Inspection on 22/02/06 for Nutten Stoven

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Nutten Stoven 18/07/07

Nutten Stoven 28/08/06

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 Vanessa Gent Unannounced Inspection 22nd February 2006 09:30 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 Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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.V282271.R01.S.doc Version 5.1 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 Mr Deva Samat Keshwara Mrs Lilu Deva Keshwara, Mr Samat Bhima Keshwara Mrs Patricia Wilson Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 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. There is a large superstore some two minutes distance by car from the home and the shops and facilities of the town 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. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The main method of inspection used is called case-tracking which involves selecting a proportion of residents and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Three residents’ assessments and care plans were examined and their rooms inspected. Some of the home’s records were checked. Two staff, three of the nineteen residents, two relatives and the manager were spoken with. What the service does well: What has improved since the last inspection? An improved format for the care plans has been introduced and is now in use, with good effect: easier for staff to read, understand and put into their care practice. The tumble dryer has been replaced and quotes and permission from the provider obtained to purchase a new sluicing machine. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 6 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. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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.V282271.R01.S.doc Version 5.1 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): 2, 3 The home has a good admissions procedure which ensures that residents’ needs will be appropriately met. EVIDENCE: Terms and conditions contracts, signed by the resident or a representative, are in place for all residents which state the number of the room to be occupied. Pre-admission assessments are undertaken by the manager or a senior staff member in the prospective residents’ previous setting and used to draw up the initial assessments and care plans. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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, 9, 10 Good care planning, contact with healthcare professionals, monitoring of health issues and safe pharmacy practices ensure that the health, social and emotional needs of residents are clearly defined and met. EVIDENCE: A new, more compact but comprehensive care plan format has been introduced and is used for all new admissions. There is good completion and reviewing of the initial assessment sheets, which are used to form the activities of daily living from which the care plan issues are drawn. These are easy to read and understand. They are reviewed monthly. There is good referencing to contact with and visits from healthcare professionals, clear records of the improvement or deterioration in the physical condition of the resident as well as holistic observations of the resident’s attitudes, temperament and behaviour, that give a good overall ‘picture’ of the Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 10 residents’ lives in the home. Signed authority for use of equipment such as bedrails is in place. The manager ensures that the residents are taken for regular six monthly health care checks with the GP and district nurse at the surgery. At these meetings, medication reviews take place to ensure that residents take only the appropriate medications for their current health needs. Residents and relatives have commented that the manager and staff really care for them and are meeting their needs. Pharmacy practices are adequate, although storage and administration space is very limited and fragmented and makes difficulties for staff to manage. Plans are in place to create dedicated ‘treatment room’ space in the new extension. Staff training in the safe administration of medications has been undertaken with the past twelve months and the community pharmacist is in regular contact with the home. Residents spoken with say that staff treat them with respect and dignity. There was a happy, jovial atmosphere with a good rapport between staff, the manager, residents and visitors. One resident said, “I’ve never been so happy as since I came here. There’s a happy atmosphere here. The home is perfect.” Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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): 14 Residents have autonomy in their lives and staff are aware of their changing needs and wishes. EVIDENCE: Residents say they have choice and autonomy in their lives, including when to get up and go to bed; which activities they wish to engage or not participate in; when and where they want to go out to the local shops with escort; what they want to eat. Although the choice at lunchtime is limited, the cook says that the menu for the lunch meal is displayed and she ascertains what people want at breakfast time, if an alternative to the set menu is desired. She also audits every six months the residents’ likes and dislikes. Care plans and talking with staff demonstrate that they are aware of residents’ needs and wishes and ensure these are adhered to. One resident said that staff had arranged for him to have a daily newspaper brought in every day and he can choice from dominoes, darts, skittles, and other activities. He was pleased with the ‘cracking’ musical night that had Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 12 taken place of late. He used to go regularly to bingo but says that he can still go if he wants. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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): 18 Residents are cared for in a safe, caring manner by staff who are knowledgeable in how to protect them. EVIDENCE: Staff have received training in protecting vulnerable adults and were able to demonstrate a good knowledge of how to prevent adult abuse and care for the residents safely. Residents say they feel safe and very well cared for and are happy. One resident said “You couldn’t wish for a better manager and staff; they’re lovely.” Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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): 20, 21, 24, 25 The residents live in a pleasant and comfortable environment, individually and communally, which is suitable for their wishes and needs, although not all areas have been assessed for their safety. EVIDENCE: Communal areas are light, airy, tidy and clean. Individual residents’ rooms are personalised and pleasantly decorated and furnished. A resident stated that “The home is perfect; beautiful and clean; spotless.” There are sufficient communal toilets and bathrooms to cater for the residents’ personal needs. Thirteen of the single and one of the shared rooms are ensuite. The hot water in the sinks in residents’ rooms was an acceptable temperature. In each ensuite, the toilet was clean and fresh-smelling and had ample fresh, clean towels and flannels in place. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 15 Although the radiator in one resident’s room was very hot to touch, it was inaccessible. In other rooms however, the very hot radiator was situated where residents could be at risk of burns. These need to be risk-assessed and notices put up to say that they are very hot. They urgently need to be covered or have low temperature surfaces to protect all residents from harm. Quotes have been obtained for a new sluicing machine to be purchased and a new tumble dryer has been installed. The new extension plans include space for a sluice room for washing and cleaning portable toilet equipment. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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, 30 There are sufficient and well-trained staff on duty at all times to ensure the comfort and well-being of the residents. EVIDENCE: The staff duty rotas show there are sufficient staff on duty at any time to care for the residents appropriately and safely. The manager maintains an excellent auditing tool to assess adequate staffing levels, to ensure that when the residents’ dependency needs rise, she is able to put more staff in place. A key worker system is in place and staff say they know exactly what they’re doing in their caring practices and work as a good, close team. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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): 32, 33, 37, 38 The quality of the management of the home, the auditing, monitoring and record-keeping of the service provided, and staff and residents having a democratic say in the running of the home, ensures that the needs and choices of the residents are met. EVIDENCE: The acting manager is highly-respected by staff, residents and relatives. She supports the staff in all aspects of their work and demonstrates good leadership, with lots of encouragement for training and personal development. Staff have a say in the running of the home in staff meetings, supervisions and informal chats with the acting manager and feel supported and valued. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 18 She is very knowledgeable of the residents’ needs and regularly audits the home’s practices, records and documentation to ensure safe practice. Record-keeping is excellent, easy to access and read, and records are reviewed regularly. Health and safety practices are in place and recent Environmental Health Officer and Fire Officer visits show good, safe practice. Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 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 X 3 3 X X 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 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 3 3 X X 3 2 X STAFFING Standard No Score 27 4 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 4 X X X 3 3 Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 OP25 Regulation 23.2 Requirement Radiators must meet the environmental health and safety standard by being covered or having a low surface temperature to protect residents from risk of harm. The provider must submit an application form and cheque to enable the manager to be registered and shown to be fit to run the home by CSCI. Timescale for action 30/04/06 2 OP31 9.1,2 17/03/06 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 Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Nutten Stoven DS0000002400.V282271.R01.S.doc Version 5.1 Page 22 - 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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