Inspection on 15/12/06 for Nyton House

This inspection was carried out on 15th December 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

Nyton House 13/04/10

Nyton House 30/09/09

Nyton House 03/07/09

Nyton House 23/06/09

Nyton House 06/04/09

Nyton House 15/04/08

Nyton House 31/01/06

Nyton House 24/08/05

Nyton House 01/02/05

Nyton House 29/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Nyton House Nyton Road Westergate Chichester West Sussex PO20 3UL Lead Inspector Ms J Hartley Unannounced Inspection 15th December 2006 11:00 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 Nyton House DS0000014643.V323043.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. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nyton House Address Nyton Road Westergate Chichester West Sussex PO20 3UL 01243 543228 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) Mrs Mary Davis Mr Philip Norman Davis Post Vacant Care Home 23 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (23) of places Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of one person in the category DE(E) Dementia over 65 years 31st January 2006 Date of last inspection Brief Description of the Service: Nyton House is a care establishment registered to provide accommodation for up to twenty-three service users in the category OP (old age not falling in any other category) and one named person in the category DE (E) over sixty five years of age. The establishment is situated in the village of Westergate. Local bus routes are near by. Accommodation is provided on ground, first and second floor level. A vertical lift services each floor. All rooms are generally for single occupancy however there are five rooms that can be used as doubles providing the occupancy levels do not exceed twenty-three. The service is privately owned. The proprietors are Mr and Mrs Davis. The current fees range from £450 to £850. (£850 is for a double room) Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit for this key unannounced inspection took place over five hours. The registered provider Mrs Davis was present throughout the inspection and provided the information required. The inspector examined information held on the service file since the last inspection in January 2006, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. Evidence was also gathered from the results of a survey, completed prior to the inspection by fourteen residents. During the visit the inspector spoke to many of the residents and some of the staff on duty. The inspector undertook a tour of the premises and looked at three care plans and three staff files. Various record books, policies and procedures were also examined. What the service does well: What has improved since the last inspection? What they could do better: Nyton House has not yet quite achieved the minimum ratio of fifty per cent of care staff with an NVQ level 2. However they are working towards it with three members of staff currently taking the award. Nyton House DS0000014643.V323043.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. The summary of this inspection report can be made available in other formats on request. Nyton House DS0000014643.V323043.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 Nyton House DS0000014643.V323043.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, and 5. Nyton House does not provide intermediate care therefore Standard Six does not apply to this home. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they need to make an informed decision about where to live. Each resident has a contract and statement of terms and conditions. Needs of prospective residents are assessed prior to moving into the home. Resident and/or their relatives are able to visit the home prior to moving in. EVIDENCE: The Statement of Purpose and Service User Guide were seen during the visit. They contain the required information and provide prospective residents with details of the home to enable them to make an informed choice. All of the Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 9 residents who returned the survey said that they had received enough information about the home before moving in. Each resident has a contract and statement of terms and conditions in their rooms, which were seen during the visit. The inspector examined three residents’ files and found that each contained a full assessment undertaken prior to the resident moving in. Residents said that they were able to visit the home and stay over night to enable them to decide if the home was suitable for them. Nyton House DS0000014643.V323043.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have individual care plans that set out their needs. Health care needs are met by the home and community health services. Residents are able to administer their own medication if they are able to and wish to. Residents feel that they are treated with respect and dignity by the staff at Nyton House. EVIDENCE: The care plans seen by the inspector during the visit clearly set out each resident’s health, personal and social care needs. Health visits and appointments are clearly recorded in red in the daily records to ensure that they are seen by staff. Care plans are reviewed on a monthly basis. It was recommended at the last inspection that the person who undertakes reviews should sign and date the care plan. If there is no change to a care plan, this should be clearly stated. This is now being done. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 11 Entries in the daily records showed that health care needs are met by the home and the use of community health resources such as opticians, dentists, chiropodists and local GP practices. Records showed that weight, nutrition, pressure sores and mental health are assessed and monitored. Residents are able to chose their own GP if practical. Medication administration records were examined. Two gaps were found in the records that were pointed out to the registered provider. Controlled drugs are recorded in a separate register and safely stored. Medication policies and procedures were examined and found to be clear. Residents are able to self medicate if they wish following a risk assessment. There is currently one resident who administers his own medication. It was recommended at the last inspection that risk assessments be drawn up for residents who self-medicate. This has now been done. Lockable storage is provided in bedrooms for medication. Residents said that they are treated with dignity and respect by the staff at Nyton House. Personal care is undertaken in private. Residents have their own telephones in their rooms enabling them to make and take calls in private. Nyton House DS0000014643.V323043.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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents feel that the lifestyle they experience in the home matches their expectations and meets their needs. They say that they are able to exercise choice and control over their lives. Residents are supported in maintaining contact with family, friends and the local community. Residents speak very highly of the quality of food provided at Nyton House. EVIDENCE: Residents spoken with during the inspection said they are able to exercise choice in all areas of their lives, including what they wear, what time they get up and go to bed and whether they take part in activities. During the visit staff were asking residents what they wanted to eat for the evening meal. Activities taking place in the home were seen posted on the notice board in the hall. Activities provided include a carol concert, making Christmas cards, crosswords, musical afternoons and trips out. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 13 Residents told the inspector that their visitors are made welcome by the staff. They said that they are able to see their visitors in the privacy of their rooms or in communal areas. Care plans are kept in residents’ rooms to enable them to have access to them easily. Residents are encouraged to look after their own finances if they are willing and able to do so. They are able to bring their own furniture and possessions into the home with them if they wish. The food provided at Nyton House was seen to be wholesome and nutritious. Fresh produce is used. There is a choice of menu and residents said that they are provided with a different meal if they don’t like any of the days’ choices. A written menu for the week is on display in the hall. The meal on the day of the visit was fish, mashed potatoes and fresh vegetables. It was well presented and smelt appetising. Comments from residents about the food include, “The menu is excellent…….and varies so excellently” and “Meals could not be better, well cooked and a variety.” Special diets are recorded and catered for. The dining room is very pleasant, with lots of light and with views of the grounds. Nyton House DS0000014643.V323043.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel that any complaints they may have would be taken seriously and acted upon. The homes’ policies and procedures on Adult Protection, protect the residents, as far as possible, from abuse. EVIDENCE: Residents said that if they had a complaint it would be listened to and taken seriously. They said they would discuss any complaints or concerns with either Mrs Davis or senior care staff. The complaints policy is in the Service User Guide and Statement of Purpose and in every bedroom. No complaints have been received since the last inspection. The homes Adult Protection policies and procedures were seen during the visit. They are clear and comprehensive. Staff receive in-house training through the use of a training pack on the protection of vulnerable adults. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Nyton House is well maintained and suitable for its stated purpose. Indoor and outdoor communal facilities are of a very high standard. The home is very comfortable, clean and pleasant, and hygiene levels are good. Pre-set valves have been installed to regulate the temperature of the water, therefore reducing the risk of scalding to residents. EVIDENCE: Nyton House is situated in its own large, well kept grounds. The environment is maintained to a high standard throughout the building. Furniture and fittings are of a good quality. Residents feel their rooms are comfortable and safe, and they are able to have their own possessions in them. The home was seen to be very clean throughout. One resident described it as “spotless”. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 16 There were no offensive odours. On the day of the visit the home was decorated with festive decorations and a Christmas tree in the hall. During the tour of the home it was noted that rooms are centrally heated, all radiators and pipe work are covered. Windows are fitted with restrictors where necessary and emergency lighting is provided throughout the home. Since the last inspection pre-set valves have been installed to regulate the temperature of the water, therefore reducing the risk of scalding to residents. Laundry facilities are sited away from areas where food is prepared and stored. Policies and procedures were seen to be in place regarding the control of infection. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels and the skills mix of staff are adequate to meet residents’ needs. Nyton House has nearly reached the target of having fifty percent of care staff with an NVQ Level Two or equivalent. Nyton House operates a thorough recruitment policy. Staff receive training and are competent to do their jobs, EVIDENCE: The homes rota was seen and showed that there are enough staff on duty during each shift to meet the needs of the residents currently living at the home. In addition to care staff the home employs three cleaners, catering staff, a full time maintenance man and a part time gardener. Additional staff are on duty in the mornings when the home is busiest. Two waking night staff are on duty throughout the night. Residents feel that they receive good quality care at Nyton House. One resident said, “I can say with confidence that the quality of care received at Nyton House is first class.” Another resident said, “One could not wish for anywhere better.” Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 18 The home has nearly reached the target of having a minimum ratio of fifty per cent of care staff with an NVQ level 2. Three members of staff are currently taking the award. Policies, procedures and staff records inspected demonstrate that Nyton House has a thorough recruitment procedure. The inspector examined three staff files and found that two written references, Criminal Records Bureau and Protection of Vulnerable Adults checks are obtained prior to the employment of new staff. The home has induction training for new staff that is linked to the Skill For Care induction standards. Training records seen show that staff have also received training in Food Hygiene, Health and Safety, Manual Handling, Medication, First Aid and COSHH. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is currently no registered manager in post at Nyton House. Nyton House has quality monitoring systems in place. The home does look after the finances of any resident. The health, safety and welfare of residents is promoted by the home’s policies, procedures and maintenance programme. EVIDENCE: Nyton House does not have a registered manager at present. A manager designate is currently completing a trial period. She was not on duty on the day of the visit. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 20 The home has quality monitoring systems in place that include Regulation 26 monthly visits by the provider, discharge surveys and regular staff and resident meetings. The most recent quality audit taken by the home was seen by the inspector during the visit. Residents are able to control their own finances if they wish. If they are unable to relatives or solicitors undertake this. The home does not control the finances of any of the residents. Staff records show that staff receive training in Health and Safety. Certificates and records were seen that show that fire, gas, and electrical equipment in the home are tested regularly. Temperature governors restrict water temperatures. The home has COSHH risk assessments in place for all chemical products. All the radiators seen in the home were covered and the windows were restricted where appropriate. Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 21 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 4 4 3 X 4 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 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X 3 4 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Nyton House DS0000014643.V323043.R01.S.doc Version 5.2 Page 24 - 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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