Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 02/11/05 for Prestwood (Coach House) Nursing Home

Also see our care home review for Prestwood (Coach House) Nursing Home for more information

This inspection was carried out on 2nd November 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The statement of purpose and the service user guide was detailed and provided sufficient information about the service provided to enable prospective service users to make an informed decision about moving into the home. Service users were encouraged to maintain contacts with family and friends and visitors were welcomed to the home. The kitchen was clean and tidy and temperature recordings were accurate and up to date. Service users confirmed that they were able to make their own decisions about their day-to-day lives. Training and policies and procedures in abuse awareness ensured the on-going protection of the service users. The home and the Commission had not received any complaints or allegations of abuse. The environment was pleasant and comfortable for the service users and provided a safe place to live. The home was very clean and bright. Recruitment and selection procedures were robust for the protection of service users. Health, safety and welfare of service users and staff were promoted and protected.

What has improved since the last inspection?

Daily reports were completed and provided a meaningful record of the current status of each service user. Recruitment and selection procedures were more robust and staff files contained all required elements as set out in the Care Homes Regulations 2001 and the National Minimum Standards.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Prestwood (Coach House) Nursing Home Coach House Prestwood Stourbridge West Midlands DY7 5AL Lead Inspector Lynne Gammon Unannounced Inspection 2nd November 2005 09:45 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 Prestwood (Coach House) Nursing Home DS0000022362.V267916.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. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Prestwood (Coach House) Nursing Home Address Coach House Prestwood Stourbridge West Midlands DY7 5AL 01384 877111 01384 877900 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) Completelink Limited Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (40), Physical disability of places over 65 years of age (40) Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. OP Minimum age 60 years PD Minimum age 60 years Date of last inspection 1st June 2005 Brief Description of the Service: Prestwood Coach House occupies a delightful rural position on the 48 acre Prestwood Estate. The home is situated off the main A449 close to the village of Kinver, which can be accessed by the local volunteer transport. Service users enjoy the well-tended gardens and views of the extensive countryside. The home provides full nursing care given by fully trained care staff and registered nurses. The home caters for long-term service users over 65 years of age and for short-term visitors staying for respite or convalescence. Stays can be long or short term. The beds are organised over two floors and the home has 20 single and seven double rooms for married couples or those who prefer to share. Three rooms which were previously double rooms have been converted to single rooms for the foreseeable future. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was made on 2nd November 2005 at 9.45 am. The inspection was carried out by one inspector who used the National Minimum Standards for Older People as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to nine hours. Two registered general nurses were in charge of the home on the day of the inspection, and were present throughout the inspection which included a tour of the building, inspection of records, observation, and discussions with service users and staff. The inspector also met with two of the Directors of the home at the end of the inspection. There were 33 residents living in the home at the time of the inspection, of which most were nursing clients. Since the last inspection on 1st June 2005, there had not been any complaints or incidents of alleged abuse received by the home or the Commission for Social Care Inspection. No requirements and recommendations against the regulations or minimum standards were outstanding from the last inspection report. Prospective service users were provided with sufficient information to make a decision about the suitability of the home following an assessment and received confirmation that their needs could be met. Care planning processes had not been maintained to the standard of the previous inspection and for those care plans sampled, reviews had not taken place for some time. However, service users confirmed that they were treated with dignity and respect and they and two relatives spoken to, were happy with the quality of care provided by the staff. A safe environment had been maintained for the service users and the home was well maintained, comfortable and spotlessly clean. The kitchen was also very clean and tidy a variety of menus were available to meet a range of needs for the benefit of those living in the home. Service users were able to make their own choices and decisions about the day-to-day activities within the home and robust recruitment and selection processes for permanent staff were in place for the protection of service users. The same robustness should be given to agency staff employed within the home. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Six requirements were raised as a result of this inspection as follows: • • To review all care plans and develop more comprehensive plans which should be subjected to ongoing monthly reviews or more frequently if necessary. To undertake pertinent risk assessments for each service user and review monthly. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 7 • • • • For staff to receive refresher training in the administration of medicines to ensure that stringent recording takes place at all times. To put in place a sample signatures list of those permanent and agency staff authorised to administer medication and ensure that this is kept upto-date. To repair or replace a bath in an assisted bathroom which had worn enamel. Receipts must be given and copies kept of every financial transaction that takes place within the home for the protection of service users and staff. Three recommendations were also raised as a result of this inspection as follows: • • To obtain a signed consent form from the individual service user or their relative for the use of bed rails. For the home to ensure that the training agency identifies the relevant year that the training record represents, includes the date of each completed training event for each agency staff member and a nominated person within the nursing agency to sign to authorise the training record. For staff and relatives/service users to sign and date receipts for the transfer of monies and/or valuables and a copy to be held by both parties. • 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. