Inspection on 23/06/09 for Notintone House Care Home

This inspection was carried out on 23rd June 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Notintone House Care Home 10/07/08

Notintone House Care Home 07/08/07

Notintone House Care Home 11/07/06

Notintone House Care Home 18/10/05

Notintone House Care Home 31/01/05

Notintone House Care Home 19/10/04

Notintone House Care Home 27/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Notintone House Care Home Sneinton Road Sneinton Nottingham NG2 4QL     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 2 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Notintone House Care Home Sneinton Road Sneinton Nottingham NG2 4QL 01159503788 01159598604 william.robins@salvationarmy.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Salvation Army care home 40 Number of places (if applicable): Under 65 Over 65 0 40 dementia old age, not falling within any other category Additional conditions: 40 0 The maximum number of service users who can be accommodated is 40 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Notintone House is a purpose built care home for older people registered to accommodate 40 service users, including people with dementia. The home is run by the Salvation Army and is situated within the William Booth Memorial complex. This complex includes a day centre, which the home provides with hot meals from the newly refurbished kitchen. The home is situated close to the city centre, with easy access to local community facilities. The service users are accommodated in single rooms on four floors, which are accessible by a passenger lift, with other aids and adaptations available to promote service user independence. There are car parking spaces at the rear of the property. Care Homes for Older People Page 4 of 28 Brief description of the care home The manager said that current weekly fee range is £392.50 to £450.00. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2009. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. We sent survey forms entitled Have your say about... to a sample of Care Homes for Older People Page 6 of 28 people but none of these were returned. The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: People coming to stay at the home for a period of respite care are not having their needs assessed, like those who are moving into the home for long term care. Everyone staying at the home needs a care plan that describes how their needs are to be met. There is not an up to date procedure for the administration of medicines and some of the practices seen did not provide sufficient safeguards to make sure there were not any mistakes made. One person was heard talking with staff about her watching her Care Homes for Older People Page 8 of 28 take her medication. More could be done to make the environment suitable for people with dementia. People said they were happy with the building and one person said, My room has been decorated recently, I wanted it pink but wasnt allowed. Staff were not using protective clothing when handling food. There are times during the day when more staff are needed on duty. One person said Someone will come to you, but it does take a little time sometimes If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The experience of service users coming to the home differs according to their needs. Evidence: A Statement of Purpose was seen that had not been updated since June 2005, however the manager showed one on his computer that he has updated to include the homes change in registration to care for people with dementia. The manager said the updated version still needs further details about how the home will provide service to people with dementia. The files for the four people who were case tracked were looked at. Two of these people were at the home for a period of respite care, and had not been assessed before they came to stay. The manager said that these people had missed the net and they need to be better at assessing people coming to stay for respite care. Care Homes for Older People Page 11 of 28 Evidence: Staff said they thought that not appointing keyworkers for people coming for respite care meant that assessments did not always get done as no one took responsibility for doing these. As none of the people who were case tracked who had been admitted to the home recently were funded by the Local Authority, a further file was seen, and this contained an assessment prepared by them. The manager said one person had not been offered a place at the home as a result of the information obtained through the pre admission assessment. There was a reference seen in the most recent residents meeting minutes to making any new residents feel welcome when they come to the home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is inconsistency in the standard of care plans. People have their healthcare needs seen to, but the practices for administering and recording medication are not sufficiently robust to make sure people receive their correct medication. Evidence: The care plans for the four residents who were case tracked were seen. One of these for a person who was there for respite care, had not been completed. Two of the other plans gave clear direction as to how the persons needs should be met, and the other one was lacking in detail. Staff said they keep the care plan they are responsible for up to date, but dont think staff look at those they are not keyworker for. In the last residents meeting minutes there was an explanation about keyworkers and that they review peoples care plans. Care Homes for Older People Page 13 of 