Inspection on 03/05/05 for Northwood

This inspection was carried out on 3rd May 2005.

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

Other inspections for this house

Northwood 19/06/07

Northwood 12/09/06

Northwood 19/09/05

Northwood 24/06/04

Similar services:

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Henry Nihill House

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

CARE HOMES FOR OLDER PEOPLE NORTHWOOD 24 Gloucester Road New Barnet Hertfordshire EN5 1RZ Lead Inspector Anthony Lewis Announced 3rd May 2005 at 09.15am 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. NORTHWOOD Version 1.10 Page 3 SERVICE INFORMATION Name of service Northwood Address 24 Gloucester Road, New Barnet, Hertfordshire EN5 1RZ 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) 020 8440 5853 020 8440 5853 Peter & Catherine Trainor Mrs Catherine Trainor Care Home 17 Category(ies) of Old Age, not falling within any other category registration, with number (17) of places NORTHWOOD Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 One specified service user who has dementia may remain accommodated in the home. The home must advise the regulating authority at such times as the specified service user vacates the home. Date of last inspection 08 December 2004 Brief Description of the Service: Northwood Care Home is located in a residential part of New Barnet a short walk from East Barnet train station, High Barnet underground station, local shops and bus services. The home is registered to provide residential support and care for up to seventeen older people, not falling into any other category. The registered providers are Mr Peter Trainor and Mrs Catherine Trainor. Mrs Trainor is also the registered manager. The accommodations are provided on two floors. The first floor is accessible to residents, who have mobility difficulties, by a stair lift. There is one double bedroom on the ground floor, which is shared by two residents. All other residents have a single bedroom. There is a comfortable lounge and dining room and a large conservatory. The front and back gardens are maintained by a resident and a gardener. The front of the premises has off street parking for several vehicles. The home is staffed with a minimum of two care workers, one domestic worker, a cook and the manager, on the early shift. On the late shift, there are at least two care staff on duty. At night, there are two staff on duty, one wake-night and one sleepin. NORTHWOOD Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on Tuesday 3rd May 2005, commencing at 09.15am and was completed at 15.35pm. The registered manager was available throughout the inspection and was very helpful and accommodating. The inspector was able to speak with three residents, two visitors and three staff members. Evidence for this inspection was drawn from a variety of sources such as the pre – inspection questionnaire for registered establishments, individual private chats with residents, staff, visitors and one health care professional and two relatives. In addition to this, there was a good response to the comment cards received from residents. Fifteen of the residents returned their comment cards. What the service does well: What has improved since the last inspection? What they could do better: NORTHWOOD Version 1.10 Page 6 At this inspection, six requirements were made. The home must ensure that the statement of purpose is updated to reflect what is happening in the home at present, taking into account that there have been internal and external changes. Reviewing resident’s care plans without consulting them is disregarding resident’s rights, choices and wishes. Staff not being trained in the emergency procedures in the event of the stair lift breaking down is putting residents at risk. Staff must receive training as soon as possible. Staff files must be looked at and information required must be included to ensure that the correct recruitment procedures are being followed and that residents are not put at risk. Staff must also receive adequate training in order to fully carry out their work to the best of their abilities. Formal supervision must occur regularly to ensure that staff feel supported by the registered providers and that their career development is being taken seriously. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. NORTHWOOD Version 1.10 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 NORTHWOOD Version 1.10 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, 2, 3, 4 and 5. The home has adequate information for prospective residents to the home and their relatives or representatives to make an informed choice as to whether to move into the home or not. The homes assessment and admission procedures ensure that prospective residents and new residents to the home are confident that all of their needs will be met. EVIDENCE: The registered providers have produced a statement of purpose and service user guide for the home and for prospective residents to the home. On viewing the statement of purpose, the last time it was reviewed or updated was in 2003. Some of the information had changed or was out of date. For instance, the Commission for Social Care Inspection has taken over from the National Care Standards Commission and the home does not have a deputy manager or office staff employed as stated. A requirement is made that the registered providers ensure that the statement of purpose is reviewed and updated