. The manager has made sure this unit follows all of best practices for care of people with memory loss. The staff are passionate about making sure people with memory loss continue to be valued and get a good quality life. This dedication has lead to positive changes in people’s well being. Residents who appeared to have become very disabled by their condition when they moved in now show that they are still able to remember things, join in conversations and make their wishes know. Residents on this unit regularly cook, make beautiful art work (which can be seen throughout the unit) go out and have been on short breaks to holiday parks. Staff always followed person-centred practices and want to give the best service they can. Residents on this unit told me about their day, what they liked and said ‘I like the girls they are really special’. The way staff worked with people was exceptionally good. They always check they are following people’s wishes, get people to use their strengths and not worry about the bits they cannot do. This lead to the unit running like a family home, with lots of friendly banter, chatting and staff seeking advice from the residents. The manager works in partnership with a local hospital trust and have an occupational therapist from the hospital working full-time at the home. Also Southern Cross employs a team of specialists including a psychiatrist, a neurorehab psychologist and clinical psychologist. This level of healthcare has helped staff make sure the care that people receive is what it should be and of a high standard. The manager always makes sure all of the units have very good staffing levels and this has really help people to follow interesting and varied lives. The manager is eager to make sure staff work to an exceptionally high standard so helps staff go on a wide range of training. All of the care staff have NVQ qualifications and over a third now have level 3 or above. Unit managers have been completing registered manager awards and some of the staff are completing job related degrees. By always up dating and making checking practice staff know they are caring for people in the right way. What has improved since the last inspection? What they could do better: There were no requirements made during this inspection and those from the last had been dealt with satisfactorily. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 7 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. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff make sure assessments are very detailed and the information staff need to know is collected. Therefore residents’ can be confident that staff know how to work with them. EVIDENCE: The manager has been working with a team of Southern Cross staff to improve the already very detailed assessment for people living at the home. Case tracking showed that the records help staff work with residents to write down all the information they need to understand residents’ lives, experiences and how they see life. Also staff make sure that the assessment outlines how people’s mental health and sometimes learning difficulties affect them plus things that cause difficulties to increase. This type of assessment has worked well for residents at Northview Lodge. Every year the manager and staff go back to these records to make sure they remain accurate and the format is still helpful. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Records clearly show how staff work with residents and meet any needs. The residents’ are involved in working out how best to meet their needs and goals. EVIDENCE: The manager and staff have developed an excellent care planning system. Case tracking showed that the staff record all of the actions needed to take to meet someone’s needs, including managing challenging behaviours. Staff record where they restrict people’s choices and help them make positive decisions. Plus staff have written risk assessment plans for all of the residents. The manager is putting new risk assessment formats in place and these give very detailed information about the presenting risk and actions staff have to take to reduce or work with the risk. Some residents talked about their plans and how they had been asked to help write them. They were happy with all the care plans and risk assessment saying the staff made sure they agreed to the actions before putting them in. Northview Lodge Nursing Home DS0000018202.V333427.R02.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 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents from all units are given access to a wide range of appropriate and stimulating activities. This means that residents lead very fulfilling lives. EVIDENCE: During the visit staff on all three units people joined in a lot of different activities. Some people went on a trip, others went to college whilst other people went out by themselves. Residents on the dementia care unit had been cooking and told me about the interesting day they had. People told me about the artwork they made and how important this was to them. Staff are very aware how important it is for people to do things that they find interesting. One of the residents told me they are in the process of doing a NVQ in care, as they want to work in care. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 12 Case tracking showed that at times staff impose limitation and restrictions on what residents do because what they want to do will be harmful. It was very clear that these decisions are not taken lightly and residents agree that they are the right. Thus there are a number of care plans and risk assessments dedicated for residents who have self-injurious behaviour or can be aggressive. One resident said ‘when I’m poorly I need the staff to keep me safe, as I feel compelled to cut down to the bone’. The risk assessment outlined what action staff should take to monitor the person’s mood and various approaches to be taken. The new records the manager is putting in place will help staff to very clearly show the thinking process behind decisions and what exactly they are expected to do. The level of risk-taking activities continues to increase in the dementia care unit and people make tea, cook, do domestic tasks and go on short breaks, which was seen as a positive development. Staff have also been going on Mental Capacity Act training and have found this to really help them look at making sure people can continue to takes risks, as it helps them feel valued. Staff have also been on equality and diversity training and are using the principles of making sure service meet every bodies needs regardless of their sexual preference, religious belief and cultural background. Thus, residents are helped to go to church or receive communion at the home. The manager is working with Southern Cross to write a good policy and procedure around helping staff recognise that residents are sexual beings and need support to express their wishes. Relatives said ‘staff always make us feel very welcome and I rate this service very highly, they have not only helped my loved one but have been there for me’. One relative has recently decided to become a volunteer at the home, as he found he wanted to give something back. People were very complementary about the food provided. They said’ you never get a bad meal plus you can always make snacks’. Some of the residents have special diets and the cook understands how these need to be made. Northview Lodge Nursing Home DS0000018202.V333427.R02.