Inspection on 25/10/06 for Northwood Nursing Home

This inspection was carried out on 25th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Northwood Nursing Home 21/02/06

Northwood Nursing Home 04/10/05

Northwood Nursing Home 11/01/05

Northwood Nursing Home 08/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Northwood Nursing Home 206 Preston New Road Blackburn Lancashire BB2 6PN Lead Inspector Jane Craig Key Unannounced Inspection 25th October 2006 09:15 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 Northwood Nursing Home DS0000022475.V305477.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. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Northwood Nursing Home Address 206 Preston New Road Blackburn Lancashire BB2 6PN 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) 01254 57208 01254 878728 Mr Brian J O`Neill Mrs Eileen O`Neill Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability (23) of places Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Under Annex 2, a maximum of 23 service users requiring nursing care who fall into the category of either OP or PD A max of 28 service users requiring personal care of the category OP Staffing for service users requiring nursing care will be in accordance with the Notice issued dated 22 January 1996 21st February 2006 Date of last inspection Brief Description of the Service: Northwood provides long and short-term care for a maximum of 28 residents who are elderly and have physical need for which they need nursing care. The registered persons are Mr and Mrs O’Neill. Mrs O’Neill takes responsibility for managing the home on a day-to-day basis. The home is a converted and extended Victorian property, which has retained its style and character. It is located in a residential area within close proximity of all local amenities (shops, churches, bus route and public houses) and less than a mile from the centre of Blackburn. Bedrooms at the home are a mix of single and shared rooms, some of which have en-suite facilities. There are a number of lounge and dining areas located on the ground floor. A passenger lift serves both floors. Residents have access to the large garden and patio area. Car parking space is located to the front of the house. Information about Northwood is sent out to prospective residents when they enquire about admission. The latest CSCI inspection report was on display in the manager’s office and is available to residents on request. At 25th October 2006 the fees ranged between £358.00 and £479.00 per week. There were additional charges for newspapers and some hairdressing. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Northwood on the 25th of October 2006. At the time of the visit there were 20 residents accommodated. The inspector met with a number of residents and spent time observing interactions between staff and residents. Wherever possible residents were asked about their views and experiences of living in the home and some of their comments are quoted in this report. Fifteen residents and two visitors had completed questionnaires before the inspection. Their views were mainly positive and have been taken into account when writing the report. Discussions were held with the registered provider/manager; two members of the management team and two care staff. The inspector also spoke to two visitors. A tour of the premises took place and a number of records and documents were viewed. This report also includes information submitted by the home prior to the inspection visit. What the service does well: The manager made sure that prospective residents had enough information to help them to make a choice about whether the home was right for them. Residents were assessed before admission. This meant that staff understood what care the person might need and whether it could be provided at the home. All residents had a care plan that was detailed enough to make sure that staff knew exactly what help the resident needed and how they wished to be helped. Residents said staff looked after their health very well. The home matched up to most residents’ expectations. One resident said he had been in several homes but none were as good as Northwood. Another said that it was “champion.” Residents were happy with their daily lives and routines. One resident said he thought it was “magnificent and couldn’t be better.” Another resident said that although it wasn’t quite the same as home, it was a very nice place. Residents had a good programme of activities to occupy their time. One resident said some of the activities were really interesting and she had done things she had never done before. Most of the comments about the meals were positive. One resident said “the food’s very good and if there’s nothing on you want you just ask.” Other residents also mentioned that they had plenty of choice and variety. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 6 All the residents who returned questionnaires said they knew who to talk to if they were not happy with anything about the home. Residents also said that they were sure that the management would try to sort out any complaints for them. There were enough staff on duty to make sure that residents had the care they needed. Several residents commented on how well they got on with the managers and staff. One said, “the carers are exceptionally good,” and another said, “the staff are great.” More than half of the carers held a qualification in care called an NVQ. When one resident was asked what she thought the home did well she said, “First and foremost the carers. I have never heard a cross word and they have never even appeared vexed.” What has improved since the last inspection? 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. Northwood Nursing Home DS0000022475.V305477.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 Northwood Nursing Home DS0000022475.V305477.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process ensured that residents had sufficient information to help them to make a decision about moving in and staff had enough information to understand the new resident’s care needs. EVIDENCE: The statement of purpose and service user’s guide had recently been updated and a new copy sent out to all existing residents or their relatives. Prospective residents were assessed before they were offered a place at the home. The files of recently admitted residents showed that the information on the pre-admission assessment was used to draw up initial care plans. Staff said they received enough information to understand the resident’s needs and start to plan their care before they were admitted. There was evidence that residents were sent letters confirming that their assessed needs could be met at the home. Intermediate care is not provided at Northwood. Northwood Nursing Home DS0000022475.V305477.