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Inspection on 17/01/07 for Old Village School Nursing Home

Also see our care home review for Old Village School Nursing Home for more information

This inspection was carried out on 17th January 2007.

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.

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

People like living at the home, the owner often visits residents and they can tell her what they think about being there. Residents have choices in how they live at the home. One resident said "I choose to eat my meals in my room." Visitors are welcome at any time. A gentleman remarked, "My visitors come whenever..." Residents are able to talk to the staff about any problems. "People are kind, I would talk to her", one said. People living at the home enjoy the meals. There is a choice, and a lady commented that "The food is good." The home is organised in the way it is run, and the manager and staff make sure that people`s health needs are looked after. The nurse`s keep up to date with the information they need, and in general, training is considered to be very important at the home. The home has the equipment it needs. For example equipment to help move people around. Staff like working at the home, and feel well supported there. They can speak freely to the people in charge. One staff member said, "When there was aproblem with the staffing, it got sorted out quickly when we told them about it."

What has improved since the last inspection?

The way staff communicate with each other has improved, and now people working in the old school house section feel happy in their work. Training for staff has improved, and staff have had training about the possibility of harm coming to residents, about the complaints policy, and about dementia care. Careful checks are now always made to make sure that the home only takes people in line with the details on the registration certificate at the home. Care plans have improved and these are now checked every month. The way residents can spend their time in the old school house section of the home has been given more thought, and activities are now better organised. Staff are now trying to make sure that the way people spend their time is fully written down in the individual care plans. Decoration is continually being done at the home.

What the care home could do better:

The care given, and care plans can be further improved now that training about the best care for residents with dementia is established. Information about the lives of residents is already being gathered to help with this, and individual memory boxes are being put together. The training manager is going to make sure that any telephone references taken before a member of staff starts work are followed up in writing. In addition to making lots of visits to the home, the owner is going to start writing a report about one particular visit every month.

