Inspection on 10/01/06 for Petworth Cottage Nursing Home

This inspection was carried out on 10th January 2006.

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

Petworth Cottage Nursing Home 04/12/06

Petworth Cottage Nursing Home 24/08/05

Petworth Cottage Nursing Home 23/02/05

Petworth Cottage Nursing Home 06/07/04

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Petworth Cottage Nursing Home Fittleworth Road Petworth West Sussex GU28 0HQ Lead Inspector Mrs L Driver Unannounced Inspection 10th January 2006 11:00 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 Petworth Cottage Nursing Home DS0000024195.V268642.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. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Petworth Cottage Nursing Home Address Fittleworth Road Petworth West Sussex GU28 0HQ 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) 01798 342785 Trustees of Petworth Cottage Nursing Home Mrs Christine Barber Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: Petworth Cottage is a care home registered to provide accommodation, personal and nursing care for up to twenty six elderly persons. The registered provider is The Trustees of Petworth Cottage Nursing Home for whom the responsible individual is Mr John Wybrow. The registered manager in charge of the day to day running of the home is Mrs Christine Barber. The premises, previously a cottage hospital, is situated in extensive grounds overlooking the South Downs. The building has been extended to form the home it is today and is currently undergoing further extension work. The accommodation is provided on ground and first floor levels in twenty two single and two double rooms. A passenger lift provides access to all rooms on the first floor. The home has a contract with West Sussex Social and Caring Services for twelve beds. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over a period of three hours in the presence of the Registered Manager, Mrs Christine Barber. Prior to the inspection the inspector read the last inspection report along with other correspondence relating to the home. The inspector viewed records and had discussions with some of the service users, relatives and staff. The inspector also undertook a tour of the home including the new wing that is still in the process of being completed. Following the inspection a CSCI Pharmacy inspector carried out an inspection and her results can be read in the report. The Pharmacy inspection resulted in one recommendation. What the service does well: What has improved since the last inspection? Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 6 The new unit has already got some service users in its new rooms. Service users stated they were happy with the new rooms. Rooms appeared bright and fresh with evidence of personal possessions in them. The manager has commenced implementing a quality assurance system into the home. The manager has reviewed the use of bed rails and has sought feedback from staff, service users and relatives in their use. Risk assessments are in place for all service users with rails in place. First aid training for staff has commenced. 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. Petworth Cottage Nursing Home DS0000024195.V268642.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 Petworth Cottage Nursing Home DS0000024195.V268642.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): 1,2,5,6 Prospective service users are provided with the homes statement of purpose and service user guide. Both need to be updated once the building work has been completed. All service users are given a contract stating the terms and conditions on admission. The home welcomes service users and their relatives to view the home prior to making a decision about whether to stay or not. EVIDENCE: The home has a statement of purpose and service users guide that need to be updated once the building work has been completed to reflect the changes. A copy is to be forwarded to CSCI when in place. Service users and relative spoken with during the inspection confirmed they had seen/ were aware of both documents. The inspector viewed sample copies of contracts between the home and service users. They contained all necessary information. The registered manager confirmed that all service users are in possession of a contract. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 9 The home welcomes service users and relatives to visit prior to making a decision as whether to stay or not. Service users and relatives spoken with during the inspection confirmed this to be the practice. The manager stated that they are welcome to stay for a meal and visit as many times as they wish before making a decision. The manager stated she is currently reviewing the pre admission assessment forms. These will be viewed at the next inspection. The home does not cater for intermediate care. Petworth Cottage Nursing Home DS0000024195.V268642.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): 8,9,11 Good arrangements are in place to ensure the health care needs of service users are met. The home has sound practices in medication administration. Dying service users are cared for according to their wishes and by sensitive staff. Staff are also very supportive to relatives. The home could demonstrate good practices for medicine receipt, storage, administration and record keeping. EVIDENCE: The last inspection report recommended that the use of bed rails be reviewed. The manager has acted on this recommendation and sought feedback from staff, service users and their relatives regarding their use. Current service users have high nursing needs and the use of bed rails appears justified and in line with risk assessment outcomes. The manager needs to ensure that she continually assesses individual need for their use. Current level of nursing needs for service users is high. The home has staff who are experienced and high in numbers who meet these needs. The home has policies on death and dying. The manager stated that information about individual wishes regarding death are acknowledged and followed. Information is sought on admission or at a more convenient date. