Inspection on 05/10/05 for Old Rectory Nursing Home - Warrington

This inspection was carried out on 5th October 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 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

Old Rectory Nursing Home -... 17/08/06

Old Rectory Nursing Home -... 27/01/05

Old Rectory Nursing Home -... 29/07/04

Old Rectory Nursing Home -... 10/12/03

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Old Rectory Nursing Home - Warrington Old Rectory Nursing Home Church Lane Grappenhall Warrington Cheshire WA4 3EP Lead Inspector Anthony Cliffe Announced Inspection 5th October 2005 09:00 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 Old Rectory Nursing Home - Warrington DS0000005153.V253316.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 - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Old Rectory Nursing Home - Warrington Address Old Rectory Nursing Home Church Lane Grappenhall Warrington Cheshire WA4 3EP 01925 604611 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 Valerie Anne Eyes Mrs Lynn Sutton Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 39 service users to include: * Up to 39 service users in the category of OP (old age, not falling within any other category. The registered manager has a qualification at level 4 NVQ in management and are or equivalent by 30th October 2005. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection. The registered provider must, at all times, employ a suitably qualified an experienced manager who is registered with the Commisison for Social Care Inspection. 3rd June 2005 2. 3. 4. Date of last inspection Brief Description of the Service: The Old Rectory is a 39 bedded care home registered to provide nursing care to adults aged over 65 years of age. It has been converted and extended from the 15th century building, which was the original rectory for the adjoining church. Communal areas comprise a large dining room, spacious lounge and conservatory. Facilities are available in the home for hairdressing. The home provides nine twin bedded rooms and twenty-one single rooms, some with en suite facilities. There is wheelchair access to the home and a passenger lift to the upstairs accommodation. It has extensive rear gardens, a veranda to the front of the building and the Bridgewater Canal passes by the grounds. The home is situated in Grappenhall village, which is within easy travelling distance from Warrington, Stockton Heath and Lymm. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by a regulatory inspector. The inspection took place over six hours and feedback was given to the manager and registered provider at the end of the inspection. It included inspection of records, observation of staff practice and discussion with residents and visitors What the service does well: What has improved since the last inspection? What they could do better: Provide adult abuse training or awareness during the induction of new staff. Provide residents with the results of satisfaction surveys carried out at the Old Rectory. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 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. Old Rectory Nursing Home - Warrington DS0000005153.V253316.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 - Warrington DS0000005153.V253316.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): 3,4 and 5 Assessments of needs are carried out before residents move into the home to ascertain if their needs can be met by the home. Residents are given information about the facilities and services at the home and have an opportunity to visit before moving in. EVIDENCE: The care documents relating to three residents were examined. These showed that the people who had recently moved into the home had pre admission assessments completed. The home had obtained copies of assessments from the NHS facility including assessment from the local authority for residents who were privately funded Three residents who had recently moved into the home talked about this experience. One of the resident said she paid a ‘flying visit’ after her family had looked at the home for her. One resident said her daughter and niece had visited the home for her and said ‘the surroundings are pleasant and comfortable and the staff were nice’. One resident said she used to visit the home when a family member was a resident and remembered the home was nice and ‘my sister spoke highly of the care and of the staff’. One of the residents confirmed she had been given information on the home prior to Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 9 moving in. The other residents said that family had been given information. A resident said she had been given a brochure when she moved in. Another resident said ‘I am registered blind and relied on information from my family and asking questions when I moved in. I have only been here two weeks and am still finding my feet. Two residents said that they were advised to have their personal clothing marked with their name on it before they moved in. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 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, 8, 9 and 10 Residents’ care plans ensure that health and social care needs are identified and met. The procedures for managing medication ensures residents receive their prescribed medication as medication administration and recording has improved. Residents are treated with dignity and respect. EVIDENCE: A number of care plans were examined. All plans had a comprehensive range of assessment documents completed in full with a care plan to address the residents’ identified needs. From looking at care plans, and from conversations with residents, the health needs of residents were met. The Old Rectory uses a range of core care plans individualised to residents’ needs. Care plans showed when the residents’ physical needs had been reviewed and treatment from a general practitioner and in an NHS facility was needed. A residents said ‘I was seen by my GP as my arthritis was playing me up and my chest felt tight. I was sent for an X-Ray, everything was clear and is ok’. A resident said she had moved from another care home for a better standard of care and said ‘I did not like the place, where it was or the staff. The sister on the unit was very flippant with me, she did not want anything to do with my supra pubic catheter coming out. When I moved into here the staff arranged an ambulance to take me to the hospital and it was reinstated. The other home Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 11 compromised my dignity as the bed became wet and I had to get changed. The upshot is I am now dry and comfortable’. The home has a lead nurse in tissue viability to which advice was sought on the care of pressure ulcers. Care plans were supported