Inspection on 06/09/05 for Nutten Stoven

This inspection was carried out on 6th September 2005.

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 22/02/06

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 06 September 2005 10:00 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. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Nutten Stoven Address 81 Boston Road Holbeach Lincolnshire PE12 8AA 01406 424941 01406 422959 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) Mr Deva Samat Keshwara, Mrs Lilu Deva Keshwara & Mr Samat Bhima Keshwara Care home only 23 Category(ies) of OP Old age - 23 registration, with number of places Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 20 January 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. The home has recently been extended to provide a new laundry, kitchen, conservatory, office, nine extra single en-suite bedrooms with patio wheelchair access and two further bathrooms. Most of the residents’ bedrooms are located on the ground floor. A passenger lift gives easy 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 C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 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. Four service users’ assessments and care plans were examined. Two staff, three of the twenty residents and two relatives were spoken with. Twelve comment cards were received from residents and three from relatives. What the service does well: What has improved since the last inspection? The statement of purpose and service user guide are now up-to-date, clear documents. Each resident has a ‘terms and conditions’ contract which shows the number of the room to be occupied and fees payable. Ongoing staff training including moving and handling, abuse awareness and NVQs (National Vocational Qualifications), is run over the twelve month period, with all staff being up-to-date in most areas of training. Staff records show that the recruitment, induction and training of new staff has improved and now ensures that the health and welfare of residents is protected. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 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 C53-C04 S2400 NuttenStoven V248184 060905 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 Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 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) 1, 2, 4, 5 The home produces a statement of purpose and service user guide that accurately indicates what is practiced by the manager and staff for the health, welfare and comfort of the residents. EVIDENCE: Documentation including an up-to-date statement of purpose which describes the facilities, services and ethics of the home, a service user guide and terms and conditions contract are now in use. The service user guide is in large print and has been distributed to each resident and the terms and conditions contract details the room to be occupied and fees payable. A resident stated that she was given clear information about the home, visited, then stayed for two days, joined in the activities and meals and was made to feel very welcome. When she decided to come to the home, the manager wrote to confirm that the home could meet her needs. She was then able to stay for a trial period of one month before making up her mind to stay longterm. She is very happy with her initial decision and says, “the staff are marvellous and she can’t fault the care”. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 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, 8 The care plans give a clear indication of the needs and wishes of residents which, along with regular contact with community healthcare professionals, enable staff to meet the residents’ needs and give them encouragement. EVIDENCE: Two relatives spoken with stated that they were involved with the creation of the resident’s care plans and staff continue to involve the resident and family in reviews and care plan updates. This was evidenced with signatures seen in the care plans examined. Relatives say they are always informed if any changes in the health of the resident occur and that staff call the doctor in if the resident is unwell. The care plans of a recently-admitted resident were already well-completed to enable staff to care for the needs of the resident adequately. The GPs come to the home to review the residents’ health status and medications regularly and specialist healthcare professional advice, such as district nurses, the community diabetic and tissue viability nurses and physiotherapists, is sought when needed. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 10 A resident says that staff are helping expertly and enthusiastically with exercises to strengthen him after his discharge from hospital and have given him the incentive to try to walk again. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 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) 12, 14, 15 Choice is given in all aspects of the residents’ lives in the home. The activities provided are sufficiently varied and frequent for many residents to enjoy participating. The choice and quality of the food ensure that residents’ nutritional needs can be met. EVIDENCE: Residents feel that the quantity and quality of activities is adequate for their needs and choice. A resident said that there are different activities every day and that most residents prefer to have activities in the home rather than going out and join in enthusiastically. A relative said that they help with raising money for the Residents’ Fund and the fund raising events are well-attended. They said “The providers always put on a brilliant Christmas party and everyone’s invited”. The regular residents’ meetings are democratically conducted which ensures that they have their say and that they have choice in all matters. One relative said that “the food is good, there’s plenty to eat and it is always freshly cooked”. Another said “the food always looks nice”. A resident stated “the food is really good; homemade and plenty of choice”. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 12 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 The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to. EVIDENCE: A complaints and compliments book is kept: no complaints but many compliments have been received. A complaints policy document is publicly displayed. Residents say they have no complaints about any part of the service provided, “in fact, the care is excellent”; “we can’t find any faults and have no concerns” but that if they had concerns, they would know who to go to. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 13 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, 24, 25, 26 The residents live in a comfortable and pleasant environment which is generally suitable for their needs although adequate sluicing facilities are needed to ensure the health and safety of residents. EVIDENCE: The home was clean, tidy, pleasantly decorated and was free from odours throughout. A relative stated that the resident’s room is lovely and is always spotlessly clean and that “the home has a calm, relaxed atmosphere”. She says that “the home is comfortable and we can sit outside”. Radiators now have thermostats fitted to ensure the surfaces are low temperature for the safety of the residents. Sluicing facilities for the cleaning of commodes have not been put into place but although the provider says these are to be installed in the building extension plans of the home, provision needs to be made until permanent facilities have been installed. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 14 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) 28, 29, 30 The quality of staff induction and training ensures the safety, health and welfare of residents. EVIDENCE: Ongoing staff training, including moving and handling, abuse awareness and NVQs (National Vocational Qualifications), is run over the twelve month period, with all staff being up-to-date in most areas of training. The induction process is comprehensive and robust, with new staff saying they feel supported until they are confident in their work. Resident say their needs are met by caring staff, who “are marvellous; ever so friendly”. Relatives say they “can’t find any faults or concerns” in the care of the residents. Staff spoken with say they get on really well with their colleagues – a good, supportive team, with excellent support from senior staff: “really nice people”. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 15 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) 33, 35, 36 The quality of the auditing and monitoring by the provider and manager of the service provided, and staff and residents having a democratic say in the running of the home, ensures that the needs of the residents are met and they have plenty of choice. EVIDENCE: Monthly, unannounced, audit visits are made by the provider and reports completed and available as required by the Commission. The provider meets with the manager at least twice weekly. Regular staff meetings are held. Staff supervisions are regularly conducted and documented. Staff say “the meetings are transparent and staff do have their say and feel listened to”, “we can get things out into the open”. Staff say the manager is supportive and helpful: “you can go to her with anything”. Residents’ meetings are held regularly, which, residents feel, are democratic and at which they can and do speak up for themselves. These meetings are all Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 16 minuted. Relatives’ meetings are not held as it is felt that the residents can adequately represent themselves. The personal allowances of fourteen residents are kept for safe-keeping by the home. These are meticulously recorded and in order. All major finances are dealt with by the residents’ own families or representatives. Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 17 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 3 3 x 3 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 4 15 4 COMPLAINTS AND PROTECTION 3 x x x x x 3 2 STAFFING Standard No Score 27 x 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 4 x 3 4 x x Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 18 Yes 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 OP26 Regulation 23(2)(k) Requirement Sluicing facilities must be put into place for cleaning of commode equipment and maintained to prevent the spread of infection. Timescale for action 31/03/06 2. 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 Good Practice Recommendations Nutten Stoven C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 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 C53-C04 S2400 NuttenStoven V248184 060905 Stage 4.doc Version 1.40 Page 20 - 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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