Inspection on 20/02/06 for Preston Private Nursing Home

This inspection was carried out on 20th February 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

Preston Private Nursing Home 11/12/08

Preston Private Nursing Home 29/05/08

Preston Private Nursing Home 24/07/07

Preston Private Nursing Home 20/09/06

Preston Private Nursing Home 15/06/05

Preston Private Nursing Home 13/01/05

Preston Private Nursing Home 12/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Preston Private Nursing Home Midgery Lane Fulwood Preston Lancashire PR2 9SX Lead Inspector Mrs Lynne Lynch Unannounced Inspection 20th February 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Preston Private Nursing Home Address Midgery Lane Fulwood Preston Lancashire PR2 9SX 01772 796801 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) www.craegmoor.co.uk Parkcare Homes (No. 2) Limited Edward Poland Care Home 106 Category(ies) of Dementia (33), Old age, not falling within any registration, with number other category (55), Physical disability (18) of places Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The registered person may accommodate up to a maximum of 73 older people when not using those places designated for persons with a physical disability The total number of persons accommodated in the home at any one time shall not exceed 106 The home must not accommodate any service user under the age of 40 years 15th June 2005 Date of last inspection Brief Description of the Service: Preston Private Nursing Home is owned by Parkcare Homes, and is registered with the Commission for Social Care Inspection to accommodate 106 service users, male or female, with general medical needs, aged 40 years and over, and for those with dementia aged 50 years and over. The home is a purpose built single storey building and care is provided in four units, each with its own lounge/dining facilities and own kitchen area. There are ninety single bedrooms of which 23 have en-suite facilities, and eight double rooms of which one has an en-suite facility. The home is set in its own grounds and has extensive well maintained gardens and a parking area. Preston Private Nursing Home is located in a rural area of Fulwood, Preston and is relatively close to shops and local amenities. It is situated on a bus route into Preston town centre. Service users are encouraged to maintain their links in the community, and every effort is given to ensuring that relationships, hobbies and interests are pursued. Activities are organised by the diversional therapists and in-house entertainment and outings are organised for those service users who wish to participate. Relatives, friends and visitors are made welcome at the home. The home has small kitchen areas for the use of service users and visitors. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.30 a.m. Two inspectors carried out the inspection over six hours. The inspectors spoke to eight residents, two relatives, four members of staff and the manager. Part of the inspection was spent looking at medication records, menus and staff training records together with the homes policies and procedures. Records in respect of safe working practices were also examined. A full tour of the building was also carried out. At the time of the inspection there were 89 residents Comment cards were distributed prior to and during the inspection with six relative comment cards being received back. What the service does well: What has improved since the last inspection? A training matrix is now in place to ensure all staff training can be tracked and that some staff do not miss refreshing mandatory training. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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 Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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): None of the above standards were inspected at this visit. EVIDENCE: Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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 the following standard(s): 9 and 10 The medication procedures are robust however good practice is not consistently followed when recording medication that is delivered into the home. Resident’s right to privacy is upheld. EVIDENCE: The recording of medication was examined and found to be generally correct, however it was noted that whilst controlled drugs were being stored correctly a new supply of a controlled drug recently delivered to the home had not been recorded in the controlled drug register. The manager gave his assurance that staff would rectify this matter forthwith. In addition a small number of signature omissions were noted on the MAR sheets. It is further advised that a clear record is maintained of all medication not given or refused, if a key coding system is to be used then details of the key code (i.e. R= Refused) must be clearly stated. Medication is stored in a secure facility and fridge and room temperatures are now being monitored and recorded. Only trained and qualified staff administer Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 10 medication and to ensure that medication is administered as prescribed the times that medication is to be administered is highlighted on the Medication Administration Record. It is however recommended that all residents that have chosen to be responsible for their own medication be closely monitored. Unused medication is appropriately disposed of by the use of a ‘Doop Kit’, which is the recommended form of disposal as advised by the Royal Pharmaceutical Society. Most rooms are currently used as single occupancy, all personal care is provided in the resident’s own room. One relative advised via a comment card that they felt some of the towels in the home were becoming threadbare and required replacing. A pay phone is available, and some residents have a personal telephone in their rooms. All residents are addressed by their preferred name, evidence of this was observed through out the inspection. All staff are instructed throughout their induction training of how to respect the residents privacy and dignity. Senior staff who monitor and supervise the staff group then reinforce good practice in this area. The inspector witnessed a number of good practice issues, one being an incident of a gentleman who became upset whist at the dinning room table. A staff member sensitively and calmly went up to the gentleman and asked if he wanted to return to his room to finish his meal. One resident informed the inspector “I get bath’s here and staff are respectful to me when they help me. The inspectors observed interaction between staff and residents and can confirm that residents were treated sensitively and respectfully. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14 and 15 Both meals and activities are well managed and co-ordinated. EVIDENCE: A dedicated chef makes meals on the premises. From discussion with the chef it was evident that he prefers to make all meals from fresh produce and enjoys producing meals that the residents enjoy. At the time of the inspection the chef was observed talking to a resident about how a boiled egg should be cooked. The chef explained to the inspector that this resident is extremely pedantic about her food and he often chats to her to ensure she remains satisfied. The menus were inspected and found to provide a varied and balanced diet, however one relative via a comment card thought that too many meals had a high carbohydrate content. The chef was able to confirm he had information about residents with special diets and personal preferences. Meal times are set, although flexible enough to accommodate preferences. Residents spoken to were satisfied with their meals provided, confirming that choice is available at each mealtime. Staff, were observed assisting the more frail residents. This task was carried out in a sensitive and unhurried manner. It was pleasing to note that residents Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 12 requiring a blended diet had their meal presented in a way that retained colour and texture. The home has small kitchen areas for the use of residents and visitors. The routines within the home are flexible and staff support residents to be as independent as their abilities allow. A good range of diversional activities, are on offer in the home, which are organised by dedicated activity co-ordinators. A weekly record of the diversional activities each resident had participated in was available for inspection. These activities were seen to be organised to meet the health and ability of the individual resident. The diversional therapist informed the inspector that outings, including regular pub lunches and in-house entertainment are organised for those residents who wish to participate. The home is to be commended for the range of activities arranged and it was particularly pleasing to find that a planned programme of diversional activities is in place on the unit that accommodates residents suffering from a dementing illness. This provides stimulation and promotes good mental health, which encourages a sense of wellbeing and often reduces episodes of challenging behaviour. Clergy from local churches meet regularly to hold services Evidence was seen during the inspection of open visiting and this was confirmed with visitors. The Statement of Purpose contains information for residents regarding open visiting. There are no volunteers currently working in the Home, however some residents do have an advocate, which is arranged through Age Concern who check the advocates credentials. The home welcomes any community involvement and the local Alzheimer’s Group visit the home regularly. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Good practices and policies are in place to enable concerns to be raised and responded to and to protect residents from abuse. EVIDENCE: The home has a comprehensive complaints procedure, which is contained in the Service User Guide and provided to residents and their relatives upon admission. A copy of this procedure was also seen displayed on the notice board on each of the units in the home. The Commission for Social Care Inspection has received two complaints since the previous inspection, both of which have been dealt with by the registered manager to the satisfaction of the Commission for Social Care Inspection. There have been no vulnerable adult referrals to Social Services. It was pleased to note that the management and staff had received a number of thank you cards from relatives expressing their thanks for the care and attention provided. In the main residents spoken to said that if they had any concerns they would approach the registered manager or staff member. One resident informed the inspector “ I have no worries at all, Mr Poland comes round nearly every day to check if we have any grumbles”. The home has an abuse policy in place, which includes guidance on whistle blowing, abuse of residents and advice for staff on what could be perceived as abusive practice. This policy is easily accessible by staff. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 14 However there is only a small number of staff that have attended the Protection of Vulnerable Adults (POVA) training, management should address this as a matter of priority as it advised that all staff should have this training. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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): 19 and 26 The home is decorated and furnished to a good standard. Good protocols are in place to ensure the risk of cross infection is minimised. EVIDENCE: The Inspector toured the home and found that the physical standards are consistently good throughout the building. A rolling programme of refurbishment is constant which results in a pleasant and well-maintained environment. A Maintenance man is employed to carry out day-to-day maintenance and minor repairs. This ensures a good and safe standard is maintained. In addition a self-employed decorator is employed two days a week on a continuous basis. Residents evidently appreciated their surroundings. One gentleman resident was keen to show the inspector his bedroom and through gestures he was able to show his pleasure at having his bedroom redecorated. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 16 Staff, are encouraged to record any areas that require attention, this record is then viewed by the maintenance man and he dates and signs the record once remedial action has been taken. All radiators were guarded and fail-safe devices are fitted to all hot water outlets, the water temperature is checked regularly and the findings recorded. The communal rooms are spacious, comfortable and furnished appropriately to meet the needs of the residents. The residents’ bedrooms were all individual, reflecting their preferences and containing personal possessions. Specialist equipment was seen around the home ensuring individual needs are met whilst promoting independence. The laundry room is situated in the basement and the facilities ensure that laundry is washed at the appropriate temperatures. Walls and floors are impermeable to minimise the risk of cross infection. The grounds of the home are extensive and well maintained. The home is purpose built and offers ground floor accommodation throughout. The management and housekeeping team pride themselves on the fact that the home always smells fresh. At the time of the inspection the home was found to be warm, thoroughly clean and free from any offensive odours. All staff receive training in infection control and Craegmoor Healthcare is pro active in finding strategies to overcome unpleasant odours. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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): 28 There is a clear commitment to supporting staff to fulfil their potential ensuring people employed at Preston Private Nursing Home have the skills required to meet the needs of the residents. EVIDENCE: There is a good skill mix of staff employed at Preston Private Nursing Home that ensures a holistic approach is adopted to meeting the assessed needs of the residents. There is a clear commitment to the training and development of all staff at Preston Private Nursing Home and all non-nursing staff are expected to embark on the NVQ training programme once they have completed their induction training. Currently 80 of the care staff employed at the home have either a nursing or NVQ qualification. Induction training is provided and staff are provided with a mentor until the registered manager is satisfied that the new staff member is competent to carry out their duties unsupervised. The registered manager ensures that, all staff attend mandatory training in all core subjects. In addition internal and external training is available in a range of subjects ranging from dementia care to Basic English courses for the overseas staff. A training matrix is maintained and examination of this document revealed that training is plentiful and staff are provided with ample opportunities to develop their skills. However there is only a small number of Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 18 staff that have attended the Protection of Vulnerable Adults (POVA) training, management should address this as a matter of priority as it advised that all staff should have this training. Craegmoor Healthcare Ltd employ a number of overseas staff and the registered manager plays an integral part in their adaptation training. Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they receive from the home and were well treated by the staff with one resident commenting, “I don’t think I could be better looked after anywhere else”. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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 and 35 The registered manager is experienced and qualified and demonstrates the skills necessary to manage this large nursing home. Systems are in place to ensure resident’s finances are protected. EVIDENCE: The registered manager is experienced and holds a RMN, RGN, Master of Business Administration and Post Graduate Diploma In Management Studies qualifications. He is supported in his role by a deputy manager and by an external management team. To ensure best practice is applied at all times the registered manager frequently attends further training in a range of subjects ranging from Constipation to Mentorship of adaptation students. This ensures that he has the knowledge to support staff whilst providing evidence for The Nursing and Midwifery Council that he has a continuous personal development programme Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 20 in order to retain his registration number (PIN number) with this professional body. The registered manager is also a key member in the adaptation training provided to overseas nurses that work within the home. Systems are in place to protect resident’s finances. The process for achieving this follows a corporate protocol. This entails all resident’s finances being centralised at the company’s head office. The registered manager has access to a bank account and is able to withdraw cash should a resident request money, however it is usual practice for the home to purchase personal items and pay for hairdressing etc and use an invoicing system. Arrangements have been made with a local supermarket to supply any personal items; staff members compile a shopping list, which is rung through to the supermarket, separate receipts are produced for items purchased. Staff will then deliver the items to the residents and forward the receipts to head office for payment. Management closely monitors this system and it is subject to audit by the company’s internal audit team. To further safeguard the resident’s finances, Craegmoor Healthcare Ltd, has commissioned a consultancy company who advise and monitor a range of business issues including resident’s finances. The inspectors are confident that in relation to safeguarding residents interest s, the system is robust and management apply due diligence in protecting residents interests. The inspectors however support the registered managers initiative in requesting that the home retains a small float of petty cash, which would enable residents to request small amounts of money for their personal use. The manager is to discuss this initiative with his line manager. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X x Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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. 1. Standard OP9 Regulation 13(2) Timescale for action Medication delivered to the home 20/02/06 must be consistently recorded. Requirement 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 OP18 Good Practice Recommendations The manger should ensure that all staff have completed training on the protection of vulnerable adults. Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Preston Private Nursing Home DS0000006073.V284186.R01.S.doc Version 5.1 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. 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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