by risk assessments and risk management plans. Some plans recorded the wishes of the resident in case of death. The care plans had been reviewed monthly as recommended at the previous inspection visit. Medication administration and recording has improved, with the introduction of an audit system, which identified when errors on the medicine administration record sheets occurred. The audit system identified where signatures had not been recorded for the administration of medicines. No errors were noted for the month of September. Residents talked about how their privacy and dignity is maintained. Residents said that staff were polite and courteous and ensured that they were covered or doors closed during help with personal care. A residents said ‘they make sure my catheter is clean and that my clothing is positioned properly. When they use the hoist they explain what they are doing as I am unsure about the hoist despite the number of years I have used one. Staff explain all the help they give you and listen to what you have to say about your care. Despite my limitations they encourage me to do things for myself’. Another residents said Staff help me when I need it. I use the call bell and they come pretty quickly. I am registered blind but they know what I can do for myself. I cannot choose my clothes, as I cannot see. Staff help and encourage me to it for myself. They help me with what I need’. A resident said ‘staff know I am very independent, so they only need to help me when I get in and out of the bath or to use the toilet in the middle of the night. When I call for help they respond quickly within two or three minutes. If they are busy they will come and make sure you are comfortable and safe’. Eleven general Practitioner cards were returned as part of the inspection process. All the comment cards said staff communicate clearly and worked in partnership. Four health and social care professionals were returned and comments made said ’ Very welcoming when I visit, open to advice I offer and willing to carry out’. ‘I spent three weeks liaising with staff on the investigation of an outbreak of Norfolk virus recently. Excellent cooperation throughout from each member of staff and especially the matron’. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 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 and 15 Residents are supported to exercise choice in their lifestyle and to meet their social needs. Residents have a good choice of meals in pleasing surroundings. EVIDENCE: Residents were seen to be free to move around the home and were at ease in asking staff for help. A variety of sitting areas were available. Staff were observed spending social time with residents. A resident said ‘as I am not weight bearing I have to rely on staff for my mobility and personal care. Sometimes my routines depend upon the qualified staff. For example I have a dressing on my foot they have to change. That’s not a problem. Otherwise I tend to choose how I spend my day. I like to sit in the conservatory its quiet and you can have a conversation and talk to one another. We keep each other up to date. Another resident said ‘despite my eyesight being poor I choose to sit in the conservatory. The other lounge has a television, which is always on and the residents are asleep. In here we chat to one another. I have known one of the residents since I was a child. We chat about our families. I behave myself and am treated well. I can talk to staff and say what I mean I am treated wonderfully well’. Another resident said ‘the staff are lovely respectful girls. You get to know them and form a relationship with them. There are not a lot of staff changes. You can tell this is a family run business. Val and Malcolm run it that way. There are lots of personal choices, if I want anything I ask. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 13 I have a routine and that is respected. They listen to what you have to say. We have a comfortable lifestyle. We recently went to Llandudno with Val and the staff. It was an enjoyable day, we needed for nothing everything was arranged’. A resident said ‘I prefer to spend my day in the conservatory, the television is always on in the other lounge and people asleep. The majority of activities take place in the other lounge and we join in. The other week an entertainer gave a talk and slide show on the war and we also sang songs. I really enjoyed it, because it helped me remember. We all talked about our experiences during the war. It helped us to get to know one another. I feel like I have settled in and am getting to know people. Two residents said they shared a bedroom and had chosen to do so before they moved into the home. The residents confirmed they had been given the option of a single bedroom when one became vacant. One resident said ‘I am new and I don’t worry about being on my own’. Residents discussed the provision of meals prior to them having lunch. Residents said they knew what was on the menu as it was written on the menu board. Two residents who were partially sighted said they asked their friends what was on the menu or staff came an asked them what they would like to choose from the options available. Residents said at lunchtime there was one main choice with options available if they wished to choose them. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 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 the following standard(s): 16 Complaints are taken seriously and acted upon. EVIDENCE: Residents talked about their awareness of the complaints procedure. Residents said they were satisfied with the care they receive and would talk to Val or matron if they were not satisfied. Two of the residents said they had raised concerns over their clothing going missing when they first moved into the home but this had been addressed and the clothing found. The residents said they were advised to have their clothing marked with their name. One residents said ‘no I am not aware of the complaints procedure, but I don’t have any complaints. It would be useful if you had to make a formal complaint, but they listen and act on what you want to talk about’. Ten residents’ comments cards were returned as part of the inspection process and all ten residents said they knew who to speak to if they were not happy with their care. Eighteen relatives/visitors comment cards were returned as part of the inspection process and six relatives said they were not aware of the complaints procedure. Two of these said they would approach the staff and ask for the complaints procedure if necessary. Four health and social care professional questionnaires were returned and indicated they had not received any complaints about the home. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26. Residents live in a safe and well-maintained home, which is clean and hygienic. There is a commitment to improving the standard of fire prevention for the benefit of residents. EVIDENCE: All communal areas and some of the bedrooms were seen and the interior and exterior of the building was well maintained. Twelve fire doors have been replaced and in tumescent strips added into the doorframe to improve fire containment. The registered provider said this is part of a replacement programme. The building was clean and hygienic. Old Rectory Nursing Home - Warrington DS0000005153.V253316.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): 27 and 30. The home provides sufficient staff numbers to meet residents’ needs. Investment in training has been made to maintain a skilled workforce. Training on the home’s adult abuse policies and procedures needs to be completed to raise staff awareness. EVIDENCE: From the staff rota, sufficient Registered Nurses and care assistants were employed to meet the residents` needs. Additional professional support is available to residents from PCT and local authority staff with referrals made when necessary. The manager confirmed that she has eighteen supernumerary hours a week. The deputy matron has six hours a week and the lead nurse on tissue viability has time to attend a local wound care forum. The staff group are stable. The Old Rectory has joined the Warrington training and development partnership. They have been offered places on the local authority adult protection-training course with confirmed dates. Health and safety training took place on 17th and 21st September 2005. From this staff were registered for an NVQ level 2 in health and safety. Five staff members completed moving and handling training in September 2005 with further training to follow. First aid training has been planned for staff. Four staff had commenced employment and had been supervised through an induction programme, but the induction programme did not include adult abuse. See recommendation 1. Old Rectory Nursing Home - Warrington DS0000005153.V253316.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): 33, 35 and 38 There is leadership guidance and direction in the home to ensure residents receive consistent quality care. EVIDENCE: The manager and registered provider undertake quality assurance. The manager completes a monthly audit with the registered provider. This is a monthly meeting with minutes taken of the meeting. The meeting covers a number of topics including the building, training and staff development. The lead nurse on tissue viability keeps a monthly audit of pressure ulcers and wounds being cared for in the home. The audit looks at how the treatment of these is progressing and evaluation of the treatment in progress. She checks the wounds daily to ensure that dressings are in tact. She attends a local form on tissue viability. She said she had found the auditing of wounds very valuable and said ‘it has promoted practice in the home, the residents are very involved in their wound care and can see progress’. The manager undertakes satisfaction surveys of meals and activities. Satisfaction surveys were undertaken July 2005 on activities provided in the home and the mid day and Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 18 evening meal. The results were published to the chef and activities organiser but not the residents. Relatives/visitors comment cards made complimentary and some negative statements about the standard of care in the home. The negative statements were addressed to the manager. Comments received were; ‘ More than happy with the care and service my mum gets. She could not be anywhere better’. ‘I am extremely satisfied with the level of care my mother receives and feel she is lucky to live in such a caring and homely environment. Mum thinks as the Old Rectory as her home. Not just as a nursing home where she happens to live’. ‘The most important feature of the home is the high number of caring well qualified staff. Meals look appetising, and outings are arranged. Matron makes nursing decisions and we are informed about these decisions’. ‘In the four years my mother has been a resident she has received excellent care, and her relatives have been welcomed and kept informed’. ‘Mr relatives have lived at the Old Rectory for over a year. We have been delighted with the care they have received. The home is spotlessly clean at all times and the food is of a high quality and beautifully presented at all times. The personal care is excellent, with little extras that make a lot of difference, like hairdressing and manicures. The staff take into account the residents’ individual likes and dislikes. Whilst always trying to ensure they remain healthy and comfortable. Special times like Christmas, birthdays and other events are made special by the trouble and attention to detail taken by all the staff, not only in decorating the Old Rectory, but preparing buffets and seasonal food. All the staff seem to work hard, and although the atmosphere is always relaxed, I realise that everything is well organised and efficient’. The home does not manage or hold residents’ monies. The resident, their families or representative holds these. A resident said ‘ my family deal with my finances; I get copies of any bills. I choose to pay privately for a chiropodist’. The manager provided details of the testing and servicing of all plant and equipment. The records maintained within the home relating to the health & safety of residents was examined. These included; Fire Log Book, Accident Book, Risk Assessments, Portable Electrical Appliance Tests, HACCP Records Maintenance Records for Hoists and Records of Discharged Hot Water. Fire drills and fire training have been held in August and September 2005. A weekly fire alarm test is recorded and monthly emergency lighting test. See recommendation 2. Old Rectory Nursing Home - Warrington DS0000005153.V253316.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 3 3 3 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 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 2 x 3 x x 3 Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 20 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. 1 2 Refer to Standard OP30 OP33 Good Practice Recommendations To include the home’s policy and procedures on adult abuse as part of the induction programme for staff. To make the results of satisfaction surveys available to residents. Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 Page 21 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 © 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 Old Rectory Nursing Home - Warrington DS0000005153.V253316.R01.S.doc Version 5.0 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. 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