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 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 Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4. The statement of purpose and service user guide provided adequate information for prospective users to enable them to make an informed decision about the suitability of the home. Contracts and confirmation that their needs could be met were provided to service users prior to moving into the home. EVIDENCE: The Statement of Purpose and Service User Guide was examined and provided informative and detailed documentation to assist potential service users when considering moving into the home. The inspector observed a sample of the standard occupancy contract and the terms and conditions within it were seen to contain all required elements as set out in the National Minimum Standards for Older People. Confirmations that individual needs could be met were provided prior to the service users moving into the home. Prestwood (Coach House) Nursing Home DS0000022362.V267916.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): 7, 8, 9 and 11. The care planning processes did not provide enough information to enable staff to have a full understanding of service user’s needs and reviews did not take place regularly. Service users had access to a range of health professionals. The administration of medication needed to be more robust for the protection of service users. Service users were treated with dignity and respect at all times within the home. EVIDENCE: Three individual care plans were examined and seen to include limited activities of daily living which, according to the records, had not been reviewed for some months. This information was not adequate to enable staff to have a detailed and clear understanding of service user’s needs and how those needs should be met and should be reviewed monthly. It is therefore a requirement of this report that all care plans be reviewed, more comprehensive care plans be developed and are subjected to ongoing monthly reviews or more frequently if necessary. One service user had bed rails in place but records did not contain a completed risk assessment for the use of bed rails or a consent form completed by the service user or relative. It is a requirement of this report that pertinent risk assessments are completed for each service user and Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 11 reviewed monthly. It is also recommended that a signed consent form be obtained from the service user or relative for the use of bed rails. On a positive note, records evidenced that service users had access to a range of other health professionals and daily records were well documented and meaningful. Some care plans evidenced the wishes of service users for the time when they were in their last days to ensure that the quality of care could be maintained and their needs met, respectfully and with dignity. Documentation for the receipt, storage, administration and disposal of medicines was examined and a few gaps were identified in regard to the recording on the Medication Administration Records. This was identified at the last inspection and it is a requirement of this report that staff receive refresher training in the administration of medicines to ensure that stringent recording takes place at all times. Controlled drugs were checked and were accurately recorded and secured. No signature list was available of those permanent staff authorised to administer medication and the signature list of agency staff authorised to administer medication was in need of updating to include the agency nurse on duty of the afternoon of the inspection. It is a requirement of this report that these signature lists are put in place and kept up-to-date. Prestwood (Coach House) Nursing Home DS0000022362.V267916.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): 14 and 15. Service users were supported and encouraged to maintain contact with family and friends and to make their own choices about their day to day lives. Menus were varied and nutritious to meet the dietary needs of the service users. EVIDENCE: During the inspection, it was observed that family and friends were openly welcomed and service users were encouraged to maintain contact with them. They also confirmed that they could choose to stay in their rooms for meals if they so wished and get up and go to bed at times to suit them. During the inspection, the kitchen facilities were examined and the catering supervisor was on duty during the inspection. Catering records were examined and evidenced that the dietary requirements of service users were met. The catering supervisor when asked said that fresh good quality food from local suppliers was delivered on a weekly basis and provided to the Coach House each day from the Main House. The kitchen was spotlessly clean and tidy. Fridge, freezer and food probe temperatures were undertaken regularly and correct. Storage areas were clean and tidy. Menus were rotated every four weeks and the catering supervisor confirmed that these were currently being reviewed and service users were to be consulted about the variety and type of Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 13 food available. Lunch was served during the inspection and the inspector observed help being given to people unable to feed themselves in a dignified and respectful manner. Discussion with service users identified that a number of them enjoyed their meals in their own room, on a tray and the inspector noticed that fruit was available in reception for service users throughout the day. One relative commented to the inspector as follows: ‘staff are very nice, very good’ and ‘ the food is excellent’. Prestwood (Coach House) Nursing Home DS0000022362.V267916.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): 17 and 18. Service users were enabled to exercise their legal rights and participate in the electoral process. Service users were protected from abuse by the home’s Adult Protection procedure and training on abuse awareness. EVIDENCE: The nurses in charge of the home on the day of the inspection confirmed that service users were enabled to vote during local and national elections if they so wished and voting cards were sent to the home by the local authority to enable service users to have a postal vote as necessary. Abuse Awareness training had taken place for staff during October 2005 and the Protection of Vulnerable Adults procedure was seen to contribute to the ongoing protection of service users. Prestwood (Coach House) Nursing Home DS0000022362.V267916.