CARE HOMES FOR OLDER PEOPLE
Old Rectory Nursing Home - Capenhurst Rectory Lane Capenhurst Chester Cheshire CH3 6HN Lead Inspector
Joan Adam Unannounced Inspection 10:00a 14 February 2006
th 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 Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Old Rectory Nursing Home - Capenhurst Address Rectory Lane Capenhurst Chester Cheshire CH3 6HN 0151 339 4810 0151 339 7231 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) The Old Rectory Limited Robert M`Connell Care Home 35 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (35) of places Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Maximum of 35 persons accommodated aged 65 years and above Maximum of 1 named service user D.O.B 01/03/42 be accommodated in the category DE 14th December 2004 Date of last inspection Brief Description of the Service: The Old Rectory is registered to accommodate 35 service users aged over 65 years of age with a diagnosis of dementia. The home is a detatched house which has been extended and converted. Accomodation consists of twenty three single bedrooms and six double bedrooms on two levels. Access between floors is via a passenger lift or stairs. None of the bedrooms at the home have en-suite facilities, wash-hand basins are fitted in all rooms.The home is situated in the village of Capenhurst with easy motorway access. Long and short term placements are offered and the home employs a team of 1st level registered nurses and support workers for the provision of nursing and personal care. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over five hours and was carried out as part of the yearly inspection process. A tour of the home was carried out and care records, fire records and staff training files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Staff on duty, residents and relatives were spoken with during the inspection. As the residents are often unable to express their views due to the nature of their health problems, more emphasis was placed in observing and checking records in order to form judgements. What the service does well: What has improved since the last inspection?
The style of plans were much improved, individualised and painted a picture of each resident. There is a notice board in the main entrance hall with the names and photographs of all staff working at the home to aid the residents to recognise them. New carpet has been purchased for both upstairs and downstairs corridors and the upstairs corridor has been redecorated as required at the last inspection.
Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 6 Five new chairs, new bed tables and eight wheelchairs with specialist footrests and equipment to assist the transfer of residents have been purchased. Six bedrooms have been totally refurbished with carpets, beds, wardrobes and chest of drawers. The vanity units identified at the last inspection have been replaced or repaired. Two of the bathrooms have had a new bath, toilet, wash hand basin and flooring. 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. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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 Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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): EVIDENCE: The key standards were as assessed and met at the last inspection. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9. Care plans at the home are detailed and address the changing care needs of the residents. Medication is administered, recorded, stored and disposed of correctly to maintain the safety of the residents living at the Old Rectory. EVIDENCE: Five care plans were examined and these were completed using the improved style of plans. The care plans were much improved, individualised and painted a picture of each resident. All plans of care were detailed and assessed areas of need such as mobility, falls, moving & handling, continence, pressure area & tissue viability, nutrition and general dependency making reference in each area assessed of the effect of the residents’ mental health on their behaviour and vulnerability. All were up dated and reviewed on a regular basis. A record was also made of support from, and visits by other health professionals such as GP’s and consultant psychiatrist. Detailed information given regarding relatives has been incorporated in to the care plans.
Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 10 Appropriate risk assessments were in place and these had been signed by relatives. Resident choices were documented such as times of rising and retiring and likes and dislikes of food. Medication recording, management, storage and disposal were inspected and found to be satisfactory. Medicine Administration Records were examined and found to have been completed correctly. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Social activities are not taking place to ensure some stimulation is in place for the residents living at the home. Relatives and friends can visit at any time and resident choice is recorded in the care plans. EVIDENCE: The home has employed an activities co-ordinator since the last inspection but they have been of sick since December 2005. Social activities are still not well managed and there are days within each week where no activities take place. Residents are frequently left to sit in small groups without any distraction or stimulation from staff. This was a requirement on the last inspection and must be addressed. Activities are particularly important for people with dementia. It was discussed with the care manager that as some residents are not able to join in the more structured type of activities that a more individual approach is applied. Visiting at the home is open and relatives and friends of residents are an important aspect of the home. Residents are not taken out in to the community at present. Choice is recorded in the care plan with diet and food preferences and the likes and dislikes of residents are discussed with the relatives. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 12 Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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 Complaints recorded are not confidential and the action taken is not recorded to ensure that residents and relatives are confident that their complaint is acted upon. EVIDENCE: The home has a complaint book to record complaints, however, this is kept in the office and can be accessed by residents, staff and visitors therefore complaints made are not confidential. There is no recording of investigations or of action taken by the home following a complaint to ensure it does not reoccur. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment. The home is clean and free from unpleasant smells. EVIDENCE: The home has met some requirements from the last inspection regarding the environment. Eight bedrooms have been completely refurbished with new furniture, carpet, curtains and wallpaper. The identified vanity units from the last inspection have been mended or replaced. The carpet in the corridors on both floors has been replaced and the upstairs corridor has been redecorated. Sensory boards have been placed along one of the corridors to give the residents at the home a tactile experience. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 15 The windows throughout the home are ill fitting and need repairing or replacing. This was a requirement at the last inspection and has not been met. There was evidence that the lawn had been mowed and the garden area looked generally tidier. The home was clean and free from unpleasant smells. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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): 30 Training is in place to up-date all staff in meeting residents care needs. EVIDENCE: Staff at the home, receive essential training such as moving and handling, fire training and health and safety. Other training has taken place in communication and infection control. A course on challenging behaviour for care staff is to commence April 2006. Two staff have been trained to train staff in safe handling of residents. NVQ training in care is in place at the home and over fifty per cent of care staff have completed the qualification, which is in line with the national recommendation for care homes. A computer has been obtained from the Cheshire Care consortium to assist staff with training. The care manager has achieved NVQ level 4 in management. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 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): 31,35,36,38 Some areas of management need to improve to maintain the safety of the residents living at The Old Rectory. EVIDENCE: The registered manager is an experienced nurse but has not yet achieved NVQ level 4 in management. The home does not have responsibility for any residents’ personal finances. Informal supervision of the staff takes place on a daily basis and formal supervision sessions are recorded. The proprietor or his designated representative must visit the home on a monthly basis, unannounced, to check on all health and safety, property and equipment and staffing issues. At the last two inspections it was required that a copy of the report produced following this visit must be sent to CSCI but as
Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 18 yet, copies are not being sent. There were no recorded visits at the home since July 2005. The fire log was checked and staff training has taken place and been recorded. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X 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 1 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 x 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X 3 3 X 2 Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 20 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 OP12 Regulation 16 Requirement The social needs of the residents must be met.( previous timescale of 15th July 2005 not met) Complaints must be recorded and addressed appropriatly (previous timescale of 15th July 2005 not met) The windows at the home must be repaired or replaced. (previous timescale of 31st July 2005 not met) Recorded visits to the home by the registered proprietor or his representative must be sent to the CSCI office. (Previous timescale of 30th June 2005 not met) Timescale for action 31/03/06 2 OP16 22 31/03/06 3 OP19 23 30/04/06 4 OP38 26 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 21 1 OP31 The manager should have NVQ level 4 or equivalent. Old Rectory Nursing Home - Capenhurst DS0000018750.V260765.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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