Inspection on 12/07/05 for Nuffield House

This inspection was carried out on 12th July 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

Nuffield House 18/10/06

Nuffield House 20/02/06

Nuffield House 25/01/05

Nuffield House 13/09/04

Nuffield House 15/04/04

Similar services:

Applegarth

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Nuffield House Barclay Street Leicester Leicestershire LE3 0JE Lead Inspector Rajshree Mistry Unannounced 9am, 12th July 2005 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. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Nuffield House Address Barclay Street Leicester Leicestershire LE3 0JE 0116 2541363 0116 2541363 socis214@leicester.gov.uk Leicester City Council 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) Vacant Care Home 34 Category(ies) of OP Old Age - 34 registration, with number MD(E) - Mental Disorder over 65 - 10 of places MD Mental Disorder - 20 DE(E) Dementia over 65 - 20 PD(E) - Physical Disorder over 65 - 6 Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within the category Dementia (DE(E)) or Mental Disorder (MD(E)) may be admitted home when 20 persons who fall within the category DE(E) or MD(E) are already accommodated within the home. No person falling within the category Physical Disability (PD(E)) may be admitted home when 6 persons who fall within the category PD(E) are already accommodated within the home. No person falling within the category Sensory Impairment (SI(E)) may be admitted to the home when 10 persons who fall within the category SI(E) are already accommodated within the home. Date of last inspection 25th January 2005 Brief Description of the Service: Nuffield House is a registered care home to accommodate up to thirty-four older person and is owned by Leicester City Council. The home is situated in a residential area and close to local shops and amenities. Public transport is nearby and a ten minute bus journey to the city centre. Nuffield House is a large purpose built property. Access to the home is level entry. Accommodation is provided on the ground and first floor, which can be accessed via the passenger lift located near to the centre of the building. All the bedrooms are single rooms with a wash hand basin. Bath rooms and toilet faciliities are located close to the bedrooms and the communal areas. There are a choice of lounges and dining area accessible to resident on the ground and first floor and a designated smoking area. There is seating available for residents to the front of the home and the garden to the rear. All areas of the home are accessible to people using mobility support, aids and equipment. The home is well maintained with comfortable furniture and decor. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 9am on 12th July 2005 and lasted for 9 hours. The method of inspection consisted of examining the information received in the pre-inspection questionnaire prior to the inspection. This inspection also addressed the concern raised by a relative with CSCI regarding the cleanliness of a residents’ bedroom. On the day of the inspection the method used consisted of a tour of the premises, examination of the health and safety records for the home, three residents were spoken with and observed, specifically to look at their lifestyle at the home, how their care needs were met and concerns addressed. Individual plans of care and relevant care records were examined. Key workers for residents’ talked about care provisions, how the identified needs were met and their training and management support. Residents visiting relative shared their views about the home and the care provided by the home for the residents. Staff spoke about the training and support they receive and how information is accessed. Towards the latter part of the inspection visit, time was spent with the Acting Manager discussing some of the findings, information received and observations made. What the service does well: What has improved since the last inspection? Nuffield House has had new double-glazing windows installed to all bedrooms and the communal areas. Two new baths with hoist have been installed. The foyer, dining room and some bedrooms have been decorated. The remaining bedrooms are also scheduled to be re-decorated. New rooms have been Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 6 created from existing space to create a manager’s office, a treatment room and a hair salon. The requirements and recommendations made at the last inspection have been addressed. Further work is continuing to update regularly the residents care plans and risk assessments. 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. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 5. Standard 6 is not applicable. The admission process is well managed with residents’ needs being assessed to ensure care needs are individually tailored and met. EVIDENCE: The admission procedure is good in that the assessments of individuals are carried out by the social worker, as part of the referral process for short and long stay. All potential residents are given clear information about the home and the services at the earliest opportunity. Risk assessments on mobility, sensory impairment, diet, continence and medication are carried out ensure needs can be met. Three residents files examined contained information detailing the residents care needs, diet and how to maintain and promote independence. Prospective residents and their relatives are encouraged to visit. A trial period of stay is offered to all prospective residents and to discuss how individual care needs can be met. Two residents spoken with were on a trial period of stay and both were keen to remain at the home providing there was a permanent vacancy. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 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 standard(s) 7, 9, 10 Residents are well cared for, having their health and social care needs met. Residents’ privacy is upheld and they are treated with respect. EVIDENCE: Since the last inspection the management team has made progress on reviewing and updating residents individual care plans, giving clear instructions for staff to follow, which meets the individual care needs. Care files were examined for three residents that were case tracked, all contained individual plans of care with risk assessments and evidence of reviews undertaken in consultation with the resident and the key worker. Two plans of care viewed required updating to give clearly instructions to staff how the care needs should be met. Another care plan was viewed, which was easy to follow, giving clear details of how the care needs should be met. The Acting Manager confirmed that care plans are being audited and gave assurance that the two care plans identified would be updated. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 10 Medication is stored in the medication trolley, in the treatment room. A trained member of staff was observed administration medication at lunchtime in the dining room. Medication for one resident was taken to the resident’s bedroom where a family member was visiting and requested to leave the medication there. The member of staff returned a short time later and removed the medication, as it was not taken by the resident and recorded accordingly. Medication procedures are accessible to all staff. The pharmacist prepares medication into manrex packaging and supplied with completed medication administration records (MAR). Medication was examined against the MAR charts for three residents and found to be accurate and auditable. All residents on medication have a photograph placed on the front of each MAR chart to avoid misadministration of medication. The home is commended for this good practice. Liquids, creams and eye drops viewed had the name of the resident and the date of opening. Assistant Managers have the delegated responsibility to ensure management of medication is monitored regularly and is safe. Residents and other visiting relatives felt the staff were helpful and that staff treated residents with respect and upheld their privacy. One visiting relative expressed concerns about how staff assist the resident, but there was no evidence that suggest that resident are was being mistreated. Staff were observed addressing residents by their preferred form of address, responding to residents requests in that they were attentive, friendly, clearly spoken and were kept informed. Whilst moving around the home staff were observed knocking on the doors and announcing themselves before entering slowly. Call bells were being responded too promptly and visitors arriving at the home are welcomed without delay. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 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 standard(s) 13, 15 All residents are able to maintain contact with families and friends. There are good choices of meals that are nutritionally balanced and meet special dietary needs. EVIDENCE: Visitors to the home are welcome at any time within reason. On the day of the inspection the Inspector met with a number of visitors from relatives of the residents to the delivery person and the District Nurse. Residents are encouraged to meet with their relatives and maintain links with the local community. There is a designated visitors room for residents wishing to meet with their visitors in private. Those residents and their visitors who spoke with the Inspector felt that those visits were not restricted whilst respecting the residents wishes. Discussion with the Assistant Manager confirmed that residents could go out with their visitors if they chose to do so, for a short walk or a meal out. Meals are varied, nutritionally balanced and appealing. The menus for the day are displayed in the dining room; breakfast, lunch and tea/evening meals. Meals are prepared on the premises and special dietary requirements are accommodated, such as sugar free meals, for residents with diabetes. Arrangements have been made for culturally appropriate Asian vegetarian meals to be delivered for one resident who has an Asian diet. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 12 One visiting relative was seen bringing in a flask of Indian tea for the resident. On the day of the inspection lunch looked and smelt appealing and a choice of main course was available. Lunch is the main meal and is served in the dining room although residents can choose to eat in the privacy of their own rooms. Residents spoken with said they were happy with the choice of meals. Drinks and snacks are available throughout the day. On the day of the inspection, staff were observed offering additional drinks to residents, as it was very hot. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 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 standard(s) 16, 18 Complaints are handled objectively and residents are confident that their concerns would be listened to, taken seriously and acted upon. A copy of the vulnerable adults procedure is available to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The complaints procedure is included within the brochure and service user guide, which is given to all residents at the point of admission. Two complaints have been received since the last inspection and one is still under investigation. Records are made of complaints received and investigated and remain on file. During the inspection visit, visiting relatives for one resident brought a concern to the attention of the Inspector regarding the loss of their residents’ hearing aid. The complaint was shared with the senior on duty and assurance was given that staff cleaning the bedroom would make effort to specifically look for the hearing aid. The senior returned a short while later, with the hearing aid in the box, which was found stored in the resident’s bedside cabinet. Discussion with the relatives and on examination of the plan of care indicated that staff were not always following the agreed arrangement to remove the hearing aid. This was raised with the Acting Manager and senior on duty and confirmed that staff were carrying out the tasks but not always recording it. Residents who spoke with the Inspector felt confident that their concerns would be addressed promptly. Residents said they would speak with the staff or raise it with the relative, who was act on their behalf. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 14 Staff training records viewed indicated that staff have received training on adult protection as part of their induction training. The Acting Manager confirmed that all staff are undertaken further adult protection training following the publication of the new adult protection procedure. Discussion with staff indicated that they were aware of what action to take regarding any suspicion or allegation of abuse. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26, On the whole the home is well maintained, providing a clean and safe standard of accommodation for the residents. Specialist equipment is available and used by trained staff to promote residents independence. EVIDENCE: On the day of the inspection the home appeared to be safe. Several residents and visiting relatives that spoke with the Inspector said the home was clean. Since the last inspection the home has had various areas re-decorated and plan to have new soft furnishings. Residents have a choice of lounges including a designated smoking lounge where they can choose to relax. The foyer and dining rooms have been redecorated since the last inspection. The home is well ventilated with ample natural light penetrating through the large windows. Access to the home and garden area is wheelchair friendly. Residents access the first floor via the passenger lift, which was used by the Inspector and found to be clean. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 16 The plants and shrubs to the front of the home require some attention to rid the garden of weeds and overgrown plants. On the morning of the inspection, on arrival several areas, such as corridors to the bathrooms and toilet facilities and residents bedrooms had strong offensive odours. The same area was re-visited in the afternoon by the Inspector and found to be free from offensive odours and smells. The home has disabled toilets throughout that are close to lounges and bedrooms. Domestic staff and carers, where necessary, were seen cleaning the toilets facilities and bathrooms. The Inspector also viewed several bathrooms and toilet facilities prior to the end of the inspection and found the toilets were clean. Residents spoken with indicated that they found the home to be clean. Two of the three sets of visiting relatives were happy with the standard of cleanliness in the home. A number of residents’ bedrooms have been re-decorated with the remainder scheduled for decoration. The Inspector viewed several bedrooms including bedroom number 1, where it was alleged that the bedroom was “filthy”. There was no evidence that the bedroom was filthy. Staff were seen shampooing the carpet in the bedroom and the bed had been stripped for washing. Bedrooms were personalised, bright and clean with ample space for residents using walking aids. Comment received from a relative “the home suits mother’s way of life, mainly of the same age group and has made friends. There are handrails throughout the home. Specialist equipment is available to assist with transfers of residents such as hoist and stand aids. Pressure cushions were seen being used by the residents and available in all the lounges. Staff are trained to use specialist equipment available in the home to maximise the residents independence. One new member of staff spoken with said she does not assist residents to transfer until she receives the moving and handling training the following week. Staff were observed wearing protective clothing to prevent cross-infection. On the whole the home was found clean and well maintained. Discussion with the Assistant Manager and Senior Carer on duty indicated that all staff have a responsibility of the cleanliness of the home in addition to the home’s domestic staff. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 The number and skill mix of staff meets residents’ needs. Staff are trained, supported, and deployed in sufficient numbers to meet the resident needs EVIDENCE: Staffing levels were sufficient to meet the resident’s needs at the time of the Inspection. Staff rota viewed reflected the staff on duty, including three agency staff. Nuffield House management team consists of the Acting Manager, two Assistant Managers, three Senior Carers, twenty Carers and twelve Domestic staff. Twelve care staff have attained National Vocational Qualification level 2 and above. The Local Authority has in place a departmental training plan, the document details general areas of training and training specific to needs of residents. Staff training records viewed reflected a variety of topics of training accessed, which included health and safety, adult protection, care practice, dealing with violence, stroke awareness, first aid, continence care and communicable disease awareness. Comments received from residents; “Staff are good, very kind”, “Staff have helped moth settle-in well and always kept informed”, “The staff work very hard and never grumble”. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 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 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) 37, 38 The health, safety and welfare of residents and staff is well promoted and protected through the home’s policies and procedures. EVIDENCE: On the whole the residents care plans and care records examined were in good order and work is ongoing to ensure all care plans are up to date. All residents have named key-workers that promote continuity of care. Records are stored securely and residents are aware of their rights to access their records. All staff have access to the home’s policies and procedures. Notices are displayed around the home with information for staff and notices boards for residents and visitors to the home. During the tour of the home fire exits were clearly marked and were not obstructed. Records of tests to fire safety equipment, alarms were in good order and health and safety issues were well documented. Fire risk assessments carried out were accessible for inspection. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 19 Individual risk assessment for residents requiring moving and handling were in place and reflected in the plan of care, and where applicable clear instructions for staff such as must be two staff to assist and use hoist to transfer. The Fire Risk Assessment was available and had been reviewed; generic risk assessments are in place, along with individual risk assessments for residents. Since the last inspection the water temperature and heating systems have been service and temperatures are regulated. There is a programme of maintenance and testing of all equipment in the home. The Acting Manager confirmed that the programme of decoration of the residents’ bedrooms is ongoing. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x 3 3 Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 21 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 Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations 2. 3. It is strongly recommended that the remaining care plans are updated and reflective of the care needs in consultation with the residents, with clear instructions to staff delivering the care. OP7& OP37 It is strongly recommended that the daily recording where monitoring or specific instructions to staff to carry out tasks are accurately recorded and regularly checked. OP20 The external garden area to the front of the home require some attention to rid the garden of weeds and overgrown plants. Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX 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 Nuffield House C51 C01 S37699 Nuffield House V233193 120705 Stage 4.doc Version 1.40 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. 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