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs were met in accordance with their wishes. Medication was generally handled safely. EVIDENCE: The care plans for three residents were inspected and others were viewed in less detail. All plans, even those for a very new resident, were detailed and individualised, which meant that staff knew exactly what care to provide to meet residents’ needs. Plans gave staff directions on how to assist residents with specific cultural needs and told staff how to assist residents who had communication needs. Staff were observed assisting one resident in exactly the way their plan specified. Residents or their relatives had signed agreement to all the plans seen. Plans were reviewed regularly and updated as and when there were any changes. Staff said they always read the care plans, which were “very useful.” All care plans included risk assessments for moving and handling, nutrition, pressure sore risk and, where applicable, bed rails. There were corresponding plans to minimise identified risks. One resident said staff always used the Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 10 hoist to help him move and he said that he felt much safer once he got used to it. There was evidence that residents’ healthcare needs were monitored and they were referred for specialist care when required. Residents said that staff looked after them well and the care was very good. The majority of residents who filled in questionnaires indicated that they always received the care and medical support they needed. The Service Users’ Charter made reference to residents’ rights to privacy and dignity and several care plans directed staff to uphold those rights. Staff had a good understanding of the core values and gave examples of how they were applied. Residents said that staff respected their privacy. One resident said, “I get all the privacy I need, there’s never been any question about me coming up to my room.” Policies and procedures for medicines management were in place and, according to information received, were reviewed earlier this year. There were complete records of medicines received and disposed of. There were no gaps on the Medicine Administration Record (MAR) charts but the records of administration of creams were not appropriate. Storage areas were clean and secure. The room temperature was monitored but sometimes rose above 250c. The registered person had plans to move medication to a room with better ventilation. Controlled drugs were ordered, stored, recorded and administered appropriately. Northwood Nursing Home DS0000022475.V305477.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had choice and control over their daily lives. Daily routines and meals suited residents. The organised activities met most residents’ social and recreational needs. EVIDENCE: Residents who completed questionnaires and those spoken with during the visit said that the home organised suitable activities. It was apparent that the manager and staff had put a great deal of thought into providing activities for individuals that reflected their past interests as well as introducing new ideas. One resident said she had “thoroughly enjoyed” a recent trip to a local Stately Home, saying that she had always been interested in history. Another resident wrote that by choice they didn’t want to join activities but staff found the time to sit with them to watch the football. The general manager had set up a special group to engage a group of men who did not want to join in mainstream activities. Information about residents’ preferred daily routines, likes and dislikes and religious or cultural needs were recorded on their care plans or ‘Getting to Know You’ document. Residents confirmed that there were no set rules in the home and they had choices about where and how to spend their time. One said, “they are very liberal, you just get up and go to bed when you want to” Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 12 and another said, “I can get up any time even though I have to wait for help.” Staff were very clear about how they needed to support residents to maintain their individual routines. Records of meals showed that residents were offered a varied and nutritionally balanced diet. Special religious or medical diets were catered for. Residents had at least two choices at every mealtime. Those who completed questionnaires had mixed views about the meals but most residents spoken with on the day of the visit described the food as, “lovely, excellent and very good.” One resident said there was always plenty of choice but they could still ask for something different. The chef was competing in the Caring Chef of the Year finals on the day of the inspection and several residents wished him well. One said, “he deserves it.” There was an open visiting policy and visitors said they were always made welcome. A resident said that her relatives had a long journey and staff offered them tea and biscuits when they arrived. Staff discussed how they ensured residents were protected by the visiting arrangements in the home. Northwood Nursing Home DS0000022475.V305477.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures for safeguarding residents were understood by some staff but a lack of training may result in allegations of abuse being mishandled. Residents were confident that complaints would be dealt with appropriately. EVIDENCE: The complaints procedure was on display. There had been no complaints either to the home or to CSCI since the last inspection. Residents said they did not have any complaints but all fifteen residents who completed questionnaires said they knew who to speak to if they were not happy and how to make a complaint. At the time of the visit one resident said, “If I did have a complaint I would see …(the general manager), she would sort it out, no question.” Staff had access to written guidance on the protection of vulnerable adults. Some had received training but this was not up to date for all staff. The staff spoken with during the inspection were aware of their roles and responsibilities in reporting any allegations to their line manager. However, they were not completely clear about reporting outside the home. The home had a contract with an independent advocacy service, details of which were given to residents and their relatives on admission. Northwood Nursing Home DS0000022475.V305477.