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 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager has shown that she will check that the service is working well, help people to raise concern and take all actions necessary to resolve issues. Thus, residents can expect that poor practice will not be tolerated. EVIDENCE: The complaints procedure is made available to residents and relatives through the service user guide as well as being sent out separately as a reminder. Case tracking showed that when people had raised any concerns staff treated these seriously and took action to resolve the issue. The staff acted quickly in response to the slightest niggle and this had made people know they were important. Residents said ‘the staff are always listening to us we have meetings every week and can moan about things. The staff always change things when we ask and if anything is worrying us sort it out’. Northview Lodge has an appropriate protection of vulnerable adults policy and follow Sunderland Social Services Department guidance. The manager is very proactive and makes sure that if any element of a concern referring to protection is dealt with under the protection of vulnerable adults guidelines. When residents have been concerned about staff behaviour she has dealt with these matters appropriately. Residents said ‘it doesn’t matter who you have an issue with its dealt with properly and fairly’. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Southern Cross Healthcare and the manager are constantly reviewing the environment and within the constraints of the design of the building ensure it meets current models of good practice. Therefore residents can be confident that their needs will be met. EVIDENCE: Northview Lodge the unit on the ground floor for younger adults is divided into two sections. This allows service users the option to choose which area of the home they live in but still mix when they want. Upstairs is divided into two one for younger adults and one for people with dementia. Kitchens are provided in units as well as a range of communal areas and bathing facilities. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 15 The upstairs unit for younger adults year has increased in size and been redecorated. But lots of thought was given to how this was achieved without reducing the quality of service on the dementia care unit. Throughout the changes the manager has shown a desire to develop a very high standard service for people with memory loss. The reduction to a smaller sized unit for people with a dementia-type illness was based on research produced by Stirling University. The way the lounges and corridors were altered made them more interesting and has allowed service users to use the facilities more productively. The manager has developed a kitchenette upstairs on the dementia care unit so as to allow people to retain their skills around making drinks and snacks. Southern Cross Healthcare has agreed plans to develop a conservatory and provide a range of new furniture. A number of areas around the home have been redecorated recently and therapy unit has been created in the downstairs unit. The overall maintenance of the building is to a satisfactory standard. Northview employs a handyperson and any minor faults are rectified in prompt manner. Dedicated domestic staff make sure the home is kept clean and free from offensive odours. Also dedicated laundry staff provide a good level of service. Staff have completed infection control training. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The high staffing levels, large proportion of nurses and good range of training means residents can be confident that their needs are met. EVIDENCE: The manager has set minimum staffing levels at 2 qualified nurse and 5 carers on the downstairs unit during the day. On the 10-place unit for dementia care 1 qualified nurse and 3 carers are duty during the day. On the 15-place unit for younger adults 1 qualified nurse and 4 care staff are duty during the day. During the night 3 qualified nurses and 5 care staff are on duty. However these staffing levels are routinely exceeded and additional staff will be provided in all units. Although some reasons for these excellent staffing levels are that on the younger adults unit placing contracts require certain staffing levels but this not the case in the dementia care unit. The manager has been given the freedom to tailor her staffing levels to meet not only the personal care needs of people within the home but also the emotional and social needs. The manager is a great advocate for all people with mental health needs and ensures this is reflected in the practices adopted at Northview lodge. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 17 100 of staff have completed training up to and in excess of NVQ level 2 and a third of staff hold at least a NVQ level 3. Some of the staff are doing NVQ level 4. The unit leaders have also been completing the registered managers award. The manager recognises that they are very skilled staff that would readily employed elsewhere so she is looking at how to keep staff wanting to work for Northview Lodge. Southern Cross Healthcare is developing a site nearby and it potentially will become part of Northview Lodge’s services. The manager is hoping the site will be developed so as residents develop skills they can move to this service and still be well supported but helped to look at living independently. Staff have been going training about how to make sure people’s equality and diversity needs are met plus insight into the Mental Capacity Act. The nurses and care staff are able to go on various courses including degrees. Staff also have access to other types of training via the use of the Internet. Residents and relatives were extremely complimentary about the service offered at Northview Lodge. Also people were very complimentary about the staff team and felt that they were skilled and competent at their jobs. Staff records are well maintained and contain all of the information the manager needs to show staff have been vetted properly. The manager told about new legislation related to age, diversity and protection of staff from harassment that will need to be incorporated into the recruitment practices and management policies. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practices adopted at Northview lodge ensure people’s health, welfare and financial matters are not compromised. EVIDENCE: The manager is extremely competent and highly qualified. She has excellent management skills and is always up-dates her practice. A robust quality assurance system is in place that meets the needs of Northview Lodge. The system in place for looking after residents’ monies does work well. People have their own bank accounts but a bank account is used for cashing cheques. The manager completes and audit every month and Southern Cross Healthcare ensures an independent account comes and verifies practices every six months. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 4 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 3 X 3 X X 3 Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 20 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. Refer to Standard OP27 Good Practice Recommendations The owners should consider how the provide opportunities in Northview Lodge, which will encourage the retention of the highly skilled staff. Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 21 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Northview Lodge Nursing Home DS0000018202.V333427.R02.S.doc Version 5.2 Page 22 - 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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