Inspection on 31/01/06 for Nyton House

This inspection was carried out on 31st January 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 15/12/06

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 31st January 2006 3:15pm 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.V274895.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. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 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 Ms Felicity Jayne Hillary-Warnett 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.V274895.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of one person in the category DE(E) Dementia over 65 years 24th August 2005 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. Ms. Felicity HillaryWarnett is the registered manager of the establishment. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over two days and in total covered a period of five hours. The inspector examined information held on the service file since the last inspection in August 2005, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose During the inspection the inspector spoke to four service users. 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. This report should be read in conjunction with the report of the announced inspection held on 24th August 2005. All the key standards, which should be inspected in a twelve-month period, are covered in these two reports. What the service does well: What has improved since the last inspection? What they could do better: Steps need to be taken to minimise the risk of scalding from water outlets where the water temperature is too high. More care staff need to be trained to NVQ Level Two or equivalent. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 6 Reviews should be signed and dated and if there is no change to a care plan, this should be clearly stated. Risk assessments should be drawn up for those service users who selfmedicate. 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. Nyton House DS0000014643.V274895.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 Nyton House DS0000014643.V274895.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): 1, 2, 3, 5 The Service User Guide and Statement of Purpose provide prospective service users the information they need to make an informed choice about where to live. Service users have a written statement of terms and conditions with the home. Service users have their needs assessed by the manager prior to moving into the home and are able to visit the home prior to moving in. Nyton House does not provide intermediate care; therefore Standard Six does not apply. EVIDENCE: The current service user guide and statement of purpose were seen and found to contain all the required information. As the current manager is leaving the home, both documents will need to be updated to reflect the change. Copies of the updated documents should be sent to the Commission. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 9 Service users have a copy of the Service User Guide and Statement of Purpose in their rooms. Each service user is provided with a contract/statement of terms and conditions that includes the required information. Copies were seen in files in service users’ rooms. Service user files contained evidence that the manager carried out an assessment for each service user prior to them being admitted. Service users spoken to confirmed that they were able to visit the home prior to moving in. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 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, 9 Individual care plans include the health, personal and social care needs of each service user. Service users are protected by the homes’ policies, procedures and training for the administration of medication. However, it is recommended that a risk assessment be drawn up for the service user who self-medicates. Standards Eight and Ten were inspected at the last inspection and were found to have been met. EVIDENCE: Care plans inspected were seen to be thorough and detailed. They include details of the health, personal and social care needs of the service users. Care plans are agreed and signed by service users and kept in their rooms. Reviews are undertaken on a monthly basis. However, this has only been evidenced by a date on the care plan. Consideration should be given to reviews being signed by the reviewer, and if there is no change to the care plan, this should be clearly stated. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 11 Service users are encouraged to administer their own medication whenever possible. Risk assessments should be put in place for people who selfadminister medication. Rooms were seen to have lockable storage space in which to keep medication. The homes’ policies and procedures on the receipt, recording, storage, handling, administration and disposal of medication were seen to be adequate. Staff records show that staff receive training in the administration of medication. MARS sheets, recording the administration of medication, are kept in service users rooms and were seen to be up to date and accurately recorded. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 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, 14 Service users find that the lifestyle they experience in the home meets their needs. They are supported in making choices over their lives. Standard Thirteen was inspected at the last inspection and was found to have been met. Standard Fifteen was found to have been exceeded at the last inspection. EVIDENCE: Service users told the inspector that they are able to exercise choice in their daily living. They choose which activities they attend, what clothes they wear, what time they get up and go to bed. If they do not like a meal on a certain day they are able to have an alternative. 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. Nyton House DS0000014643.V274895.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 Service users are protected from abuse by the homes’ policies, procedures and staff training. Standard Sixteen was inspected at the last inspection and was found to have been met. EVIDENCE: The homes’ policies and procedures regarding Adult Protection were inspected and found to be thorough. Training in Adult Protection is now being organised for staff to take part in. Nyton House DS0000014643.V274895.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): 19, 25, 26 Nyton House is well maintained and suitable for its stated purpose. Indoor and outdoor communal facilities are of a high standard. The home is very clean and pleasant, and hygiene levels are good. Water temperatures at some outlets were found to be very hot. Steps need to be taken to minimise the risk of scalding to service users. Standards Twenty and Twenty-Four were inspected at the last inspection and were found to have been met. 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. Service users’ feel their rooms are comfortable and safe, and they are able to have their own possessions in them. 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. Water Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 15 from some outlets on the ground floor was found to be very hot, therefore creating a risk of scalds. There were no risk assessments regarding the temperature of the water. Steps need to be taken to minimise the risk of scalding. 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.V274895.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, 28 Staffing levels and the skills mix of staff are adequate to meet service users’ needs. Nyton House has not yet reached the target of having fifty percent of care staff with an NVQ Level Two or equivalent. Standards Twenty-Nine and Thirty were inspected at the last inspection and were found to have been met. EVIDENCE: The homes rota was seen and showed that there are enough staff on duty during each shift to meet the needs of the service users currently living at the home. In addition to care staff the home employs domestic staff, catering staff and maintenance staff. Additional staff are on duty in the mornings when the home is busiest. Staff training records indicate that the home does not have a minimum of fifty per cent of care staff with an NVQ Level Two or an equivalent qualification. Nyton House DS0000014643.V274895.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): 31 The registered manager has the experience and qualifications required to be registered manager of Nyton House. Standards Thirty-Three, Thirty- Five and Thirty-Eight were inspected at the last inspection and were found to have been met. EVIDENCE: The current registered manager, Ms. Felicity Hillary-Warnett, has the experience and qualifications required to be registered manager of Nyton House. However, she has handed her notice in and the post will be vacant until a replacement has been employed. Until that time Mrs Mary Davis, the registered provider, will be acting manager of the home. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 2 4 STAFFING Standard No Score 27 3 28 2 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 19 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. 1. Standard OP25 Regulation 13 (4) Requirement Timescale for action 30/04/06 2. OP28 18 (1) (a) To prevent risks from scalding, pre-set valves of a type unaffected by changes in water pressure and which have failsafe devices are fitted locally to provide water close to 430C. A minimum ratio of 50 trained 30/06/06 members of care staff (NVQ level 2 or equivalent) is achieved by 2005, excluding the registered manager and/or care manager. 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 OP1 Good Practice Recommendations When the post for registered manager becomes vacant, the Statement of Purpose and Service Users’ Guide should be updated to reflect the change. When they have been updated, copies should be sent to the Commission. 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. DS0000014643.V274895.R01.S.doc Version 5.1 Page 20 2. OP7 Nyton House 3. OP9 Risk assessments should be drawn up for those service users who self-medicate. Nyton House DS0000014643.V274895.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Nyton House DS0000014643.V274895.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!