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered person was actively working towards improving the environment to ensure that residents had a comfortable and homely place to live. EVIDENCE: The registered person was aware that there were several areas of the home in need of redecoration and refurbishment and had a three-year plan to remedy the shortfalls. Work had commenced and several bedrooms had been decorated and had new soft furnishings. The dining room had been decorated and re-carpeted. A new stair lift was due to be fitted. Residents were satisfied with their bedrooms and said they were comfortable. At the time of the inspection the home was clean and free from offensive odours. Residents who filled in surveys indicated this was almost always the case. One resident said, “they are always cleaning.” Most staff had recent training in infection control procedures. There was written guidance about disposal of waste and handling laundry. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 15 The laundry was sited in the basement, away from resident areas. A hand washing sink had been fitted as recommended at the last inspection but the walls and floor were still not easily cleanable. The laundry was adequately equipped for the size of the home and on the day of the visit it was tidy and organised. Residents did not have any complaints about the laundry Northwood Nursing Home DS0000022475.V305477.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were supported by a competent and qualified staff team. EVIDENCE: The majority of residents who completed surveys said that staff were always available when they needed them. One wrote, “they always come to my buzzer when I need them.” Residents spoken with at the time of the inspection said there were enough staff around and they received attention when they needed it. Staff were in evidence in the communal rooms throughout the visit. Staff themselves said that their numbers were flexible and could be increased. They said that an extra carer was always rostered to attend to visiting professionals such as the chiropodist, optician or dentist. All residents were very complementary about the staff. One resident talked about staff being very patient and another said that staff, “have never even appeared vexed.” Other residents commented that staff were, “excellent,” “kind, and “very caring.” Northwood has a very stable staff team and no new staff had been employed since before the previous inspection. There were robust recruitment procedures in place and the registered person was completely clear about the need for pre-employment checks. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 17 An induction programme, that met the common induction standards, was in place. The registered person was aware that not all refresher training in the safe working practice topics was up to date. It was not clear from the training matrix what the shortfalls were. Other training was taking place regularly. Staff had attended courses in diabetes awareness, self esteem and assertiveness and several were booked on a course for managing violence and aggression. Staff had individual training plans that were drawn up during their supervision and appraisals. The manager stated that 86 of care staff were trained to NVQ level 2 or above. Northwood Nursing Home DS0000022475.V305477.R01.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 at least once during a 12 month period. 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. Residents benefitted from a safe and well managed home. The level of consultation had improved which meant that residents had opportunities to contribute to service development. EVIDENCE: One of the registered providers managed the home on a day to day basis. A management team, who each took responsibility for a different area of the service, supported her. In addition to holding a nursing qualification, the registered person had recently completed the Registered Managers Award. She attended courses to keep her clinical and managerial skills up to date. Residents were clear about the management structure in the home and said that the managers were very good. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 19 The home had recently been reassessed for the Blackburn with Darwen Quality Assurance award. Following a requirement at the last inspection, the registered person had sent out surveys to residents asking their opinion on a number of areas, such as care, staff, and food. Responses were generally positive. Records of residents meetings showed that they had opportunities to discuss anything about the home and put forward suggestions. Actions and outcomes from the previous meeting were always discussed so that residents were kept informed of how their suggestions were progressing. Staff also had opportunities to contribute ideas and the registered person had recently started a monthly award for staff whose ideas were taken up. Relatives were also asked to Residents who were capable managed their own finances but families generally handled residents’ money. The home held a small amount of cash on behalf of one resident. There were complete records of all transactions. The fire officer had recently inspected the fire risk assessments and other documents regarding fire safety. The registered person said there were no recommendations following his visit. Staff were very clear about how to respond in the event of a fire. Information submitted by the registered person indicated that the maintenance and servicing of equipment and installations in the home were up to date. Potentially hazardous substances were stored safely. Accidents and incidents were recorded. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18 Requirement Staff must receive training appropriate to the work they perform. This would include: • Adult protection training • Refresher training in the safe working practice topics Timescale for action 28/02/07 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 OP9 OP26 Good Practice Recommendations Staff should sign to evidence that they have administered creams and other topical preparations. The registered manager should ensure the laundry floors and walls are easily washable. Northwood Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Nursing Home DS0000022475.V305477.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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