Inspection on 28/08/06 for Nutten Stoven

This inspection was carried out on 28th August 2006.

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 18/07/07

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 Julie Western Key Unannounced Inspection 29th August 2006 09:00 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 Nutten Stoven DS0000002400.V309654.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.V309654.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 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.V309654.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 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. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced, was carried out over three hours and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history and residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection consisted of case tracking a sample of residents’ records and assessing their care. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents and two care and ancillary staff were spoken with. The Manager was present throughout the inspection What the service does well: What has improved since the last inspection? What they could do better: The acting manager is still awaiting registration to become the registered manager and should apply as soon as possible. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 6 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.V309654.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.V309654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home clearly sets out what it intends to do for its residents and this information is freely available to residents. A comprehensive initial assessment ensures that the needs of residents can be met. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was clear and comprehensive. A copy of the service user guide was kept in each room. The Manager said that prospective residents were offered one month’s trial on both sides. One resident described how she had heard how good the home was from friends before being admitted on a permanent basis. Terms and conditions contracts, signed by the resident or a representative, were in place for all residents. The Manager herself, or a senior carer, carried out the pre-admission assessments of residents, either in their own homes or in a hospital or care setting. Residents were assigned a key care Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 9 worker who assisted them to settle in. Intermediate care is not provided by the home. Nutten Stoven DS0000002400.V309654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The three care plans looked at in depth contained concise but clear assessments, including risk assessments; they were signed by the resident where possible and reviewed monthly. There was a clear medication policy and the most recent visit from the pharmacist was 13/06/06, from which there were no concerns recorded. The Manager confirmed that only trained staff administered medication and said that residents were taken for regular six monthly health care checks with the GP and district nurse at the surgery. Residents said they felt safe and well looked after; one said ‘The staff are excellent’. The staff team were observed carrying out their duties with patience Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 11 and sensitivity towards the residents, especially when attending to their personal needs. Nutten Stoven DS0000002400.V309654.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Social activities are extensive and create a variety of events and activities which residents are informed about. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: The Manager said that the carers were jointly responsible for arranging activities and events; these were displayed on the walls in the entrance hall. Future events included a 101st birthday party with ‘the good old days’ entertainers. Regular events included visits from various entertainers, board games, A resident described the trips to Skegness and said she had not wanted to go on them, but preferred to stay in her room. She had enjoyed the annual summer fete, which was organised and attended by relatives. Menus were balanced, nutritious and easy for older people to eat, with a use of fresh fruit and vegetables. Residents all said they enjoyed the meals and the cook visited each resident asking their preferences for all meals including tea. Residents’ meetings showed that they were frequently asked for their input to the menu. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure EVIDENCE: Residents spoken with said they did not wish to complain but knew how to make a complaint. The home had received no complaints in the last twelve months. There was a clear adult protection procedure, which was linked to the Local Authority procedures. All staff members spoken with had received training on adult abuse through the NVQ training and were knowledgeable about complaints. All residents were on the electoral register and exercised their rights to vote if they wished. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 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, 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The residents live in a comfortable and pleasant environment with both private and communal space, which is generally suitable for their needs. EVIDENCE: The home had a rolling maintenance rota and risk assessments were carried out on the premises to ensure that residents were safe from any potential hazards.. Overall, the standard of decoration was good and afforded residents a great degree of comfort; communal areas were tidy and clean. There were adaptations such as raised toilet seats, grab rails and corridor rails and a call system was installed throughout the home The gardens and grounds were well maintained and contained places for residents to sit out in good weather. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 15 Individual residents’ rooms were personalised and pleasantly decorated and furnished. A resident said ‘My room’s the best in the building – it’s like a sitting room’ There were sufficient communal toilets and bathrooms to cater for the residents’ personal needs. Thirteen of the single and one of the shared rooms were en-suite; toilets were clean and fresh-smelling and had ample fresh, clean towels and flannels in place The hot water in the wash basins in residents’ rooms was an acceptable temperature. The radiators previously identified as being too hot and unsafe for residents to touch were turned off and the Manager said that if the application for the 8-bed extension was turned down these radiators would be covered; if accepted, they would be taken out as part of the work on the extension. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 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 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to the service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: The staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were arranged to accommodate the needs of residents; staff and residents spoken with confirmed that there were enough staff members on duty to complete their tasks. The staff group has been stable for some time and there were no full time vacancies. The most recent staff member to be appointed had given two references, which were followed up, had a CRB check and had undertaken an induction programme before commencing work. Training records showed that the home has achieved a 95 rate of carers with the National Vocational Qualification, a professional award, at Level 2. with one carer working towards it. Two had achieved it at Level 3 with four working towards it. One staff also had the Assessors award. The Manager showed a strong interest in training and said that the aim was for all senior carers to have completed Level 3. The training plan showed an ongoing programme of training, with future planned training including health and safety, aggression and de-escalation, dementia awareness and first aid. All senior carers were fire marshals. The Manager was also taking a group of Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 17 carers to Addenbrooks hospital in Cambridge, on a team-building day, to look at drugs for depression, art therapy and sexuality. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 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 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, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents are listened to and they are involved in decisions affecting them EVIDENCE: The acting Manager has completed the NVQ Manager’s award at Level 4 and has the Assessors Award. She has had several years’ experience in caring in this country and South Africa and has managed this home for the past 18 months. She is applying to become the registered Manager. Staff members were involved in the running of the home through staff meetings, supervisions and informal chats with the acting manager and said they felt supported and valued. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 19 The home operated its own quality assurance system and practices, records and documentation were audited regularly to ensure safe practice. Health and safety practices were in place and recent Environmental Health Officer and Fire Officer were positive. Residents spoken with said they were constantly asked for their views on matters concerning the running of the home and there were questionnaires which had been completed by residents or their relatives. Residents’ finances were controlled by the Manager and audited regularly, some by a solicitor. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 4 28 3 29 3 30 4 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.V309654.R01.S.doc Version 5.2 Page 21 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. 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 OP32 Good Practice Recommendations It is a recommendation that the acting Manager applies to become the registered Manager in accordance with Regulation 8. Nutten Stoven DS0000002400.V309654.R01.S.doc Version 5.2 Page 22 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.V309654.R01.S.doc Version 5.2 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. 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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