Inspection on 18/07/07 for Nutten Stoven

This inspection was carried out on 18th July 2007.

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

Nutten Stoven 28/08/06

Nutten Stoven 22/02/06

Nutten Stoven 06/09/05

Nutten Stoven 20/01/05

Nutten Stoven 22/09/04

Nutten Stoven 20/01/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Nutten Stoven 81 Boston Road Holbeach Lincolnshire PE12 8AA Lead Inspector David Bacon Key Unannounced Inspection 18th July 2007 08:30 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 Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nutten Stoven Address 81 Boston Road Holbeach Lincolnshire PE12 8AA 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) 01406 424941 01406 422959 Mr Deva Samat Keshwara Mrs Lilu Deva Keshwara, Mr Samat Bhima Keshwara None Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th August 2006 Brief Description of the Service: Nutten Stoven is a large, detached, former farmhouse set in its own grounds on the edge of the market town of Holbeach. The shops and facilities of the town, including a superstore, are approximately ten minutes walking distance away. The garden is well maintained to provide a secure, tranquil outdoor area with a patio, to the rear of the property, where residents can sit in fine weather. There is parking for several cars to the front of the building. The home is registered to provide personal care for up to twenty-three residents of both sexes over the age of 65 years. There are seventeen single bedrooms, thirteen of which are ensuite and three shared rooms, one of which is ensuite. Nine of the single en-suite bedrooms have patio wheelchair access. Most of the residents’ bedrooms are located on the ground floor. A passenger lift gives wheelchair access to the bedrooms on the upper floor. The homes statement of purpose states that it aims to provide a friendly ‘home from home’ atmosphere where residents can enjoy a quality of life and independence and are given the care and assistance that they need. Copies of inspection reports are contained within the homes statement of purpose and are on display in the home. The care fees range up to £400 per week. Hairdressing and private chiropody are not included in the fees. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place during July 2007 and the visit to the home was undertaken over approximately four hours. The methodology for the inspection visit used is called ‘case tracking’. This means that the care received by three service users was looked at in detail, including service users care, staff and general home records, which pertain to their care and support. We also spoke with three service users, the acting manager and four staff members about the support offered to people living at the home. A partial tour of the premises was conducted including areas relating to the service users who were case tracked. Observations were also made of day-today care practice. Notifications received along with a pre-inspection questionnaire, completed by the manager were also viewed as part of the overall information gathering regarding the service. What the service does well: What has improved since the last inspection? An improvement plan is now in place to update the overall physical standard of the home for service users. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 6 Several service users bedrooms have been redecorated since the previous 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. The summary of this inspection report can be made available in other formats on request. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place for the safe introduction of service users to the home. Service users can be assured that their care needs will be appropriately met, they are satisfied with the admission process and are involved in planning the care they will receive. EVIDENCE: An up to date statement of purpose and service user guide have been produced, which are displayed in the main entrance. The care records viewed identified that a comprehensive assessment of each service users care needs had been undertaken. Assessment information clearly identified individuals care needs and included potential risks and individuals likes and general preferences along with a brief life history. The Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 9 acting manager said that an assessment of need was undertaken prior to any admission to the home, which was confirmed by the service users spoken with. Service users receive written notification where the home staff can meet the individuals care needs prior to admission and signed copies of terms and conditions of residence contracts are maintained. The records seen documented service users involvement in the assessment process. Service users are notified of their rights during the admission process including data protection and confidentiality. Discussions held with service users confirmed that they were satisfied with the homes admission arrangements. Comments included: “Oh, they were marvellous to me, very good, they make you welcome and give you what you need”. “They settle you in and give you information, it’s all very informal, which is good”. “I only came here temporarily but am very settled here, they make you welcome and the care is good”. “They answer any questions they can, I have no complaints about it, they were very good to me”. Intermediate care services are not provided at the home. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users feel they are treated respectfully and they can be assured that their care needs are met. Procedures for the administration of medication are appropriate. EVIDENCE: The service users spoken with said: “You get the care you need and you don’t have to wait, it’s all here”. “I am very satisfied, the staff are a marvellous help, tremendous”. “They do treat you well, as you would want and it’s right that they do”. “It’s a friendly place and you don’t have to worry about being treated right, they have done me proud really”. “They know how to treat you properly, it’s what they are good at”. Information gathered from the initial assessment is used to complete a person centred care plan, of which service users are involved and the records seen clearly documented each individual’s care needs and how these are met and included individual preferences. Information regarding advocacy services is Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 11 provided to service users and the acting manager said that these services were further promoted where service users were without representatives or family to support them. Care records documented any health care needs, which included input from supporting agencies and records were updated and reviewed as necessary. The visiting district nurse said that they were satisfied with the care provided by the home and that staff followed any given instruction of advice. The staff spoken with confirmed that they received regular awareness training and support specific to service users assessed care needs and to promote service users privacy, dignity, choice, rights and independence of which policies, procedures and records are in place. Systems are in place to enable service users to administer their own medicines where this is risk assessed as appropriate. Medicines were properly stored and records clearly documented medicines as receipted into the building, as administered and where disposed. Staff whom administer medication receive accredited awareness training regarding this. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a good standard of meals, which they enjoy and their dietary needs are met. Service users choose how they spend their time and they can maintain and develop community links as they prefer although the activities provided should be reviewed and more fully promoted. EVIDENCE: Service users are initially consulted with about their likes and dislikes and any preferred routines as part of the admission process, which then forms part of the overall care plan. Service users said they were encouraged to make informed choices during each day, that there were no restrictions as to how they could spend their time and that their visitors were made welcome, which was confirmed by the representative spoken with. Service users said that they were satisfied overall with the homes provision of activities of which some information is displayed in the home but this is limited. Service user comments included: “Its up to you what you do, there’s no rules you can join in if you like or do what you like”. “There are things to Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 13 do if you want”. “You can do as you like here, its very relaxed, there’s things to do if you like but it’s up you”. “I’ve not seen much in the way of activities but then I wouldn’t want to get involved”. “We had a fare recently and they come round asking if you want to get involved in things, it’s alright”. Recent activities have included: dominoes, skittles, music and movement. Service users are initially consulted with about their dietary needs and preferences as part of the admission process and this information is forwarded to kitchen staff for reference. A four-week menu is in place and the records seen identified a choice of food being available at each mealtime. Meal safety checks are undertaken and records of these are maintained. Service users comments regarding meals included: “I’ve been surprised with the food, it’s better than I thought, there is a choice and if it wasn’t right they’d find you something”. “It’s difficult to please everyone but overall I can’t complain, it’s not bad”. “Lovely stuff, very good”. “You are offered a choice and it tastes good, they help some of them who need it”. “Yes, the meals are good, we have a good choice”. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to express any views about the home and staff are made aware of the systems in place to protect service users from abuse. EVIDENCE: Records show that there have been no complaints or safeguarding adult’s referrals since the last inspection. Policies and procedures are in place to safeguard service users of which are also displayed in the home. Information regarding local advocate services is also displayed. Pre inspection information received indicated that staff receive awareness training regarding safeguarding adults policies. The service users and representative spoken with said that they felt able to express any views regarding the care provided and that these would be appropriately acted upon. Comments included: “The nice thing about this place is that we all get along, you can talk to any of them”. “You are given information when you arrive and in this it says how you can complain but I can’t see any need to”. “You wouldn’t need to complain”. “I’ve raised a couple of things with the staff and they have been sorted, you don’t expect perfection but they do try”. “I’ve no cause to complain and would talk to the staff, or the manager”. The staff members spoken with were aware of these and explained the correct action to be taken in the event of an issue of abuse being identified. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 15 Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a hygienic, comfortable, safe and generally wellmaintained environment. EVIDENCE: The environment was clean, tidy and well maintained throughout all the areas seen and the acting manager said that a rolling programme of decoration was in place. The service users spoken with were satisfied with the cleanliness of the home. Comments included: “They clean my room once a week or more, it’s kept clean anyway”. “They do a good job, it’s always nice and tidy, you don’t have to tell them”. “I have my room as I like and they keep it that way”. “It’s a nice homely place”. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 17 The staff spoken with were satisfied with the systems in place to maintain a safe environment and confirmed that they received awareness training regarding this subject matter, which was further evidenced in the records seen. Substances identified as being potentially hazardous to health are stored safely and information sheets and risk assessments are in place providing guidance to staff. Systems are in place to minimise risks of infection through water outlets and water temperature valves are fitted to water outlets and records of temperatures are kept along with maintenance records. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is staffed to meet the current needs of service users and appropriate recruitment procedures are in place. Staff attend awareness training to meet service users care needs. EVIDENCE: The service users spoken with confirmed that there were adequate numbers of staff, which was further evidenced during the visit. Comments included: “You don’t really have to wait for help, you call for them and you can rely on them”. “I have no complaints about the staff, they are a good lot and work very hard”. “They are kind, helpful and you can talk with them and that’s not bad is it”. The staff records viewed evidenced that appropriate recruitment checks had been undertaken prior to staff commencing work at the home. The checks included criminal record bureau checks, obtaining professional references and staff completing application forms. Records detailed where all newly appointed staff had received a formal induction, which was further confirmed by the staff members spoken with who said they received adequate training to undertake their roles. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 19 The staff members spoken with said that they received regular training specific to the needs of service users of which a training programme is in place. Staff also confirmed they were supported to express their views regarding the care provided to service users and that they received regular supervision and staff meetings. The pre inspection information received identified that 90 of staff have completed a nationally recognised care qualification. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that care is provided in a safe and appropriate manner although a registered manager must be in place. Service users are supported to express their views regarding the care they receive. EVIDENCE: The areas viewed during the visit were well maintained of which records are kept and a risk assessment of the premises has been undertaken, which is updated as necessary. The service users and representative spoken with confirmed that they were satisfied with the management of the home, the care provided and that they Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 21 felt able to express their views and that these would be acted upon. Quality satisfaction questionnaires are sent once each year, which are assessed and acted upon. Service users meetings are held every three months to further enable service users to express their views about the service provided. Service users comments included: “I can talk with any of them but there are meetings where you can have your say”. “If you wanted to say something then they would listen, they are quite good like that”. “They do listen, which is right”. “I have no complaints, it’s a friendly place, I don’t know what to compare it with but I don’t want for anything, I’m quite satisfied”. However, there is no registered manager in post, which was identified during the previous inspection and confirmation is now required that this matter is being addressed. The staff members spoken with said they received very good management support including regular staff meetings and supervision of which records are maintained. Policies and procedures are in place to protect service users where the home has any involvement in their finances. Monies are kept separate and receipts and records of transactions and totals are maintained. Service users sign for any transactions where possible and they (or their representatives where appropriate) are invited by the acting manager to audit their account. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 22 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 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 23 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 OP31 Regulation 8 Requirement Confirmation must be received detailing the action being taken to register a manager for the home. Timescale for action 01/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations It is a recommendation that the activities provided are reviewed and fully promoted to meet service users recreational needs. Nutten Stoven DS0000002400.V343375.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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