Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 07/06/05 for Old Rectory Nursing Home - Capenhurst

Also see our care home review for Old Rectory Nursing Home - Capenhurst for more information

This inspection was carried out on 7th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The atmosphere at the home was warm and welcoming. The home was clean and hygienic. Residents clothing is laundered well and clearly labelled. The home has a regular group of staff that have worked at the home for some time and they are aware of the needs of the residents. The same agency staff are used for consistency and made to feel like members of the team. Staff were friendly and attentive to the residents and had a good knowledge of the residents needs and the character and history of the residents in their care. The home manager is experienced and competent.

What has improved since the last inspection?

A new carpet has been ordered for the downstairs corridor. New style quite detailed care plans have been introduced and will be completed for all residents over the next few months. These will contain better information about residents care needs to be identified and met by staff at the home.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE THE OLD RECTORY NURSING HOME Rectory Lane Capenhurst Chester CH3 6HN Lead Inspector Joan Adam Unannounced 07 June 2005 09:00 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. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Old Rectory Nursing Home Address Old Rectory Lane Capenhurst Chester CH3 6HN 0151 339 4810 0151 339 7231 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) The Old Rectory Limited Robert McConnell Care Home with Nursing 35 Category(ies) of Dementia - over 65 years of age - 35 registration, with number Dementia - 1 of places THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Maximum of 35 persons accommodated aged 65 years and above. 2. Maximum of 1 named service user DOB 01/03/42 be accommodated in the category DE. Date of last inspection 14/12/04 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 passesnger 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. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over seven 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, staff files and staff training files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Two inspectors carried out this inspection. Five of the staff on duty, nine residents and two relatives were spoken with. 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? A new carpet has been ordered for the downstairs corridor. New style quite detailed care plans have been introduced and will be completed for all residents over the next few months. These will contain better information about residents care needs to be identified and met by staff at the home. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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) 3,6 Assessment procedures before residents move into the home are thorough and allow family members to be part of the process of assessing needs. The home only admits those people whose needs are in keeping with the skills and knowledge of staff working within the home. EVIDENCE: Care plans of two recently admitted residents contained pre-admission assessments. The manager, a registered mental health nurse, had carried these out. These assessments were also supported by additional assessments carried out by other health or social care workers, for example, where people had been admitted from hospital, hospital staff had carried out discharge assessments. Copies of these were kept in the residents’ files. The manager and other senior staff confirmed that the identified needs were discussed with family member as part of the admission process. The home does not provide intermediate care. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 9 THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 standard(s) 7,810 When the remaining 28 care plans are completed using the new paperwork, the complex and various needs of residents will be fully identified within the care plans. One care plan did not address the changing care needs of the resident. Throughout the day staff were seen to be providing care and support in a very positive way that showed that there was a good relationship between residents and care staff. EVIDENCE: Five care plans were examined and these were completed using the recently improved style of plans. These plans had detailed assessments of areas of need, such as mobility, falls, moving & handling, continence, pressure area & tissue viability, nutrition and general dependency. These plans were detailed and made reference in each area assessed of the effect of the residents’ mental health on their behaviour and vulnerability .A record was also made of support from and visits by other health professionals such as GP’s and Consultant Psychiatrist. One care plan identified that a resident had been THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 11 steadily losing weight over a period of months. The nutritional assessment had been completed and a care plan was in place stating that the resident should be referred to a dietician regarding weight loss. There was no evidence that this resident had been referred to a dietician. Staff were observed in the routines of providing care and support. This was being done in a very respectful way. Residents spoken with were unable to express a view as to how they feel but the interaction observed between the residents and staff was positive and showed that staff had built a good relationship with the residents in their care. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 standard(s) 12,15 Social activities are not well managed, there are days within each week where no structured activities take place. Residents are frequently left to sit in small groups without any distraction of stimulation from staff. Families visit without restriction and are an important resource in taking residents out of the home. Meals are both well presented and provide a reasonable choice, however the present location of the dining room in a link corridor does not provide a homely or positive location EVIDENCE: There is a programme of activities on display within the home, this identifies a four weekly programme, with the activities for each day allocated to a named carer. Staff said that there were not always enough staff on duty during the afternoons to support these activities. Visitors were seen during the afternoon, there were no restrictions on visiting and relatives were seen to be made welcome. One relative spoken with said that they could visit the home at any time but that they had not seen any activities taking place on a regular basis. They also said that the garden area was rarely used and was concerned that their relative didn’t get enough fresh air. Meals on the day of inspection were both well presented and provide a reasonable choice, however the present location of the dining room in a link corridor does not provide a homely or positive location. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 13 Staff said that there were limited opportunities for staff to take residents out, except for special occasions and they felt that the support of visiting relatives was an important role in the lives of the residents. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Relatives are not confident in the complaints procedure at the home. Arrangements are in place to protect residents from abuse. EVIDENCE: A copy of the complaints procedure is available in the service users guide and displayed on the notice board in the main entrance. One complaint made to CSCI has not been entered in to the complaints file. One relative spoken with said that complaints that they had made in the past had not been addressed properly and that the relative had been made to feel uncomfortable when visiting the home following the complaint. Staff members spoken with were aware of the abuse policy and had received training on abuse awareness in April 2005. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,24,26 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment. The home is clean free from unpleasant smells. EVIDENCE: Bedrooms were clean and well personalised with the residents’ own belongings. A number of areas inside and outside the home have been identified as needing attention to benefit the residents. The windows throughout the home are ill fitting and require repairing. There are a number of bedrooms with melamine furniture which needs repairing or replacing. A number of bedroom sinks are ill fitting and loose. The upstairs corridor of the home has wallpaper, which is torn in places and the woodwork is badly chipped. This has been discussed with the manager on previous occasions but as the home is to have an extension built it was felt that the redecoration could wait. The manager agreed that some remedial work could take place, as the date to commence the extension has not yet been agreed. The downstairs corridor has a new carpet on order to meet a requirement made at the last inspection. A relative THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 16 said that the enclosed garden is not used by the residents and was concerned that their relative didn’t get enough fresh air. The pathway to the lawned area is overgrown making access difficult. It was recommended that this area should be made safe and accessible. All other areas for repair were discussed and agreed by the manager at the inspection. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 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) 27,29 Resident’s benefit from a service that provides adequate staffing levels and well-informed and knowledgeable staff. EVIDENCE: The staffing numbers at the home are adequate to meet the needs of the residents. Trained nurses are on duty twenty fours hours a day supported by care staff. Duty rotas were seen and staffing levels were being maintained. Staff members from the kitchen, laundry, housekeeping and general care were spoken with. They were aware of their various roles and responsibilities, had an understanding of the policies and procedures that directed their work and had a very good relationship with the people they cared for. Care staff spoken with had detailed knowledge of the needs and personalities of the residents and spoke about training they had received over the last year. This included Adult Protection, Moving & Handling and NVQ but had not included any specific training in Dementia Care. The records of four recently appointed staff contained two written references, one of which was from a previous employer. Enhanced checks with the Criminal Records Bureau and a CV. New staff members were provided with a formal induction that was in the form of a work book. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 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) 33,36,38 The management of the home maintains the safety of the residents living there. Items addressed during formal supervision sessions need to be recorded. EVIDENCE: Residents’ choices are recorded in the plans of care. The proprietor or his designated representative visit the home on a monthly basis, unannounced, to check on are health and safety, property and equipment and staffing issues. Discussion with residents, relatives and staff take place during these visits. At the last inspection the inspector requested that a copy of the report produced is sent to CSCI but, as yet, copies are not being sent. Informal supervision of the staff takes place on a daily basis but formal supervision sessions are not recorded correctly. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 19 Accident records seen showed that these are recorded appropriately. Safety certificates were in place for items of equipment such as hoists and passenger lifts. The fire log was checked and staff training has taken place and been recorded. THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x 2 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x 3 x x 2 x 3 THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 21 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. 2. 3. 4. 5. 6. Standard OP7 OP12 OP16 OP19 OP36 OP38 Regulation 15(1) 16(2m) 22(3) 23(b) 18(2) 26(5a) Requirement The needs of the residents must be adressed within the care plans. The social needs of the residents must be met. The complaints at the home must be addressed appropriatly Areas identified as needing attention are addressed. Staff at the home must be appropriatly supervised. recorded visits to the home by the registered proprieter or his representitive must be sent to the CSCI office. Timescale for action 12th August 2005 15th July 2005 15th July 2005 31st July 2005 15th July 2005 30th June 2005 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 THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 © 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 THE OLD RECTORY NURSING HOME F51 F01 S18750 The Old Rectory V231005 070605 Stage 4.doc Version 1.30 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. 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!