Inspection on 23/06/05 for Nower Care

This inspection was carried out on 23rd June 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 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

Nower Care 14/08/06

Nower Care 24/11/05

Nower Care 10/11/04

Nower Care 20/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Nower Care Nower House Coldharbour Lane Dorking Surrey RH4 3BL Lead Inspector Mary Williamson Announced 23/06/05 10:00 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. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Nower Care Address Nower House Coldharbour Lane Dorking Surrey RH4 3BL 01306 882844 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) Dorking Residential Care Homes Ltd Wendy Sharples CRH 50 Category(ies) of PD(E) - Physical Disability - over 65 - 3 registration, with number OP - Old Age - 50 of places DE(E) - Dementia - over 65 - 7 SI(E) - Sensory Impairment - over 65 - 2 Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Of the 50 (fifty) service users accommodated under the category of OP, up to 7 (seven) may fall within the category DE(E): Dementia (older persons). Of the 50 (fifty) service users accommodated under the category OP, 3 (three) may fall within the category PD(E): Physical disability (older persons). The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE. Of the 50 (fifty) service users accommodated under the category of OP, 2 (two) may fall within the category SI(E): Sensory Impairment (older persons). Date of last inspection 10/11/04 Brief Description of the Service: Nower Care is a care home for fifty service users located on the outskirts of Dorking Town. The home provides personal care in a homely and comfortable atmosphere. Service users accommodation is offered in single bedrooms some of which have en-suite facilities. There is ample communal space available which includes six lounge areas. The home has been undergoing extensive refurbishment in recent years to enhance service users accommodation. This building project has reduced the garden facilities on a tempory basis. Leisure activities and trips out to the local amenities and places of interest are also provided. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and the first in The Commission for Social care Inspection programme year 2005/2006. The inspection was undertaken by Mary Williamson who is the lead inspector for the service. The registered manager Wendy Sharples was present throughout the inspection and Chris Horwood the general manager was present for the latter part of the inspection. Approximately 60 of the service users and 15 of the staff were spoken to during the inspection. Five service user comment cards and two relative comment cards were also received. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. The home was functioning well and the service users were engaged in individual and group activities overseen by the leisure activities co-ordinator. Interaction between the service users and the staff was observed to be respectful and positive. The staff recruitment procedures and staff training programmes were not inspected during this visit. The inspector would like to thank the service users, staff and the management team for their helpful and positive approach to the inspection process. What the service does well: The home provides good quality care to service users as identified in individual care plans. The interaction between the service users and staff is professional, respectful and caring. The management team are currently working to keep disruption to a minimum while the refurbishment of the home continues. Social and recreational activities are varied and are provided on a regular basis. Service users records are generally well maintained and computerised. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 6 There are appropriate systems in place to ensure that all the personal and health care needs are being met. 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 Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 7 contacting your local CSCI office. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 4, and5. The home was found to be operating effectively in respect of these standards. The quality of the information available to prospective service users was good and indicated that it would help service users and their families make an informed choice about the home. EVIDENCE: The home has a statement of purpose and service users guide in place, providing prospective service users, their families and designated representatives with the information necessary to make an informed decision about living in the home. The service user guide also includes an application form to be completed prior to admission. This provides the home with the initial information, which includes the diagnosis of the service user, enabling the home to determine if their needs can be met. Contracts of terms and conditions of occupancy are in place and outlines all the relevant charges and care to be provided. These contracts are signed by the service or their designated and a copy is retained on file. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 10 The manager undertakes a pre admission needs assessment on all prospective service users in order to establish if the home can meet their needs. The home has developed it’s own assessment tool for this purpose. The manager stated that trial visits are encouraged whenever possible, which may be for coffee or a meal. Relatives may visit on behalf of the prospective service user if they are unable to do so for themselves. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 11 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, and 10 Evidence gathered during the inspection confirmed that the home meets each of the assessed standards, with the exception of standard 7. The home was able to demonstrate that the service users health and personal care needs were being appropriately met. EVIDENCE: Individual care plans are in place. These are written with the input from service users, their relatives, information gathered from the pre admission needs assessment, and any other information relevant during the admission process. All the care plans are computerised, and are updated daily. The information is then cascaded to the care staff during daily handovers. The printed copy of the care plan must be signed by the service user, or a designated representative. There was evidence that risk assessments are also carried out, for example moving and handling, risk of developing pressure sores, and nutrition assessment, which are also included in the care plan. Service users have access to appropriate health care services. They are all registered with a local GP and are seen on a regular basis. There is also input Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 12 from the district nurses who monitor dressings, blood tests, flu vaccines, pain relief and catheter care. Visits from the chiropodist, dentist and optician are also arranged. Staff were observed to interact with service users in a positive and respectful manner. They were seen to address service users politely and explain their actions when giving care. The staff were observed to knock on bedroom and bathroom doors prior to entry. The home has a policy in place relating to privacy and dignity and staff have training in this policy during induction training. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 13 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, and 15 Evidence gathered during the inspection confirmed that the home meets each of the assessed standards. This indicated that service users social, recreational and dietary needs are being met. EVIDENCE: The home employs an activities co-ordinator who organises activities on an individual and group basis. Art and craft, aromatherapy, music and movement, general knowledge quiz, board games, and card games are an example of what is on offer. Outside entertainment is also provided at least once a month. Trips to the local theatre and shopping outings are also arranged. Service users spiritual needs are also supported and various local clergy are made welcome in the home. Relatives and friends are encouraged into the home at any reasonable time. They are also involved in the care planning process and informed of any changes that occur. The kitchen was visited during the inspection. The cook explained that the menus are planned over a six-week period. There was a list of service users dislikes kept in the kitchen for information. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 14 The menus were not available. therefore the service users and staff were not aware of the choice of lunch being offered. It was only when the inspector asked that enquiries were made to the kitchen and the lunch menu was written on the board in the dining room. Lunch consisted of chicken pie, a selection of fresh vegetables, boiled and mashed potatoes, followed by fresh fruit salad and ice cream. The food offered was nutritious, wholesome and appetising. Two service users commented that the food was adequate but unimaginative while others commented that the food was very good. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 15 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, and 18 Evidence gathered during the inspection confirmed that the service users are appropriately protected and that views are listened to but not recorded. EVIDENCE: The home has a complaints procedure in place and is available to all service users and their families on admission to the home. The home does not keep written records of complaints received. Currently the home is dealing with two complaints from service users who are unhappy about having been moved to other rooms to accommodate the building project in progress. The management have been requested to keep The Commission for Social Care Inspection informed of the outcomes and a requirement has been made accordingly. There is an abuse awareness policy available and both the registered manager and general manager confirmed that all staff have training in abuse awareness during their induction period. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 16 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, and 24 The evidence gathered during the inspection indicates that standards 21, 22, and 24 were met and there are shortfalls relating to standards 19, and 20. EVIDENCE: The home is suitable for its stated purpose. It has been developed and improved in recent years and the current building project has linked both buildings by a central reception area. New en-suite bedrooms have been constructed to enhance the space standards. The home provides ample communal facilities, which includes six lounge/quiet rooms. The hallway at the main entrance needs redecorating. Due to the ongoing building work, access to the garden is limited and this was a negative comment by several service users. It is recommended that an action plan outlining timescales for the provision of suitable garden facilities is sent to The Commission for Social Care Inspection within the next month. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 17 There are ample bathrooms and toilets facilities situated throughout the home. Some have been adapted to meet the mobility needs of the service users. There is access to a physiotherapist and occupational therapist to provide specialist advice for mobility equipment to meet individual and collective assessed needs. Ramp access is available from the new reception area to the front of the home. Service user accommodation is provided in single rooms. The standard of decoration and facilities varies from been refurbished with en-suite facilities to very basic accommodation on the Dyson Wing. The staff and relatives are committed to ensuring that the bedrooms are kept as individual and personalised as possible. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 18 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) These standards were not assessed due to the time constraints of the inspector. These will be examined in detail at the next inspection. EVIDENCE: Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 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, 37, and 38 Evidence gathered during the inspection indicates that the home is well managed in the best interests of the service users. The standard of record keeping is generally good, with three shortfalls highlighted in previous standards. EVIDENCE: The home is well managed by a registered manager with considerable experience in the provision of care to older people. She also has achieved her NVQ level four award in management. There is also a general manager in post who oversees the administration and current building project in the home. The standard of record keeping is generally good. Pre admission needs assessments, risk assessments, and most care plans are generally well Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 20 maintained. There was however no menus available to service users for information on the day of the inspection, there was no printed copy of a care plan in place for one service user, and the home does not keep a written record of complaints received. There is a wide range of health and safety policies and procedures available and these were seen throughout the inspection. Risk assessments are in place for safe working practice. The fire safety records were seen and are well maintained. There are contracts in place for regular servicing of the fire fighting equipment and fire alarm systems. All accidents are recorded and filed accordingly. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 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. 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 x 3 x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 x x x x 2 3 Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 22 NO 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 7 and 37 Regulation 15(2)(a) Requirement The registered person shall ensure that printed care plans are available and signed by the service user or representative. N Timescale for action 10/08/05 2. 3. 16 19 22(8) 23(2)(d) 10/08/05 4. 20 23(2)(o) 5. 37 17(a)(2) The registered person shall 10/08/05 ensure that all parts of the care home are kept reasonably decorated. The registered person shall 10/08/05 ensure that extennal grounds are safe and suitable for service user use. The registered person shall 10/08/05 ensure that information relating to menus are available to service users and that a record of complaints is kept in the home. 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 19 and 20 Good Practice Recommendations It is recommended that an action plan is sent to The Commission for Social Care Inspection outlining the programme of refurbishment for the home to include the h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 23 Nower Care when the garden will be available for service users use. 2. Nower Care h09-h58 s13730 Nower Care v227220 230605 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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