CARE HOMES FOR OLDER PEOPLE Old Village School Nursing Home Bedford Road Marston Moretaine Bedfordshire MK43 0ND Lead Inspector Carol Mitchell Unannounced Inspection 17th January 2007 10:30 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 Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Village School Nursing Home Address Bedford Road Marston Moretaine Bedfordshire MK43 0ND 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) 01234 768001 01234 767693 oldvillageschool@aol.com Old Village Care Limited Mrs Alice McCauley Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (40), Physical disability of places over 65 years of age (40) Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th February 2006 Brief Description of the Service: The Old Village School Nursing Home comprises of three units, two of these are located in a building attached to the original home by a partially covered corridor. There are plans for alterations to join the two buildings, and in the process completely cover the walk way, and reduce the number of shared rooms in the older building. The two units in the newer building provide care for younger adults with physical disabilities and complex healthcare needs, and the unit in the original converted schoolhouse accommodates older adults with nursing care needs. The newer building is purpose built and the accommodation is over two floors in separate units with passenger lift access. The rooms are all single occupancy and they all have en suites. The accommodation in the schoolhouse is all on the ground floor and there are three shared occupancy rooms with screening, and three rooms with en suite facilities. The home is in Marston Mortaine, which is situated between Bedford and Milton Keynes with good road links to both towns and easy access to the M1 motorway. There are garden areas and parking is available to the rear. The following information about fees was obtained on 17th January 2007: Lowest fee, £526 Highest fee, £1630 Items not covered by the fee include hairdressing (starts at £6), chiropody, aromatherapy. Further information about this home is available by phoning, emailing, or visiting the home. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report takes account of information received by the Commission since 10th February 2006, and from the key inspection visit on 17th January 2007. The inspection visit was unannounced, and took place over four hours during the day. On this occasion, the visit focussed on the school house part of the premises where older residents with nursing needs live. During the visit the inspector spoke to residents, staff, and the training manager, who is also a senior registered nurse at the home. Some records were checked during the visit, and the inspector looked around some parts of the old school house building. The inspector would like to take this opportunity to thank all those who helped with this inspection. What the service does well: People like living at the home, the owner often visits residents and they can tell her what they think about being there. Residents have choices in how they live at the home. One resident said “I choose to eat my meals in my room.” Visitors are welcome at any time. A gentleman remarked, “My visitors come whenever…” Residents are able to talk to the staff about any problems. “People are kind, I would talk to her”, one said. People living at the home enjoy the meals. There is a choice, and a lady commented that “The food is good.” The home is organised in the way it is run, and the manager and staff make sure that people’s health needs are looked after. The nurse’s keep up to date with the information they need, and in general, training is considered to be very important at the home. The home has the equipment it needs. For example equipment to help move people around. Staff like working at the home, and feel well supported there. They can speak freely to the people in charge. One staff member said, “When there was a Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 6 problem with the staffing, it got sorted out quickly when we told them about it.” What has improved since the last inspection? What they could do better: The care given, and care plans can be further improved now that training about the best care for residents with dementia is established. Information about the lives of residents is already being gathered to help with this, and individual memory boxes are being put together. The training manager is going to make sure that any telephone references taken before a member of staff starts work are followed up in writing. In addition to making lots of visits to the home, the owner is going to start writing a report about one particular visit every month. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 8 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 Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and senior staff at the home make sure that they find out about the needs of residents before they move in. Therefore people living at the home can feel sure that their needs will be met. EVIDENCE: The manager, her deputy or the training manager visit prospective residents to assess their needs and check that the home is suitable. They also spend time with the person, and talk to anyone caring for him or her. A formal tool is used to help with the recording of the information. An information pack is available on request, and the complaints policy is to be included in this in the future. Residents are issued with contracts. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are written for residents, and there is good support from family doctors and others. Staff receive training about health needs, and equipment is provided. Therefore people living at the home can be sure that their health care needs will be met. EVIDENCE: Residents spoken to during the inspection visit looked comfortable and well looked after. Staff seen were kind and sensitive when dealing with residents, and were mindful of the need for privacy when giving personal care. Staff know how to move residents who find it difficult or impossible to move on their own, and training is given to make sure that staff know how to meet particular needs, for example special feeding techniques. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 11 The home has excellent relationships with local family doctors, one of whom visits twice a week and makes extra visits when necessary. Other health care professionals also visit the home. These include the dietician, therapists, specialist nurses, dentist, and optician. Work has been done to improve care planning, and risk assessments and care plans had been written for the sample of residents checked. Individual detail was included in plans, which are being reviewed every month. Care plans are still being developed to better reflect the needs of people with dementia, and training regarding dementia care is now well established. Within the home due emphasis is given to making hand washing facilities readily available and easy to use. Infection control training is included in the training given to registered nurses and care staff. Moving and handling equipment was available and being used during the inspection visit. The training manager makes sure that staff are trained in the use of equipment, and is also instrumental in the purchase of new equipment when this is needed. The necessity to maintain and develop clinical knowledge is given priority at the home, and nurses have opportunities to attend a variety of clinical courses including for example wound care, palliative care, and updates on the safe administration of medicines. A small sample of medicine administration sheets was checked and found to be in good order. At the time of the inspection visit no residents wished or are able to administer their own medicines, but this has been supported by the home in the past, and would be again should the need arise. The supplying pharmacist is very supportive to staff at the home, and inspects the medicines every year. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff find out about how residents like to live in the home, and what they enjoy doing. Residents are encouraged to make choices. Therefore people can be sure that their expectations of living at the home will be met. EVIDENCE: At the time of the inspection visit the person employed to support residents in various group and individual activities was on holiday. Sometimes residents enjoy painting and doing craft activities. Others enjoy discussing the past with the help of memory cards or current affairs, having manicures, playing games, or playing musical and percussion instruments. Occasional visits by musicians/singers are arranged, and some of these activities are shared with the homes other two “units”. Following the training received by staff about dementia care, work is being done to gather biographical information and to compile individual memory boxes for some residents, and care plans are also being developed to reflect this. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 13 Residents eating lunch in the lounge said that it was enjoyable. The meal smelt and looked appetising, it was hot, and served efficiently. A choice was offered, and people had chosen their meal in advance. Blended meals were presented attractively, so that the component parts could be recognised easily. Staff were very attentive to the needs of some residents to have help with eating, and they assisted in a caring, unrushed, and careful manner. A gentleman in his room reported that he enjoys his meals, and that there is choice. He chooses to stay in his room, where he has some personal possessions, and this is respected by all of the staff at the home. The gentleman said that he does not feel too bored, and that his visitors are made welcome at any time. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff take any complaints very seriously, and they listen to what people say. Staff have learned about how residents can be at risk of harm. Therefore people living at the home can be sure that they will be listened to and protected from harm. EVIDENCE: The complaints policy is displayed, and is discussed with every prospective resident or family member. It is to be included in the home’s information pack in the near future. Since the last inspection visit, the training manager has discussed the complaints policy with each staff member, and this has been recorded. In the event of a complaint being received, or possible abuse issue being suspected, relevant agencies are notified and cooperated with, and any issues are carefully investigated. Records are maintained. Protection of vulnerable adults training is now firmly established at the home, and details of the training are recorded. The training manager has attended a course for trainers, and she delivers the training. Detailed workbooks are done after staff have attended the course, and the completion of these is Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 15 checked so that feedback can be given, and any deficits in knowledge followed up. There is a system for tracking the training so that no member of staff misses out on this vital training. Staff spoken to were able to say what they would do in certain circumstances to do with possible abuse, and if they should receive a complaint. When asked, residents said that they feel quite able to raise concerns if they need to, and the relationship between residents and staff was relaxed and comfortable during the inspection visit. At least one resident has an advocate to help make sure that her views are heard and understood, and her best interests served. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are employed to make sure that the home is kept clean and well maintained. Therefore people at the home can be sure that they are living in a comfortable and safe place. EVIDENCE: Two maintenance men are employed at the home, and decoration and maintenance are ongoing. Recently the kitchen has been painted and replacement skirting boards fitted to some corridors. Housekeeping staff are employed, and the communal rooms and bedrooms seen during the inspection visit were clean and comfortable. In conversation residents said that they are happy with their rooms and the accommodation Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 17 provided. A gentleman reported that his laundry is managed in an efficient way. There had been a problem with the operation of the lift at the home, but this was in full working order by the time of the inspection visit, and the lift has been serviced. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and senior staff make sure that people working at the home are trained properly. Checks are done before anyone is allowed to work at the home. Therefore residents at this home can be sure they are in safe hands. EVIDENCE: In conversation residents and staff thought that there are sufficient staff working in the old school section. There were six nurses and care staff on duty in each unit at the time of the inspection visit. In the old school section there were two registered nurses and four health care assistants for 23 residents. Also on duty were kitchen, housekeeping, maintenance, administrative staff, and the training manager (who is a registered nurse). The sister’s post for the old school unit is currently vacant. The unit receives support from the manager, training manager, and deputy manager and staff questioned felt well supported. They are able to contact a member of the senior team at any time, they enjoy their work, and get job satisfaction from Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 19 doing it. Since the last inspection team communications and morale have been improved in the old school unit. Staff spoken to were able to describe the care needs of specific residents, and they had received induction and other training, including dementia training. Training at the home is very well catered for by the training manager who keeps well organised records and knows what training is due for whom, and when. Training is delivered to a high standard and understanding is checked afterwards in a methodical way. National Vocational Qualification training is now very well established, and a further six staff have just started a course, with another four or so to follow on in a few months. A sample of staff files demonstrated that proper recruitment procedures are in place, and the correct checks are made before anyone is allowed to work at the home. Written references are requested and usually obtained, but in one file checked, telephone references had been obtained and only a brief note made to reflect this. On the day of the inspection visit, the training manager undertook to ensure that the full details are recorded, and that a follow up in writing is again requested. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in an organised way, and the owner and managers support staff, and try to find out about what the residents think. Therefore people living at the home can be sure that it is run with their best interests at heart. EVIDENCE: The manager is supported by a deputy, the training manager and administrative staff. The home is well organised. For example, there is a system for making sure that all staff have read and are familiar with the home’s policies. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 21 The owner takes a very keen interest in the home and visits about three times every week. Staff and residents reported seeing and talking to her during such visits, and they find her friendly, approachable, and very supportive in terms of needs for the home such as equipment and training. (In addition, the owner needs to write monitoring visit reports once a month in line with Regulation 26). The views of residents are sought through the use of questionnaires and residents meetings are sometimes held if some residents want this and can take part. Care is taken to make sure that relatives are as involved as possible in reviews and other matters. Staff feel well supported by the management team. Staff supervision and appraisal are in place and mentors have undergone specific training for this role. Shift handovers and staff meetings are held and staff report being able to raise issues and make changes when necessary. Training in essential areas such as health and safety and moving and handling is well established. Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 22 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 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x x 3 x 3 Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Old Village School Nursing Home DS0000017682.V326813.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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