Inspection on 24/11/05 for Nower Care

This inspection was carried out on 24th November 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 23/06/05

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 Unannounced Inspection 24th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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 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) Dorking Residential Care Homes Limited Ms Wendy Anne Sharples Care Home 50 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (50), of places Physical disability over 65 years of age (3), Sensory Impairment over 65 years of age (2) Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 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, 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). 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). 23rd June 2005 Date of last inspection 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 friendly atmosphere. Service users accommodation is offered in single rooms 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 temporary basis. Leisure activities and trips out to the local amenities and places of interest are also provided and arranged by the leisure activities coordinator. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and the second in The Commission for Social Care Inspection programme year 2005/2006. Mary Williamson who is the lead inspector for the service undertook the inspection. The duty manager Zuzana Schmidt-Mayerova was present throughout the inspection. Chris Horwood the general manager was present for the latter part of the inspection. The Registered Home Manager was out with a service user for the duration of the inspection. Most of the service users were spoken to during the inspection some in more detail than others. The general feedback regarding the home and the care they receive was very positive. The service users were also very complimentary about the food and the catering arrangements in the home. Several staff also contributed to the inspection process. Three relatives were visiting the home and took the time to talk with the inspector. Their comments were also very favourable in support of the staff and the care provided. 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 general manager gave the inspector an update on the progress of the building project and the plans for the next stage of the development. The inspector would like to thank the staff team, service users, and relatives for their helpful and positive input to the inspection process. What the service does well: The home continues to provide good quality care to service users as outlined in well maintained individual care plans. The staff are committed and provide care in a sensitive and dignified manner. There is a good and varied leisure activities programme in place and this is coordinated by a leisure activities person. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 6 The home continues to under go refurbishment and the management team are doing their best to keep disruption to a minimum. There are appropriate systems in place to ensure that service users health, and personal care needs are 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 contacting your local CSCI office. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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 Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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): These standards remain unchanged since the last inspection. Please refer to the previous inspection dated 23rd June 2005. EVIDENCE: Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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, and 9. Individual care plans outline personal care needs and the team leader was able to demonstrate that health and person care needs are being appropriately met. EVIDENCE: Individual care plans were seen. These are written with input the service users, relatives and any relevant information available. These plans are well maintained, computerised, and updated daily. A printed hard copy is also available. All service users are registered with a local GP, and are well supported by him. There is an opportunity for service users to retain their own GP on mutual arrangement. The service users are also supported by the district nurse, who undertakes dressings, takes blood for various tests, administers flu vaccines, and monitors pain control. The dentist, chiropodist, and optician all visit on a regular basis. Physiotherapy can be arranged privately. There is a policy in place for the administration of medication. All staff who administer medication are familiar with this policy and receive regular training. The Nomad system is in place, and medication is supplied by Info Health Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 10 Pharmacy,in Coulsdon. The pharmacist audits the medication and undertakes regular monitoring visits. All medication was stored correctly. Medication recording charts are well maintained. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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. Appropriate arrangements are in place to meet the social and recreational needs of the service users. Family links are maintained. Dietary needs are being met. EVIDENCE: There is a programme of activities and events displayed in the front hall, which is rotated monthly. This is organised by the activities coordinator with input from service users. This includes art and craft, board and card games, music and movement, carol service, trips to the local theatre and to see the Christmas lights. Family links are maintained and relatives are welcome to visit at any reasonable time. There was an opportunity for the inspector to meet with four visitors during the inspection who all confirmed this. Relatives are involved in the care planning process and have also been invited to the Christmas Party. Spiritual needs are also supported and various local clergy visit the home on request. Service users stated that they could choose when to get up or go to bed. They can participate in-group activities or choose to read their daily newspapers alone. There are a number of lounge areas to facilitate their choice. However Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 12 the inspector noted that when service users were asked what was on offer for lunch none of them were aware. At this point a member of staff began to write the lunch menu in the board in the dining room. This situation remains unchanged since the last inspection, and a system needs to be introduced to help service users remember what they can expect for lunch and supper. The kitchen was visited which was busy but well organised. The cook plans the menus on a six- week rota and these are varied and nutritious. There is an alternative dish available to cater for service users likes and dislikes. Special diets are catered for. Lunch was observed which consisted of shepherds pie, a selection of vegetables and potatoes, followed by ginger sponge and custard. The last EHO inspection was on 2/6/05 and this was satisfactory. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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. Service users and their relatives are confident that complaints are acted upon and systems are in place to protect service users from abuse. EVIDENCE: The home has a complaints procedure in place and this is available to all service users on admission to the home. This procedure is included in the service users guide. The home now keeps a written record of complaints received. There is a copy of Surreys Multi Agencies Protection of Vulnerable Adults policies and procedures in place. The home also has a policy on abuse awareness in place and all staff have training in this during induction training. This was confirmed by a group of staff during discussion. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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, 21, 22, 24, and 26. The standard of accommodation varies and continues to be upgraded during the current building project. Adaptations support mobility needs. The home is clean with mal odour identified in an isolated area. EVIDENCE: The home continues to be refurbished which has linked both buildings by one large reception area, which has been tastefully decorated. The standard of accommodation and decoration varies from new en-suite single rooms to smaller very basic rooms in the Dyson Wing. The general manager explained that this wing was next to be redeveloped in order to meet the environmental standards of the home. There are ample toilets and bathrooms situated throughout the home. Some of these have been adapted to meet the mobility need of the service users. Grab rails have been fitted throughout the home; hoists, shaft lifts, and wheelchairs are also available. There is a ramp to access to the garden. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 15 Service users accommodation is provided in single rooms. All rooms are personalised to reflect individual personalities and interests. The standard of individual accommodation varies considerably from well- furnished en-suite facilities to very basic facilities. As mentioned this situation has been identified and is in the next phase of the development. One bedroom had a portable heater as back up heating as the radiator was only warm and the hot water in the wash hand basin was tepid. (Room 39) The home is clean and free from offensive odour with the exception of one room and hallway on the first floor. The manager must introduce measures to control this. The laundry was visited and is well equipped with new washing machines and dryers. However there are no facilities available in the laundry room for staff to wash their hands after handling dirty or soiled laundry. This must be addressed and outlined in the homes control of infection policy. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 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, and 30. The number and skill mix of staff ensures that the service users needs are being met. EVIDENCE: The staff rota was seen and the number and skill mix of staff on duty reflected the assessed needs of the service users. The number of staff on each shift has been increased by one since the last inspection. On the day of the inspection there was a duty manager, six carers, four cleaners, one cook, two kitchen assistants, and a laundry assistant on duty. The service users stated that they are satisfied with the number of staff and that their call bells are answered within a reasonable time scale. During discussion with staff they confirmed that they all undertake induction training. They have training in manual handling, food hygiene, first aid, fire safety, and medication administration. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 17 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, and 38. The home was functioning well and is well managed in the best interests of the service users. The health and safety of service users is generally maintained with the exception of the control of infection arrangements. EVIDENCE: On the day of the inspection the registered manager was out with a service user. The duty was in charge and conducted the inspection. The overall management structure is satisfactory. There is a registered manager in post with considerable experience in the provision of care for older people. A general manager who oversees the administration and current building project in the home supports her. There is a wide range of policies and procedures relating to health and safety in place. Staff are familiar with these policies and procedures and have regular training in COSHH procedures. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 18 The infection control procedures need to be revised to address the hand washing facilities in the laundry room. The fire safety records were seen and are well maintained. During a discussion with staff they confirmed that this training is undertaken on a regular basis. Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 3 X 2 2 2 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 20 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 14 Regulation 12(2) Timescale for action The registered person shall make 09/01/06 provision for service users to make decisions regarding the food on offer. The registered person shall 09/01/06 ensure that all parts of the care home are kept reasonably decorated. The registered person shall 09/12/05 ensure that suitable heating is provided in all parts of the home The registered person shall 09/12/05 ensure that sufficient hot water is available in wash hand basins in service users rooms. The registered person shall make 09/01/05 arrangements for maintaining satisfactory standards of hygiene in the home. The registered person shall keel 09/01/06 the care home free from offensive odours. Requirement 2 19 and 24 23(2)(d) 3 4 25 25 23(2)(p) 23(2)(j) 5 26 and 38 16(2)(j) 6 26 16(2)(k) Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Surrey Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Nower Care DS0000013730.V270044.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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