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 11 The inspector observed, during the inspection, the manager giving support to a relative of a dying service user. This was done very sensitively and sympathetically. The home has very close links with other professionals such as the Macmillan Nurse who offers advice and support to the home. The home had policies and procedures for medication handling, available to staff. Lockable storage was clean and well organised. The temperature of the medicines fridge was monitored daily. Handwritten medication administration charts were signed by the GP and had a photograph of the resident. Records were kept of sample signatures of nurses who administer medicines. The procedure for disposal of medicine was being updated. Petworth Cottage Nursing Home DS0000024195.V268642.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): 13,14 People who use this service are able to maintain contact with family and friends in a welcoming environment. Individual choices are acknowledged and respected in many aspects of day to day care. EVIDENCE: Discussion with service users and relatives evidenced that the home is active in welcoming friends and family into the home. The registered manager is known to all relatives and friends who visit the home. The manager stated the home is very family orientated and is well respected within the local community. This was confirmed by two relatives the inspector spoke with. There is freedom for relatives and friends regarding visiting times. During the inspection the inspector spoke with the husband of a service user who visits daily and has lunch at the home with his wife. He pays £2.50 to cover the cost of his meal. He was very complimentary about the welcome he gets when arriving at the home. The manager stated that current service users have high nursing needs and many are nursed in bed. She stated that involvement in the community outside of the home is difficult for the majority of current service users, but those who wish and are able to can access local facilities in the area. Service users spoken with during the inspection were happy with the contact they have. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 13 The home is extra-ordinary in the number of volunteers it has, approximately 50 at present, and who are evident in the home on a daily basis. There is a lead volunteer who provides induction and regular contact with the many volunteers to ensure good practice. The manager stated that service users are told on admission that the home has no rules, except that some degree of tolerance for other service users may be needed from time to time. All service users spoken with were happy with the level of choice and individual care provided. Service users confirmed they have choice in when they wish to go to bed and get up and in food choices. Evidence of many service users exercising their choices in their own daily routines were seen and spoken of. Service users may choose to eat in their own rooms or in the dining room and can stay in their own rooms if they wish rather than sitting in the lounge. Relatives voiced no concerns about this area. Petworth Cottage Nursing Home DS0000024195.V268642.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): 16,18 The home has procedures in place for service users and relatives to voice any concerns. They are handled objectively and efficiently. There is a procedure in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has detailed complaints procedure and a copy is on display in the home. The manager needs to update the information to ensure the correct name of the Regulatory body (CSCI) is referred to. The complaints folder showed there has been one complaint since the last inspection that was dealt with efficiently and effectively. It was unsubstantiated. Both service users and relatives spoken with were confident that any concerns or complaints would be taken seriously and dealt with promptly by the manager. A procedure for dealing with allegations of abuse is available in the home. The home is also in possession of the West Sussex Area Adult Protection folder. Staff receive training in Adult Protection and the manager needs to ensure that all staff receive regular updated training. Service users and relatives voiced no concerns about any bad practice in the home. Petworth Cottage Nursing Home DS0000024195.V268642.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): 20,21,23,24 Major building work is still in progress which will ultimately provide service users with greater living space and improved facilities. EVIDENCE: The new unit is nearing completion with some areas already occupied. All new bedrooms have en-suite facilities. Once the new section is fully operational the annexe to the original building will be altered and upgraded to provide modern facilities that will meet the National Minimum Standards. In the meantime staff continue to work hard to keep the building as clean and hygienic as possible under difficult conditions and to avoid disruptions to service users. All areas of the home were seen to be free form dangerous obstructions and cleanliness maintained to an high standard. Access to safe and comfortable indoor and outdoor communal facilities is somewhat limited at present due to the building work, but those areas they can access are safe. There are sufficient toilets and bathing facilities in place. A tour of the home evidenced that service users personalise their own rooms Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 16 with their own belongings etc. All service users spoken with stated they were happy with the facilities in their rooms. All in all the home is coping well under difficult circumstances during the major building work and is maintaining a good standard of facilities for service users during this time. Staff were seen to be working well and delivering the care needed to service users, unaffected by the building work in progress. The manager is constantly reviewing the work in progress and has much input into the daily work being done and the possible effects it may have on the running of the home. She evidenced her commitment to ensuring the standard of care does not drop during this difficult period. She is commended for this. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27,28,29, The number and deployment of staff is sufficient to meet the needs of the service users. Staff training is provided to ensure they are competent to deliver the care needed. The recruitment procedure is robust and provides the safeguards to offer protection for the people living in the home. EVIDENCE: Staffing levels have been increased during the period of building work plus a recent change in duty times has been implemented to ensure more staff are available at busy times. Extra staff have been deployed for night times with one RGN on each wing at night. The staff team is a stable one with service users and relatives voicing very complimentary comments about them. Service users stated that call bells are answered quickly and that staff are respectful and friendly. The manager took time out during the inspection to comfort a relative who was distressed, evidencing her commitment in prioritising her work and role. The inspector viewed one new member of staffs recruitment file and found it to be satisfactory with all checks in place. The home recruitment policy remains sound. Staff receive training to be able to fulfil their roles and the home has very close links with other professional such as the Tissue viability nurse, Macmillan nurse, Dietician and Speech Therapist. Staff stated they would access advice if needed and were positive about the contact they have with these specialists. Each member of staff has a development file with copies of policies and procedures enclosed. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 18 The home has actioned the recommendation for first aid training to be provided with two staff having completed and other staff currently accessing a course. Qualified staff are also to access the training in the near future. Currently one member of staff, a senior carer is completing a mentoring course. Fire training is on-going and of upmost importance during the building work. All staff are up to date with fire training. Staff have had training in Adult Protection however the manager is advised to access local Adult Protection training for staff to ensure they are up to date and with current protocol. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36 Service users live in a home that is efficiently run and safe. This is a home that is client focused and benefits from a stable staff team led by a manager who is open and inclusive. Service users finances are safeguarded by the policies in place. EVIDENCE: The registered manager has many years experience and leads a stable team of competent staff. She is a RGN and is currently completing the Registered Managers Award. She has good management skills and is aware of all day to day issues in the home. Although the home is currently operating under difficult conditions the manager continually ensures the health and safety of service users and staff is promoted and protected. As recommended in the last inspection report the manager has started to introduce a Quality Assurance system, she is aware that this needs to be Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 20 developed over the next year. Service users have already been sent a questionnaire regarding the home and the care they receive. The home does not administer any service users monies, they would be billed separately if necessary for any expenses occurred. Staff supervision is informal at present and this now needs to be formalised. Through discussion the manage is aware of what is expected and said she is being proactive in implementing it in the near future. One member of staff is completing a mentoring course which will be helpful in delivering supervision. The last fire service inspection was carried out in December 2005, due to the continual building works. The manager is currently in discussion with the fire service regarding the homes evacuation procedure. This is a priority and the manager is well aware if the importance in ensuring the correct procedure is possible during this difficult period. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 21 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 3 3 X X 3 N/A X 3 3 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 X 3 Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 22 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. 3 4 5 Refer to Standard OP18 OP1 OP33 OP9 OP36 Good Practice Recommendations The registered manager is recommended to ensure all staff receive regular updated training for Adult Protection. Provide CSCI with an updated Statement of Purpose and Service Users guide when building work completed. Continue with developing the homes quality assurance system. Disposal of unwanted medicines should be reviewed according to CSCI guidance. Continue with plans to implement formal supervision in the near future. Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Petworth Cottage Nursing Home DS0000024195.V268642.R01.S.doc Version 5.0 Page 24 - 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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