Inspection on 24/08/05 for Petworth Cottage Nursing Home

This inspection was carried out on 24th August 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 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 10/01/06

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 Linda Riddle Announced Thursday 24 August 2005 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. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 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 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 (OP) - 26 Both of places Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23 February 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 H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This annual announced inspection was carried out over a period of eight hours by one inspector. Prior to the inspection the previous two reports were read along with other documents and correspondence relating to the home. A pre-inspection questionnaire was completed by the registered manager and returned to the Commission for Social Care Inspection and some of the information included in this contributed to the inspection process. Many residents were unable to comment to any degree upon their care but five of the more able and four visiting relatives were spoken with. Eight members of staff were also spoken with, discussion took place with the registered manager and a tour of the building was undertaken. Records and other documents were also examined as part of the inspection process. What the service does well: What has improved since the last inspection? The assessment process has been made more rigorous to ensure that information given to the home about prospective residents is in fact correct. This will help to prevent residents being admitted who are then found to have more complex needs than the home has been led to expect. The new unit is nearing completion and some residents will be transferring to it in the very near future. This will enable work to commence to upgrade and alter the existing annexe. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Admission procedures ensure that there is a proper assessment prior to people moving into the home. This provides assurance that their care needs will be met. EVIDENCE: The admission procedure is adequate to guide staff on the actions to be taken to ensure that new resident’s needs are properly assessed and planned for. Residents spoken with provide some information about their care needs which was checked out in the care plans and in discussion with staff, including the catering staff. The four files examined at random contained full admission and assessment information. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 9 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 Good arrangements are in place to ensure that the health care needs of residents are identified and met. EVIDENCE: Individual plans of care were seen to be available for each resident. The four examined contained comprehensive information on all aspects of the health, personal and social care needs of residents and what action is needed by staff and other professionals/practitioners to meet them. Daily entries are made and the plans updated monthly by key workers, overseen by the trained nurses. Significant events such as falls are recorded. Assessments had been undertaken in relation to falls, the development of pressure sores and all other possible risks to residents. These were also seen to be reviewed and updated monthly. Care staff said that there is good communication from the manager and senior staff and they have clear direction to care for individual residents. It was observed that with the change of shifts, time was given for the handover of information involving the manager, trained nurses and care staff. The practice of using cot sides on beds has the potential to cause accidents. It was noted that consent from resident’s relatives/representatives had been Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 10 obtained and risk assessments undertaken, but the practice should be reviewed especially when new more fully adjustable beds are obtained. Due to the frailty of current residents all medications are under the control of the home. They are received, recorded, stored handled and administered in accordance with policies and procedures in place. If a resident wishes to selfmedicate a risk assessment is undertaken to determine whether he/she is safe to do so. All medicines are handled by trained nursing staff. They are currently disposed of by returning them to the GP surgery from where they are dispensed. The registered manager agreed that she would seek advice with a view to making the required contractual arrangements for their disposal in future. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 15 Social activities are limited because of the mental and physical frailties of residents but are suitable and sufficient to meet their needs. Meals are well managed, creative and provide daily variation for residents. EVIDENCE: Staff or volunteers organise regular Bingo that some residents said they enjoy, but the majority are not able, or have no wish to participate in organised activities because they are very frail. Some said they like to read and watch television. Background music is played in the lounge. Birthdays and special occasions throughout the year are celebrated. The home has many volunteers who attend the home frequently and they provide company and spend time talking with residents, serving the teas and coffees and taking some residents for walks or assisting with the annual outing. In this way residents see lots of different people other than the staff which provides interest and stimulation. One resident said how much he had enjoyed the recent outing to Littlehampton. Meals are based on eight-weekly rotating menus which means that they are not repetitive and residents receive a good variety. The cook was spoken with and is very knowledgeable about the resident’s needs and individual preferences. All residents spoken with were very complimentary about the quality of food and cooking. Examples of comments received included “I need Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 12 a special diet, the cook caters marvellously for me and tries to vary it as much as she can” and “the food here is as good as you’d get in the best hotel. Residents said that they could choose where they have their meals, in the privacy of their rooms or in one of the communal dining areas. Staff are on hand to assist those residents who cannot manage to feed themselves. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Complaints are handled objectively and residents and others are confident that their concerns will be listened to, taken seriously and acted upon. There is a procedure in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a detailed complaints procedure and a copy of this is clearly displayed in the home. Records showed that just one complaint had been received in the last year and there was evidence to show that it had been thoroughly investigated. This complaint was found to be partially substantiated and appropriate action was taken to resolve it. Residents asked, said they knew who to complain to and had every confidence that they would be listened to and their complaint acted upon. Relatives spoken with were also confident that any complaints or concerns are taken seriously and dealt with promptly. A procedure for responding to allegations of abuse is available and was seen. Staff said they had received training in Adult Protection and when asked were aware of their responsibilities in relation to reporting any bad practice should they witness this. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 14 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, 22, 25, 26 Major building work is on-going which will ultimately provide residents with greater living space and improved facilities more suited to their needs. EVIDENCE: The new unit is nearing completion and some residents will shortly be transferring to this accommodation which provides each room with en-suite toilet facilities. The annexe to the original building will then be altered and completely upgraded to provide modern facilities which will meet the National Minimum Standards. In the meantime, staff are working hard to keep the building as clean and hygienic as possible under difficult conditions and to minimise the disruption to residents. A full time maintenance person is employed who keeps records of the work he undertakes. Three assisted bathrooms remain available for use during the interim period. The doors to resident’s rooms in the new unit are fitted with locks and the registered manager confirmed that all doors in the annexe would also have these as part of the upgrading. This was a recommendation in the last two inspection reports. Resident’s rooms were seen to contain many of their personal possessions and looked very ‘homely’. The premises has not been assessed by Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 15 an occupational therapist in relation to suitable aids and adaptations for the resident group accommodated. This was a recommendation in the previous report. It is now recommended that once all building work is completed, a full assessment of the entire premises be made. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 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 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) The number and deployment of staff throughout the day and night is sufficient to meet the needs of the residents. Staff receive appropriate training to ensure that they are competent to care for elderly people. The procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. EVIDENCE: The staff team is generally a very stable one. Residents and relatives spoke highly of their kindness and commitment. One resident said “they do everything for me, they are marvellous” another said “I need a lot of help, the staff do everything they can for me”. Residents said that staff respond quickly to call bells, and this was observed during the inspection. They said that they are kind and patient and considered that their privacy and dignity are well respected. Relatives commented that there are always staff around to help or provide information if needed. It was seen that staff took time to stop and speak with residents when they were not specifically attending to any particular care needs. New staff undertake a formal recognised induction training, records of which were seen. 60 of the care staff have now achieved National Vocational Qualifications in care at levels 2 and/or 3 which is commendable. In addition l staff receive training in work related topics such as Adult Protection, Infection Control and health and safety related topics. The trained nurses also attend relevant courses and seminars to maintain their registration. Full training records and personal staff profiles were examined. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 17 Four staff and two volunteer files examined at random showed that very robust recruitment procedures are followed. The files contained a great deal of information and included at least two references, identification documents and evidence of Criminal Records Bureau clearance checks. There was evidence of staff having been issued with statements of their terms and conditions of employment. Staff confirmed that they also have clear job descriptions. A check sheet in the manager’s private office showed that every member of staff and every volunteer (there are more than 60) had undergone a Criminal Records Bureau check. The thoroughness of the procedures and the presentation of the files is to be commended. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 37, 38 The absence of an effective quality assurance/monitoring system means that the home’s success in meeting its’ aims, objectives and statement of purpose cannot be fully measured. Sound practices promote and safeguard the health, safety and welfare of the people living and working in the home. EVIDENCE: An effective quality assurance and quality monitoring system which incorporates an annual development plan has not yet been implemented. A requirement has been made in this respect. Records required to be kept for the protection of residents and for the effective and efficient running of the home were seen to be maintained up to date and accurate. Although, as has been said, the home is currently operating under difficult conditions, the health and safety of residents and staff is continuing to be Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 19 promoted and protected. Additional staff have been brought in during the period of upheaval. Fire exits were seen to be clear and various safety notices and instructions displayed around the building. Records showed that staff had received up to date training in health and safety topics such as moving and handling, food hygiene (for those working in the kitchen) infection control and fire safety. There is a need for sufficient numbers of staff to undertake first aid training in order that there is always a trained first aider on duty. A recommendation has been made in respect of this. A risk assessment of the premises had been undertaken. Hot water temperatures are regulated and the maintenance person tests them regularly. Records of these tests were seen. Restrictors are fitted to windows of rooms above ground floor level. There are contractual arrangements in place for the servicing and repairs to equipment and installations, such as hoists, passenger lift, call-bell system and fire warning system. Medical equipment is also services and tested as necessary and the maintenance person ensures the safety and condition of wheelchairs. There are accident reporting systems for residents and staff and these were examined. The registered manager monitors the accidents to residents. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 2 x 3 3 3 STAFFING Standard No Score 27 3 28 4 29 4 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 1 x x x 3 3 Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 21 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. Standard 33 Regulation 24(1)(2)( 3) Requirement The registered person shall establish and maintain a system for reviewing and improving the quality of care provided at the care home. Timescale for action 31 November 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 8 22 Good Practice Recommendations The practice of using cot sides on residents beds should be reviewed. When all building work is complete an assessment of the premises by an occupational therapist should be arranged to ensure appropriate aids and adaptations are provided. Petworth Cottage Nursing Home H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 H60-H11 S24195 Petworth Cottage V234062 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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