Inspection on 04/12/06 for Petworth Cottage Nursing Home

This inspection was carried out on 4th December 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 10/01/06

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 A Taggart Unannounced Inspection 4th December 2006 09:30 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 Petworth Cottage Nursing Home DS0000024195.V319725.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. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 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 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 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, are 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.V319725.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit was carried out at 9.30am and lasted five and a half hours. Prior to the visit the inspector spent time planning by reading the last two inspection reports and any other correspondence or documentation relating to the service. A pre-inspection questionnaire was sent to the manager Mrs. Barber, survey forms were sent to relatives and visitors and comment cards to residents. The inspector also held telephone conversations with three family members in order to gain feedback about survey being undertaken and the care provided in the home. As part of this unannounced inspection ,the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service users guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. The inspector spent time talking with residents, staff, volunteers and visitors and saw lunch, the main meal of the day being prepared and served. A tour of the home was undertaken during which all communal areas and most bedrooms were seen and the inspector saw records for the running of the business including accident records, maintenance books and fire records and all were in good order. Four care plans were tracked with any relevant information being discussed with the resident or staff team and four staff files were also seen. One did not contain a current Criminal Bureau Check. The medication system was tracked and errors were found in recording. The manager of the home Mrs. Barber was not present but two of the RGN’s Mrs. Smith and Mrs. Sercombe assisted with information. The inspector thanks everyone who assisted during the visit and helped with information regarding the survey. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: To ensure that the home’s procedures protects residents at all times improvements need to be made to the medication recording system and all new staff should undertake a current Criminal Bureau Check or Pova First before commencing work Petworth Cottage Nursing Home DS0000024195.V319725.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. Petworth Cottage Nursing Home DS0000024195.V319725.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 Petworth Cottage Nursing Home DS0000024195.V319725.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. The home provides sufficient information to prospective residents to allow them to make a choice about the home, visits are encouraged and contracts of terms and conditions of residency agreed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a statement of purpose and service user guide in place and two residents and a family member confirmed that they had received these documents when making enquiries about the home. The documents have recently been updated to reflect the changes to the environment and the new address of the Commission. Two residents said that they had visited the home with their families, prior to moving in and had been made very welcome. Trial periods of up to a month can be organised if appropriate. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 10 The manager or a senior nurse visits prospective residents in their present accommodation and carries out a pre-admission assessment. Family members confirmed that they had been included in the process and the assessments were seen on resident’s personal files. As most of the people living in the home are quite unwell, it was not appropriate to question them about receiving contracts but three family members who were telephoned by the inspector, confirmed that they were made aware of fee changes annually, had signed contracts and copies were seen on file. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 11 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. The people living in the home have their needs detailed in a plan of care and receive good healthcare support. To ensure that people are protected by the homes procedures, medication recording should be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: For each person living in the home there is a comprehensive plan of care in place, which has been designed following information from the pre-admission assessment. The plans contained detailed information to guide the staff team to the individual needs of each person and the documents are kept reviewed and updated. As detailed in the last report a number of people are nursed using bed rails and where this is in place risk assessments are compiled and signed agreements are kept on file. This practice must continue to be re-assessed on an individual basis at regular intervals. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 12 During the visit the inspector observed that several people did not have their call bells on their beds. The staff on duty said that this was because they were too unwell to use them. As good practice care plans should contain details of how often people will be observed if they cannot use their call bells. To ensure that individual needs are met the home works with a variety of healthcare professionals including the Macmillan nurses, Tissue Viability nurse and Dietician and records also show that people have access to a Speech Therapist when required. One resident said that they were at present trying to access a Physiotherapist in order to assist with their mobility difficulties. There are policies and procedures in place regarding the storage and administration of medication and only the trained nurses at the service carry out administration. A system has now also been set up for the disposal of unwanted medicines. Medication was suitably stored and there was a record of controlled drugs, which is audited weekly, but a very large number of gaps were found in the current Medication Administration Sheets. To ensure that residents are protected by records being current at all time, a Requirement has been made regarding the recording of medication administration Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 13 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. There are activities available to provide interest and stimulation, visitors are made welcome and people are offered a variety of fresh, home cooked meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Many of the people living in the home are nursed in their rooms and are too unwell to access the community but for those who can and wish to participate, a programme of activities is provided. There was a list of entertainment leading up to Christmas posted in the home and five people were getting ready to go out Christmas shopping supported by staff using the local community transport. There is an ecumenical service at the home every Sunday and a mobile library visits on a regular basis. The people spoken to were happy that their individual lifestyle choices were respected and said that they were treated with dignity and respect. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 14 Visitors are made welcome at any time and were very complimentary about the care provided and the way they are kept involved in their relatives care. There is a variety of fresh home cooked food provided and people said they were very happy with the quality and choice of meals. Lunch, which was the main meal of the day, was lamb hotpot, cabbage, sweet corn and new potatoes with rice pudding and apricots to follow and alternatives and specialist diets were catered for. Some people also said that they had enjoyed bacon and eggs for breakfast. People chose whether they sat in their rooms or the dining room to eat and one visitor joins his wife every day for lunch at a small financial cost. Petworth Cottage continues to have a large number of volunteers who provide support and fundraising for the home and residents said that they enjoyed their company each day. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 15 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. The people living in the home and their families can be confident that any concerns or complaints will be dealt with in a timely manner and work practices and staff training are designed to protect residents from risk of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place, a copy of which is displayed in the entrance hall next to the signing in book so that all visitors are made aware of the process to follow if they have a concern. All of the family members spoken to were aware of the complaints procedure and said they felt confident that the manager of the home would take any concerns very seriously and deal with them immediately. Comments from residents included, “ It is pleasant here, extremely pleasant and I have no complaints, if I had I would go to the manager”, and “If I had a complaint matron would soon find out what the problem was and put it right”. Most of the staff team have now attended training in the protection of vulnerable adults from abuse and the staff members on duty were aware of the procedure to follow should they suspect an abuse of any kind had taken place. A regular agency person said, “I have received abuse training and would report any concerns straight away. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 16 Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 17 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 excellent. The home provides a comfortable, clean and safe environment for the people who live there and residents are happy with their private space. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Petworth Cottage provides an attractive, warm, well-maintained and homely environment for the people who live there. The new unit has now been completed and provides much improved facilities such as en-suite bathrooms, wide accessible corridors and easy access to rooms. Communal space is attractively furnished and well maintained and people said they were very happy with the facilities provided. There is a light airy dining room and people said they especially liked sitting in the sunny conservatory overlooking the South Downs. There is also an attractive garden, which people said they enjoyed in better weather. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 18 The relative of a person living in the home said, “ Nothing at all adverse about the home, I visit every day and the home is very clean and staff are very kind indeed. Private bedrooms are comfortable and warm and have been personalised with belongings brought to the home by the people living there. One person said they were very happy to have been able to bring some of their furniture with them and also were glad to have their own telephone installed in order to keep in touch with family and friends. Sufficient bathing facilities are available including specialist assisted baths, shower rooms and toilets and equipment to assist mobility such as hand rails, grab rails and hoists are also situated throughout the building. The home was very clean and hygienic throughout. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 19 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. The people living in the home are supported by a committed, caring and welltrained staff team but recruitment procedures need to be improved regarding Criminal Bureau Checks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were six carers, two RGN’s and four ancillary staff on duty and the number of people available was sufficient to meet the needs of the current resident group. The staffing rota showed that one trained nurse and two carers are available during the night. Where the home needs to employ agency staff to provide cove, these are people who work at the home regularly and are aware of the needs of the people they support. An agency staff member on duty at the time of the visit said, “This is a good, well-run home with all of the necessary equipment in place. The staff are very good and very supportive. Both the people living in the home and their families were very complimentary about the staff team and the level of care provided in the home. Comments included, “The staff here work extremely hard and are very good to us. I have no complaints”, “This is a very nice home, everything is here for you and the Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 20 staff are very, very good” and “This is a very good home, the food is always nice and the manager and staff team are very efficient and kind to people”. Each staff member has a training record in place and courses recently undertaken include, nutrition, infection control, dementia care and fire training. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 21 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. The home is managed by a competent and committed manager and in the best interests of service users. Policies and procedures are in place but to ensure the safety of residents at all times, medication recording and staff recruitment procedures need improvement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home Mrs. Barber was not present during the visit but the people living in the home, staff members and families spoke highly of her skills and dedication and said that she was “hands on”, accessible and supportive. There is evidence in the training files that Mrs. Barber continues to update her skills and knowledge and she is at present undertaking the Registered Manager’s Award. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 22 A quality assurance process has been started by questionnaires having been sent to families and professionals involved with the home. Mrs. Sercombe said that the manager was now going to collate the returned results and publish the outcomes in order to ensure that the future plans for the home involves all stakeholder views of the service provided. The staff on duty confirmed that they receive supervision on a regular basis, but as the manager was not present records were not available. Records for the running of the business were seen including accidents reports, maintenance records, fire equipment testing and staff fire training records and these were in good order. The current gas certificate, electrical appliance testing certificate and call bell maintenance certificate could not be located during the visit and Mrs. Sercombe said that she would ask the manager to send copies to the Commission as soon as possible. There is a very high commitment to health and safety in the home, but as previously stated, in order to ensure that people are protected by the homes procedures at all times Requirements have been made in respect of medication recording and Criminal Bureau Checks. Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 23 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 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 4 3 3 X X 3 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 3 X 3 X X 3 3 2 Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13 Requirement To ensure that residents are protected by the homes medication procedures medication recording sheets should be signed and current. New staff should only commence work following a currant criminal Bureau Check having been carried out. Timescale for action 30/12/06 2 OP29 18 30/12/06 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 Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Petworth Cottage Nursing Home DS0000024195.V319725.R01.S.doc Version 5.2 Page 26 - 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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