to reflect the present situation in the home. NORTHWOOD Version 1.10 Page 9 The home has produced an attractive brochure, which sets out the facilities and accommodations and care that is provided. The statement of terms and conditions was viewed and found to contain information on fees, accommodation and care to be provided. The registered manager said that residents pay extra for hairdressing, newspapers and chiropody service. The registered manager went through the admissions process, which was also contained in the statement of purpose. Six resident’s files were viewed and all found to contain a copy of their terms and conditions and care plans. One resident has been diagnosed as suffering from dementia. The condition of the home is that only one resident with dementia can be accommodated in the home. The registered manager said that all staff have had dementia training. On viewing some of the staff files, there were certificates to corroborate this. The home does not provide any other specialist needs. One visitor to the home, whose mother lived in the home for eighteen months and died three years ago, still visits other residents in the home, she said that her mother was able to visit the home for the day and have lunch with the residents and have a trial stay in the home prior to making up her mind as to whether she wished to live there. NORTHWOOD Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11. Resident’s rights and choices are not adhered to. Staff do not adequately consult them when decisions are being made regarding their health, personal and social care needs. Resident’s wishes, dignity and privacy are being respected by the staff team who are ensuring that information gathered, is recorded in resident’s files and that records are maintained appropriately. EVIDENCE: Six resident’s files were viewed and found to contain comprehensive care plans relating to residents health care and social needs. The registered manager stated that care plans are reviewed regularly with other staff on a monthly basis, but residents are not fully consulted. A requirement is made that the registered providers ensure that residents or their representatives are consulted when their care plans are being reviewed and that any consultation is recorded. NORTHWOOD Version 1.10 Page 11 The registered manager said that there is one resident with a pressure sore and Methicillin Resistant Staphylococcus Aureus (MRSA) and that this was being taken care of by the district nurse who visits the home at least three times a week. On the day of the inspection, the district nurse was visiting and was available to discuss the care to the resident with the pressure sore and MRSA and other residents in general and the care provided by the home. The registered manager said that staff have been trained by a doctor in infection control, a certificate of the training was available. Signs were appropriately displayed in the bathrooms and toilets and other parts of the home regarding washing and cleaning. The morning medication and the Medication Administration Record was checked. Staff have been dispensing medication and recording information and signing appropriately. The temperature of the medication cabinet was seen to be recorded daily as per a requirement from the previous inspection. Residents spoken to said that their personal care is always carried out in a professional and dignified manner by all staff. All the bathrooms and toilets were seen to lockable when in use as per a requirement from the previous inspection. All resident’s files examined had clear information on the resident’s wishes and funeral arrangements in the event of their death. One relative, whose mother lived in the home for eighteen months and died three years ago, visits the home regularly to spend time with other residents. She stated that the staff team ensured that her mothers last days in the home were made as comfortable as possible and that the staff team were very supportive when her mother eventually died. NORTHWOOD Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Residents are supported by a dedicated staff team to participate in leisure activities and are confident that they are able to voice their opinions and choices. Residents are able to have their meals in a jovial and supportive setting, without constraints and are confident that meals will be at flexible time to suite them. EVIDENCE: Residents spoken to said that they are able to get up when the wished and eat at time that suited them and that the staff team are very flexible and accommodating. A daily activities board was seen in the dining room. It showed that in house activities are provided daily. Residents spoken to said that they enjoyed the activities. Comment cards indicated that residents are generally happy with the activities that the home provides. One resident spoken to at the beginning of the inspection was awaiting a taxi to take her to her day centre. On the day of the inspection, there were a number of visitors to the home. Two were spoken to and stated that they were free to visit the home without restrictions at any reasonable time. NORTHWOOD Version 1.10 Page 13 One resident said that she was able to bring some of her own furniture into the home when she initially moved in. The home has information and a procedure if residents wish to access their own files. On a tour of the home, the menu was examined in the kitchen and the cook spoken to regarding the meals