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): 25 and 26. The home was suitable for the service users and the home provided a safe, comfortable and very clean environment for them. EVIDENCE: Documentation and a tour of the home evidenced that the building was safe and extremely comfortable for the service users. The rooms were well maintained, bright and homely. The conservatory was a particularly pleasant area for the service users and contained a number of books and games. Only one area was identified as in need of attention, and this related to a bath in an assisted bathroom that had worn enamel. It is a requirement of this report that this is repaired or replaced as soon as possible. Water temperatures were checked regularly and when tested, the inspector found that the water had been maintained to the correct temperature. Equipment was seen as having regular servicing e.g. the hoist was serviced in October 2005. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 16 The heating was centrally heated and rooms were individually and naturally ventilated with well maintained windows. All pipe work and radiators were guarded and lighting in bedrooms was domestic in character. The home was very clean and mal odour free. Prestwood (Coach House) Nursing Home DS0000022362.V267916.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): 29 Recruitment and selection procedures for permanent staff were robust to ensure the on-going protection of the service users and the same robustness should be applied to the use of agency staff. EVIDENCE: The recruitment and selection procedures within the home for permanent staff were robust and provided ongoing protection for service users. Two staff files were examined and one contained an application form, CRB clearances, two references and details of qualifications and training. The second file included all of the required elements but was awaiting the return of the CRB check before the new member of staff could commence employment. Proofs of identity were also held on each file including a recent photograph of the individual member of staff, and the management of the home were to be credited for the well-documented and thorough approach to ensuring the protection of those living within the home. The nursing agency that provided staff to Prestwood Coach House on occasions had provided a training record of those staff used on a regular basis by the home. However, this record was not dated i.e. the relevant year, and did not provide details of when the individual training took place and therefore, did not provide a full picture of the current training status of those agency staff. It is recommended that the home ensure the training agency identifies the relevant year that the training record represents, includes the date of each completed training event for each agency staff member and a nominated person within the nursing agency signs to authorise the training record. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 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 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): 34, 35, 37 and 38. Financial accounting and recording needed to be more robust to safeguard service users financial interests. Records held were accurate and secure. The health, safety and welfare of service users were protected at all times. EVIDENCE: Discussion with the nurses in charge and examination of financial records confirmed that reasonable accounting and financial procedures were in place and records and amounts of service users pocket monies were accounted for and kept secure. However, it is a requirement of this report that receipts are given and copies kept of every financial transaction that takes place within the home for the protection of service users and staff. It is recommended that staff and relatives/service users sign and date receipts for the transfer of monies and/or valuables and a copy to be held by both parties. It was observed that insurance cover was in place to a minimum of £5 million and all Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 19 records for the protection of service users were kept secure, up to date and in good order. The health, safety and welfare of the service users and staff were protected and a variety of records were examined including fire safety records which showed that weekly fire alarm testing took place, fire drills were carried out and frequent staff training sessions took place. Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 X X X X X X 3 3 STAFFING Standard No Score 27 X 28 X 29 4 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 2 X 3 3 Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 21 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 OP7 Regulation 15(2)(b) Requirement To review all care plans and develop more comprehensive plans which should the current condition and needs of the individual be subjected to ongoing monthly reviews or more frequently if necessary. To undertake and record pertinent risk assessments for each service user and review monthly For staff to receive refresher training in the administration of medicines to ensure that stringent recording takes place at all times. To put in place a sample of signatures list of those permanent and agency staff authorised to administer medication and ensure that this is kept up-to-date. To repair or replace a bath in an assisted bathroom which had worn enamel. Receipts must be given and copies kept of every financial transaction that takes place within the home for the DS0000022362.V267916.R01.S.doc Timescale for action 02/11/05 2. OP7 15(2)(b) 02/11/05 3. OP9 13(2) 01/03/06 4. OP9 13(2) 02/11/05 5. 6. OP25 OP35 13(4) 17(2) 01/03/06 02/11/05 Prestwood (Coach House) Nursing Home Version 5.0 Page 22 protection of service users and staff. 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 OP7 OP29 Good Practice Recommendations To obtain a signed consent form from the individual service user or their relative for the use of bed rails. For the home to ensure that the training agency identifies the relevant year that the training record represents, includes the date of each completed training event for each agency staff member and a nominated person within the nursing agency signs to authorise the training record. For staff and relatives/service users to sign and date receipts for the transfer of monies and/or valuables and a copy to be held by both parties. 3. OP35 Prestwood (Coach House) Nursing Home DS0000022362.V267916.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Prestwood (Coach House) Nursing Home DS0000022362.V267916.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!