28 Evidence: Two of the care plans seen showed the person had a weekly bath or shower, but this was not recorded in the other two. Staff said it was keyworkers responsibility to arrange baths and that people could bathe more frequently if they wished. There were some entries showing people had attended medical appointments and one person was heard talking to staff about going to the dentist later in the day, which she was seen going to, with a member of staff. When the manager was administering some eye drops he commented that the persons glasses needed cleaning and asked a member of staff to do this. Part of the morning medication round was observed. Most people were given their medicine in the dining room, however those who did not come down for breakfast had their medication taken to them with their breakfast. This meant that a member of staff took several peoples breakfast and their medication, in the blister packs, upstairs on a trolley. When the staff had finished giving people their breakfast and medication they informed the manager who was giving out medication in the dining room who signed the Medicine Administration Record. The homes medication procedure, which was out of date, did not describe this practice. The Medicine Administration Records were not fully completed as a few gaps were seen, where it was not recorded whether people had or had not had their medication. There has been one medication error concerning some controlled drugs missing in the last 12 months reported. This was reported to ourselves and the Police at the time, although not resolved. The manager said in the notification he sent us about this that he will be checking the controlled drugs register daily. The controlled drug book was seen and this showed that one person was not being given her medication as described by the pharmacist and there was no record made to explain the reason for this. The manager said he will ensure thsi is correctly administered from now on. People were seen being treated and spoken to in a respectful manner. Staff described maintaining peoples privacy and dignity and were aware of additional support needed by people with dementia to do this. One person said, I am well treated, and treated respectfully. and another was heard talking to staff about her watching her take her medication. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to take part in activities they enjoy and have their spiritual needs met. People are provided with a wholesome and varied menu. Evidence: There is an activities coordinator employed in the home who organises various activities for people to take part in. There was a clothing rail arranged for today, and this was well attended. People enjoyed looking at and trying on new clothes. People were heard saying they had enjoyed it and asked if they could come back in a couple of months with the next season stock. One person was heard discussing the best place to hold the clothes rail sale with the activities coordinator. Staff described a variety of activities provided, ranging from using a Wii games console which has recently been purchased to knitting. There are prayer meetings held each morning and a chapel service every Sunday and Wednesday. This is shown on the television in the lounge for people not feeling up to Care Homes for Older People Page 16 of 28 Evidence: attending. There was information seen in a recent residents meeting minutes about a forthcoming boat trip and introducing some exercise classes. One person was seen returning from a short break holiday with a relative and another person said she sometimes goes out. There are some people who make use of community resources, such as the nearby fish and chip shop. People were seen making various choices during the visit. This included attending the clothes sale and choosing some new clothes, where they went in the home and what they had to eat at mealtimes. One person said she has her own fridge in her bedroom. Some people had shepherds pie for lunch and some others had spaghetti bolognaise. Staff were heard asking people if they had enjoyed their dinner, to which they said yes. One person said she was very pleased when she heard it was apple crumble for pudding. Another person asked if she could have some ice cream and some was bought. People had selected from a choice of kippers or sandwiches for tea and some people were ordering a take away. There was reference to discussing the menu in the residents meeting minutes seen. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel that if they had cause for concern this would be dealt with seriously, and they feel safe in the home. Evidence: There is a complaints procedure in place and staff are aware of this. We were told there have not been any complaints received in the last twelve months. People told us that they know how to make complaint, one person adding, I have not had one to make. There have been two safeguarding investigations in the last 12 months and the manager said he is waiting for feedback from the Local Authority as to the outcome of these. Both investigations involved incidents between people living in the home. The manager said action had been taken to prevent any futher incidents. Staff were aware of the procedures and knew how to respond if they heard an allegation. Staff were aware of the recent investigations. People told us they feel safe in the home. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and well maintained environment, but people with dementia have few visual aids to assist them. Evidence: In the minutes of a recent residents meeting people were informed that decor around the home is going to be touched up. There were some signs on doors to assist people with dementia, and the manager said he will be looking at further ways to improve the environment for people with dementia. There is a maintenance man employed who carries out routine maintenance and attends to minor repairs. There was one bathroom out of use, and the manager explained that a new battery was needed for the hoist and he was looking for a cheaper quote than he had received, but he will be ensuring this room is back in use soon. People said they were happy with the building and one person said, My room has been decorated recently, I wanted it pink but wasnt allowed. Care Homes for Older People Page 19 of 28 Evidence: We were told there is a dedicated team of housekeepers who ensure the home is kept clean and odour free, and to control and prevent the spread of infections. During the visit people were seen cleaning in various areas of the home. Staff were seen using protective clothing when assisting people, but were not doing so in the dining room when serving meals and assisting with feeding. The manager said they had not been, but would start doing so. There are suitable arrangements for the disposal of waste products. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not having their needs met in good time due to their not being enough staff on duty, but they have had the training needed to meet their needs. Evidence: The manager said that he is currently reviewing the allocation of staff on shift, and is in the process of recruiting some more staff as he feels additional hours are needed during the day. The manager said he is looking for increased staffing at hot spots throughout the day, such as getting up and mealtimes. Staff commented that there are a lot of agency staff being used at the moment, which they dont think is good for service users. Staff said sometimes male residents dont get shaved until later in the day and one had not been shaved until the evening yesterday. One person said Someone will come to you, but it does take a little time sometimes We were told there are 15 staff who have gained a professional qualification and staff spoken with confirmed they have one. There have not been any recently appointed staff at the home, but the manager was Care Homes for Older People Page 21 of 28 Evidence: aware of the correct procedures to follow. Staff spoken with knew about the required checks they need before they can start work in the home. The staff training matrix showed that regular training is provided and staff have completed mandatory training. Staff said recent training they had done included moving and handling and first aid. The manager said training on the Mental Capacity Act is booked for July 2009. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements for the management of the home, but more could be done to include the views of people living there. Evidence: The manager has been in post since 2002 and he has completed a professional qualification and is currently working towards another. A survey of peoples views has been carried out and the results of this were fed back in a residents meeting. One person said, I sometimes go to meetings, but feel there is too much saying what has been done or what we are doing, there is not enough of our ideas. Minutes of meetings seen did contain a lot of useful information, but did not show contributions from people in the home. The assessment we ask the provider to complete and send back to us was not returned by the date requested and we had to send a reminder. The information Care Homes for Older People Page 23 of 28 Evidence: contained in this was brief and did not give sufficient detail about the service and the views of people living there. There is a system to help people who require some assistance to manage their personal allowances. This is managed by the administrator, who makes a record of each transaction, which is then witnessed by another person. We were told in the assessment they completed that equipment is serviced or tested as recommended by the manufacturer or other regulatory body. Dates were provided showing this to be the case. Staff said they did not have any concerns about health and safety within the home. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 Include in the Statement of Purpose how people with dementia will have their needs met. This will ensure people with dementia know how they will be supported 01/09/2009 2 3 14 Ensure all people coming to live at the home have been assessed. This will ensure that people will only stay at the home if their needs can be met there. 01/09/2009 3 7 15 Ensure all people at the home have a care plan, which provides details of how peoples needs must be met. Staff will then know how people want their needs to be met. 01/08/2009 Care Homes for Older People Page 26 of 28 4 9 13 Review and update current medication procedures and ensure these are adhered to be staff. This will ensure people receive their medication safely. 01/08/2009 5 19 23 Develop the building so that it more suitable for people with dementia This will assist people with dementia to orientate themselves. 01/10/2009 6 26 13 People must use protective clothing when handling food This will help protect people from the risk of infection. 24/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 33 33 Encourage people in the home to express their views and ideas in residents meetings. Include more detail, including the views of people living in the home in the Annual Quality Assurance Assessment Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!