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Please note that the information on this website is now out of date.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 23/06/05 for Oldbury Grange Nursing Home

Also see our care home review for Oldbury Grange Nursing Home for more information

This inspection was carried out on 23rd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Residents living in the home said that the staff are kind and caring and help them should they need this. Staff were observed to be caring towards residents and were aware of residents likes, dislikes and needs. Residents said that they enjoyed the meals and that choices were available at mealtimes. Good opportunities are made available for staff training with the majority of care staff completed or enrolled on NVQ training programmes.

What has improved since the last inspection?

Since the last inspection there has been an increase in the number of domestic hours available leading to a noticeable improvement in the standards of cleanliness within the home. Practices for the assessment and management of wounds continue to be developed to meet best practice guidance.

What the care home could do better:

There are a number of things that the manager and staff need to do to make sure that the residents get the care that they need from staff. Assessment and care planning must improve so that the staff are able to know what to do for each resident. The refurbishment of current bathing facilities and improvements in standards of infection control and cleanliness in the kitchen are necessary to ensure a safe and comfortable environment for people living in the home. The most serious concern from this inspection were: staff are being employed without proper employment checks to ensure that they are suitable people to work with residents .A letter was left at the home to inform the owner and manager that these should be put right immediately.

CARE HOMES FOR OLDER PEOPLE Oldbury Grange Nursing Home Oldbury Road Hartshill Nuneaton CV10 0TJ Lead Inspector Louise Thompson Unannounced 23 and 30 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. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oldbury Grange Nursing Home Address Oldbury Road Hartshill Nuneaton Warwickshire CV10 0TJ 02476 398889 02476 398881 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) Dr B Sidhu & Mrs C Sidhu Ms Charan Kanwal Sidhu Care home with nursing 44 Category(ies) of OP - Old age (44) registration, with number of places Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 27 January 2005 Brief Description of the Service: Oldbury Grange Nursing Home is situated in the Warwickshire countryside a short distance from Hartshill. Dr and Mrs Sidhu currently own the home. The home is registered to provide nursing care for 44 elderly people. The accommodation is purpose built with service user accommodation provided on two floors. Access to each floor is possible via passenger lift or stairs. Garden and patio areas are easily accessible to service users, including those that use wheelchairs. The accommodation provides excellent views over the local countryside. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days and was unannounced. A tour of the premises took place and staff, care, and other records were inspected. Six of the staff on duty, ten of the residents and three relatives were spoken to. What the service does well: What has improved since the last inspection? 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. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 6 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 Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 7 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 The assessment process prior to admission of residents is inadequate.Without suitable assessments there can be no assurance that care needs of residents will be met. EVIDENCE: The manager is responsible for assessing prospective residents prior to admission to the home. Individual records are kept for each resident inspection of the records of three resident files showed that full pre admission assessment information had not been completed/ recorded for two of the files observed. Care management assessments and care plans were available for those who are supported by local authority funding. This information was not readily accessible and available as filing systems were disorganised. The manager had reviewed the systems for management and filing of assessment information by the second inspection visit. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 8 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) 7,8,9 and 10 Care plans for identifying and meeting health care needs are satisfactory further development is needed to ensure that social and personal care needs are identified and met. The health needs of service users are met with evidence of multidisciplinary working taking place on a regular basis. EVIDENCE: Individual care plans are available and those examined identified residents’ health care needs and the actions staff needed to take to ensure that these were met. The personal and social care needs of residents were not fully assessed and lacked suitable care plans. The manager said that new assessment documentation was being implemented in the near future to improve this. Good evidence was seen on all four files viewed of suitable risk assessments and appropriate care plans. All plans had evidence of monthly review and evaluations were comprehensive where there had been changes. Only one of the files viewed had evidence of resident/relative involvement in care planning/reviews. Care plans are kept in resident rooms and are accessible to residents and relatives. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 9 Access is available to health professionals outside of the home, which includes the Chiropodist, GP, District nurses and the Dentist. Systems for the assessment and management of wounds are good. Records for one resident admitted with extensive leg ulcers were comprehensive and in accordance with good practice guidelines. Tissue viability advice is obtained from the Nurse Practitioner at the local surgery. The systems for nutritional screening are satisfactory, with evidence seen on files observed of nutritional assessments, regular weights and suitable care plans. One resident has nutritional needs met via a nasogastric tube, staff have attended training on the management of nasogastric feeding and procedures/guidelines for this were available. Systems for the storage of medications were suitable. No omissions were observed on the Medicine administration records. Changes to prescribed medications were not always dated and signed and the route of administration for those with PEG and nasogastric tubes was not specified. The manager said that unused medicines were currently returned to the Pharmacy. She was aware of recent changes to legislation and was in the process of arranging alternative disposal. Staff were observed treating the service users with dignity and respect during the inspection. Five residents said that the staff were very caring and that they enjoyed living in the home. Two relatives spoken to said that the staff met residents care needs. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 10 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 and 15 Dietary needs of residents are met with a varied selection of food available that meets residents’ tastes and choices. Aspects of cleanliness and hygiene in the storage of food present risk to residents. Social and leisure opportunities need further development to meet residents’ interests and capacities. EVIDENCE: The activity organiser has recently been appointed and is in the process of developing the activity timetables and variety of opportunities available. She said that she has discussed with residents their likes and dislikes and is using this information to make sure that needs are met. At the inspection there was little documented evidence of this, newly devised activity sheets are being implemented. During the inspection residents were seen enjoying a bingo session, others were playing cards. One resident was doing her cross-stitch. Residents in the downstairs lounge were watching TV. The activity organiser said that trips have been arranged these include canal trips and a visit to the Black Country museum. Three residents and two relatives said that they were able to spend their day as they wished and could choose whether to take part in social activities or not. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 11 Residents said that they enjoyed the meals provided and that choices were available at mealtimes. One recently admitted resident told of the meal choices that day saying that meals were nicely cooked and that drinks were available at all times should she want one. A tour of the kitchen and storage areas identified a number of hygiene issues, which were discussed with the manager: A large black bin in the kitchen area, which was used for the storage of foodstuffs, required cleaning. The dry goods store required cleaning. A number of food items were out of date The seal of the small fridge in the store was damaged, the fridge was dirty, and required defrosting. Cleaning materials and equipment were stored next to opened foodstuff. Packets of mashed potato were not dated when opened. The staff attended to these issues at the time of the inspection visit. At the second visit the store was observed to maintained in a clean state. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 12 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 The system for the management of complaints is satisfactory. EVIDENCE: The complaints procedure for the home is located on the notice board in reception and is also included in the service user guide. A copy of the guide is available in each resident’s bedroom. The manager said the home have received four complaints in the last year. These have been investigated and satisfactorily resolved. Records of the investigations and action taken as a result were seen during the inspection. Two residents said that if they had any concerns they would tell the manager about these. No complaints have been received by the commission since the last inspection visit. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 13 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, 21, 25 and 26 Facilities for bathing are in need of improvements to provide an environment with sufficient and suitable equipment and facilities for all residents. Some progress has been made in systems and procedures for the management of hygiene and infection control EVIDENCE: The accommodation is purpose built with resident accommodation provided on two floors. Access to each floor is possible via passenger lift or stairs. Garden and patio areas are accessible to residents, including those that use wheelchairs. Some patio slabs outside the lower floor lounge were observed to be uneven and the small enclosed patio area visible from the dining room needed attention. Not all of the existing bath facilities are accessible to current service users and all are in need of redecoration and refurbishment. Staff said that residents mostly use the recently installed shower facilities of which there is one situated on each floor. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 14 On the first day of inspection the hot water in the bathroom on the lower floor ran cold to the touch. By the second visit a plumber had visited to correct this. Since the last inspection additional domestic hours have been provided and the home was observed to be much cleaner than at the previous visit. There were no obvious odours. A number of infection control issues were identified and were discussed with the manager. These include: • • • • Used razors left lying in a number of bathrooms. Creams prescribed for named residents in other residents’ rooms. External clinical waste bins were unlocked and required emptying. In room 28(shared room), unlabelled toiletries and dentures were stored together. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 15 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 and 30. The procedures for the recruitment of staff are not robust with appropriate pre employment checks not being carried out and potentially leave residents at risk. Good opportunities are available for staff training and development. EVIDENCE: Duty rotas seen for June 2005 demonstrated that occasionally staffing numbers and skill mix had not been maintained within agreed levels. The manager said that this was largely due to two staff that had just left employment giving little/no notice. The home is registered to provide adaptation training to overseas nurses. At the time of the inspection English classes were being provided on site for the overseas staff. Three staff are currently undertaking adaptation training and two have recently completed this and are awaiting their registration. The home is also a placement for student nurses. The manager said that she has appointed three care staff and is awaiting references before they can commence duty. The staff files of four recently appointed staff members indicated that the manager had not completed all the necessary recruitment checks to ensure the protection of residents. Two references were available on three of the files viewed. However in the case of two overseas staff these were photocopies of references and the manager had not requested references. The relationship of the referees was not specified only one reference was from a previous employer. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 16 Gaps in employment were not recorded One of the files contained little/no evidence of personal identification. The manager said that the staff contracts/ terms and conditions were still not completed. The matron has reviewed the systems for induction and is implementing this for new starters. Good opportunities are made available for staff training. Records observed were not up to date and therefore it was not possible to accurately identify numbers having attended training. Staff have recently attended training on alternative pain relief, dementia care, management of nasogastric tubes and tissue viability. The home accesses a number of courses provided by a local training provider, a tutor visits the home regularly to support the staff. NVQ training is ongoing with 14 of the care staff having already achieved the NVQ level 2 and a further 8 enrolled on this. Two staff have achieved NVQ 3 and a further three are to commence level 3. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 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 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) 37 and 38 Issues surrounding some aspects of health and safety need attention to safeguard the health, safety and well being of the residents. EVIDENCE: The current systems for the management of some files and information are disorganised and confusing. Some items of information requested during the inspection were difficult to locate. Documents are stored in the manager’s office and Matrons office. Certificates for the service and maintenance for most major systems were available the manager said that these were done by appropriately qualified personnel. The landlords gas certificate was not available, invoices seen demonstrated that the work was completed in September 2004. Servicing of fire equipment and electrical wiring checks were due the manager said that dates had been arranged for these to be undertaken. The MOT certificate for the minibus had expired. The manager arranged for this to be done immediately. The certificate was seen at the second inspection day. Accident records were satisfactorily maintained. Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 2 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x 2 x x x 2 2 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x 2 2 Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 19 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. Standard OP 1 OP 3 Regulation 4, 5 14 Requirement The manager must forward a copy of the revised Statement of Purpose and Service User Guide. The registered manager must ensure that a comprehensive pre admission assessment is completed for each prospective resident. Records of this assessment must be maintained The manager must ensure that care plans include the social and personal care needs of each resident. The manager must ensure that: Medicine administration records indicate the circumstances for administration of prn medications. Changes to prescibed medications are signed and dated. The means of disposal of medications must be reviewed. The registered manager must ensure that the arrangements for social and leisure activities are flexible and varied. These should suit residents preferences and capacities. Records are to be maintained of this and of resident participation. E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Timescale for action 31/08/05 31/08/05 3. OP 7 15 31/09/05 4. OP 9 13 31/08/05 5. OP 12 16 31/09/05 Oldbury Grange Nursing Home Version 1.40 Page 20 6. OP 15 16, 13 7. OP 19 23 8. OP 21 23 9. OP 25 13 10. OP 26 13, 16 11. OP 27 18 12. OP 29 17, 19 Schedule 2 The registered manager must ensure that the dry food goods store is regularly cleaned and that good stock rotation is maintained. The issues identified in the main body of this report must be attended to and suitable standards of hygiene maintained. The small fridge must be repaired/replaced. (Old timescale of 31.03.05 not achieved.) The registered manager must ensure that the uneven patio slabs to the rear of the property are attended to. The registered manager must provide a timed action plan for the redecoration and refurbishment of bathing facilities. The registered manager must ensure that monthly records are maintained of hot water checks. (Old timescale of 31.3.05 not met) The registered manager must address the infection control issues identified in the environment section of this report which, includes attention to management of clinical waste and staff practices. (Old timescale of immediate not fully met) The registered manager must ensure that staffing numbers and skill mix are maintained within previously agreed levels. These are to be based on resident dependency levels and assessed care needs. The registered manager must ensure that staff files contain all evidence as specified in Schedule 2 of Care Homes Regulations 2001. Two references and CRB and POVA checks must be 31/07/05 31/09/05 31/09/05 31/08/05 31/08/05 31/07/05 01/07/05 Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 21 13. OP 38 23, 13, obtained prior to staff commencing duty.(Old timescale of 27.1.05 not met) The manager must forward certificated evidence of : Landlords gas certificate and service of boilers. Completion of service of the fire alarm system and five year electrical wiring checks. 31/09/05 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 OP 19 Good Practice Recommendations The inspector recommends that the small patio/garden area outside the dining room is cleared and replanted to make a more attractive area for residents to view from the dining room. The inspector recommends that the manager obtains advice from suitably qualified personnel with regards to employment law and staff contracts. The inspector recommend sthat the staff training matrix is up dated to accurately identify training attended. The inspector recommends that the current systems for filing are reviewed. 2. 3. 4. OP 29 OP 30 OP 37 Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Oldbury Grange Nursing Home E53 S4403 Oldbury Grange V235645 230605 Stage 4.doc Version 1.40 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!