and meal preparation. The menu showed evidence that meals are appropriate to resident’s cultural needs and background and are prepared by a competent and experienced cook. Residents are offered a variety of vegetables with all main meals and a desert. The atmosphere at lunchtime was congenial and unrushed. Staff were observed supporting residents in cutting up foods and to eat. Staff were observed ensuring that residents were asked as to their choice of drink and desert. NORTHWOOD Version 1.10 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17 and 18u. Residents are confidant that their complaints will be taken seriously by the staff and registered manager and that their rights will be respected. The homes recruitment and training programme ensures that residents are protected from any form of abuse. EVIDENCE: The complaints file was viewed. There were no recorded complaints in the past twelve months. Staff and residents spoken to stated that if they had a complaint, they would speak to the registered manager. Information on the complaints procedure are posted on the walls in various parts of the home. There is also a complaints procedure in the statement of purpose. The registered manager stated that the majority of the residents would be voting in the forthcoming elections some by postal vote and other will be accompanied to the poling stations by staff. The home has an adult protection procedure produced by Barnet council and staff have had training in adult protection and copies of their certificates were seen in their file. Staff’s Criminal Record bureau (CRB) were viewed, no staff have been included or referred for inclusion on the Protection of Vulnerable Adults register. Staff spoken to said that they were aware of the whistle blowing policy of the home. NORTHWOOD Version 1.10 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24 and 25. Residents and their representatives are safe in the knowledge that the facilities, equipment and general layout and structure of the home will meet all of the their needs and that the home is safe and clean at all times. EVIDENCE: The home is ideally located in a residential part of Barnet within easy reach of transport, leisure facilities and transport. All areas of the home are kept clean and tidy and has been designed to take into account residents mobility needs. All communal areas are of the home are wheelchair accessible and provide space for all the homes residents to move about freely. Residents are able to meet with visitors in the lounge, dining room, the conservatory or their bedroom. All communal furnishings are clean, tidy and in good order and meets the needs of the residents. Lighting is adequate and adds to the ambiance of the home. NORTHWOOD Version 1.10 Page 16 None of the bedrooms have en-suite facilities. All bathroom and toilet facilities are located near to resident’s bedrooms on both floors. All bathrooms have facilities for residents with mobility needs. Doors are wide enough for wheelchair users. All bathrooms and toilets were clean and tidy. The home has a stair lift to transport residents between floors and ramps for easy access into and outside the home. Grab rails are provided to appropriate parts of the home. A hoist is provided for lifting residents and there are shower facilities for residents who prefer to have a shower. On speaking to the registered manager, she stated that none of the care staff have received training or guidelines in the event of the stair lift breaking down whilst transporting a resident between floors. A requirement is made that the registered providers ensure that all staff working in the home receive appropriate training in emergency procedures to be carried out in the event of the stair lift breaking down between floors. All bedrooms are adequate in size. Residents spoken to said that they were happy and comfortable. The majority of bedrooms in the home were viewed on a tour of the building and found to contain all the furnishings needed for their comfort. Residents spoken to said that they were able to furnish their bedrooms to their tastes and needs. One of the ground floor double rooms was seen to have a screen for privacy. On the day of the inspection, the home was found to be warm and cosy. All resident’s bedrooms have a good size radiator. Staff ensure that the temperature of water is monitored and recorded. All areas have adequate lighting and emergency lighting where required. Whilst touring the building, all areas were clean, tidy and free of any offensive odours. NORTHWOOD Version 1.10 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 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, 28, 29 and 30. Resident’s health and safety is being compromised by the registered providers not ensuring that all the staff receive the necessary training for the work that they carry out. EVIDENCE: The staff rota was viewed and showed that there are at least two staff on duty every shift. On the early shift and for part of the late shift, the registered manager is on duty Monday to Friday. The home also employs two ancillary staff, a cook and cleaner. The rota showed that the registered providers also cover shifts when required. None of the staff are registered nurses, although one member of staff spoken to said that she was in the process of applying for nurse training. The registered manager said that none of the staff have NVQ2 although some are at present studying for their NVQ2 and others will be registered this summer. All staff files were viewed and all had an application form, two references, inductions, terms of conditions and a CRB. A number of staff did not have a photograph and the senior carer and a number of care workers did not have the appropriate job description. A requirement is made that the registered persons ensure that all staff files contain all of the information set out in Schedule 2 and 4 of the Care Homes Regulations and that the information is up to date. NORTHWOOD Version 1.10 Page 18 Staff files showed evidence that all staff are receiving a full induction. Some staff have not received the necessary statutory training and a number of staff certificates seen, dated back to the 1990s. In addition, some staff files had little proof that they had received sufficient training relevant for the work that they carry out. A Requirement is made that the registered providers ensure that there is a staff training and development programme in place to ensure that staff receive the necessary training for the work that they carry out. NORTHWOOD Version 1.10 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 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) 31, 32, 33, 36, 37 and 38. Residents are safe in the knowledge that a competent and experienced registered manager is managing the home and ensuring that the wellbeing of residents and staff is taken seriously. EVIDENCE: The registered manager has managed the home for more than twenty years and has a good understanding of the needs of the residents and staff team. She stated that she has undertaken many training courses over the years and is contemplating studying for the NVQ4. Through indirect observation of the registered manager throughout the inspection, she showed understanding and sensitivity towards the residents and Staff. Resident’s seemed at ease in her presence and when spoken to the residents were very complimentary about the way the registered manager manages the home. Staff spoken to, said that they had a lot of respect for the manager. NORTHWOOD Version 1.10 Page 20 The registered providers ensure that quality assurance is conducted by using a, Relatives/Representatives and Service User satisfaction Survey and Audit. The survey covers a variety of issues such as food, activities, accommodation provided and staffing. On viewing the staff’s file and talking to the registered manager, staff are not receiving regular supervision. Some staff have been more that three months without formal supervision. A requirement is made that the registered providers ensure that all staff employed to work in the home, receive formal supervision at least six times a year and that the information is recorded and retained in their file. A notice was seen on the wall in the hall, which gives information to residents who wish to see their files and explained the procedure to do this. All resident’s files were kept under lock and key in the office. Staff files viewed showed that they all have undertaken the lifting and handling course. Both floors had information on the walls regarding fire safety and evacuation of the building in the event of the alarm sounding. Food was seen to be stored correctly in the fridges and freezers and staff record the temperatures daily. All bathrooms, toilets and some bedrooms have a call system cord, which was tested and found to be in working order. Infection control training certificates were seen for all staff. The home was seen to have the following certificates on file: Electrical installation 21st May 2004 Gas Safety Record 7th May 2004 Bacteriological Analysis Certificate 15th September 2004 NORTHWOOD Version 1.10 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 2 3 3 3 x STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 2 3 3 NORTHWOOD Version 1.10 Page 22 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 OP1 Regulation 4 (2) Schedule 1 Requirement Timescale for action 10/06/05 2. OP7 3. OP22 4. OP29 5. OP30 6. OP36 The registered providers must ensure that the statement of purpose is updated and that a copy sent to the Commission. 15 (2) (c) The registered providers must (d) ensure that residents or their representatives are consulted when compiling and reviewing their care plan and a record made of any such consultation. 18 (1) (c) The registered providers must (i) ensure that all staff receive appropriate training in emergency procedures in the event of the stair life breaking down whilst transporting a resident between floors. 17 (2) (3) The registered providers must (a), 19 ensure that all staff files contain (1) (b) (i), the appropriate information and Schedule that the information is kept in 2 and 4 staffs file for inspection. 18 (1) (c) The registered providers must ensure that all staff working in the home, receives appropriate training for the work that they perform and that a copy of their certificates are kept in their file for inspection. 18 (2) The registered providers must ensure that all staff working in Version 1.10 10/06/05 10/06/05 10/06/05 29/07/05 10/06/05 NORTHWOOD Page 23 the home have formal supervision at least six times a year and that the content of the supervision is recorded. 7. 8. 9. 10. 11. 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 Good Practice Recommendations NORTHWOOD Version 1.10 Page 24 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 NORTHWOOD Version 1.10 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!