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Inspection on 16/02/06 for Prestwood (Main House) Nursing Home

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

This inspection was carried out on 16th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Care planning processes were well documented and organised. Health care needs were met very well. Service users were confident that their views were listened to and taken into account. The environment was clean, bright and comfortable, and able to suit needs. Staff were trained and competent to carry out their jobs and training was comprehensive and up-to-date. Financial processes and practices were robust for the protection of service users. The home was well managed and service users were protected from risk of abuse. Excellent relationships between service users and staff were observed and service users confirmed that they were well cared for at Prestwood House.

What has improved since the last inspection?

Both the ground floor and the lower floor had been redecorated throughout and new carpet put down in the corridors on the same floors, which had created a bright and fresh environment for the service users. No requirements or recommendations were outstanding from the previous inspection.

What the care home could do better:

One requirement was raised as a result of this inspection to remove all wedges from fire doors to prevent them closing.

CARE HOMES FOR OLDER PEOPLE Prestwood (Main House) Nursing Home Main House Prestwood Stourbridge West Midlands DY7 5AL Lead Inspector Lynne Gammon Unannounced Inspection 16th February 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 Prestwood (Main House) Nursing Home DS0000022361.V280975.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. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Prestwood (Main House) Nursing Home Address Main House Prestwood Stourbridge West Midlands DY7 5AL 01384 877440 01384900 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 Mrs Jayne Elizabeth Tatler Care Home 59 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (59) of places Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. OP Minimum age 60 years 2 beds for persons with a minimum age of 55 Date of last inspection 10th August 2005 Brief Description of the Service: Prestwood House provides full nursing care, given by fully trained care staff and registered nurses. The service is for older people requiring nursing and residential care; there are also two beds available for elderly dementia care. There are 59 beds available organised on three floors, occupying a delightful rural position on the 48-acre Prestwood Estate. The home is situated off the main A449 close to the village of Kinver with good road connections. Service users enjoy the well-tended gardens and views of the extensive countryside. The Prestwood site accommodates both the Main House and the Coach House annex, sharing utility resources, and a level of joint managerial control, at times of emergency staff coverage is available. The principle aim of the Home is to add life to years not years to life. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried on out 16th February 2006 at 9.30am using 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 seven hours. The inspection included a tour of the home, inspection of records, observation and discussions with service users and staff. Since the last inspection on 10th August 2005, no complaints nor any incidents or reports of abuse of any kind had been received. What the service does well: What has improved since the last inspection? Both the ground floor and the lower floor had been redecorated throughout and new carpet put down in the corridors on the same floors, which had created a bright and fresh environment for the service users. No requirements or recommendations were outstanding from the previous inspection. Prestwood (Main House) Nursing Home DS0000022361.V280975.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. Prestwood (Main House) Nursing Home DS0000022361.V280975.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 Prestwood (Main House) Nursing Home DS0000022361.V280975.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): 1, 2 and 4 The Statement of Purpose and Service User Guide were informative and detailed to provide sufficient information to prospective services to make an informed decision about the home. Contracts were in place for each service user and they received confirmation that the home could meet their needs prior to moving in. EVIDENCE: The Statement of Purpose and Service User Guide provided clear and detailed information about Prestwood House and the services it provided to enable prospective service users to determine if the home was suitable to meet their needs prior to moving into the home. The ‘Terms of Business’ was examined and contained details regarding: medication, moving and handling legislation, alcohol and smoking, laundry services, no-restraint policy, cot sides, fire procedures, termination, services covered by fees, those items/services not covered by the fees, hospital appointments, complaints procedure etc. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 9 A standard letter used to confirm to service users that the home could meet their needs following an assessment was examined and found to be satisfactory. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 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 and 11 Care planning processes within the home were clear and consistent to adequately provide staff with the information they needed to meet service user’s needs satisfactorily. Health care needs were met very well and service user’s needs at the time of their death were treated with dignity and respect. EVIDENCE: Three service user care plans were examined and found to be detailed and well organised to provide staff with information to understand and meet individual needs. Care plans were reviewed monthly and risk assessments were completed as required and also reviewed monthly. Health care needs were met very well and service users had access to a range of other health care professionals, such as GP, District Nurse, Chiropodist, Phlebotomist, etc. Comprehensive wound care records evidenced very good nursing care. The home had instigated a ‘Last wishes’ form which was seen on a care plan, signed by the relative and detailed, in a very dignified and sensitive manner, the ‘end of life’ requirements for the individual service user. Prestwood (Main House) Nursing Home DS0000022361.V280975.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 and 14 All key standards were inspected at the previous inspection on 10th August 2005 and found to be satisfactory. A range of activities continued to be provided for the service users and service users confirmed that they were supported to make their own decisions and choices within their everyday lives. EVIDENCE: Discussion with the activities co-ordinator and service users and relatives confirmed that a variety of activities were provided for the benefit of the service users. Photographs of service users enjoying Christmas activities were seen, and the home had a service user who was a local celebrity artist and copies of her work were also shown around the home. Other service users participated in art classes within the home and these were also displayed around the lower floor of the home. The activities co-ordinator organised visits from a number of entertainers to the home and outings for the service users. Visitors to the home included a volunteer who obtained computers for the service users and taught a number of them the rudiments of information technology. Some of the service users used the computers to type up letters to family members or businesses and others used them to type up their life stories. Future visits had been planned from Kinver Brownies, local schools and Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 12 choirs to entertain the service users. The activities co-ordinator was also qualified in teaching ‘chair aerobics’ which was available to the service users. Previous outings had included trips to: Clent, Bridgnorth, Tuck Hill, Garden Land, Clent nurseries and Garden village. On the day of the inspection, a number of service users were going out on a trip to Hartley Arboretum and one gentleman spoken to said he was really looking forward to it. Discussions with service users and relatives confirmed that service users were supported and enabled to make their own choices throughout their day–to-day lives. One service user said that she preferred to stay in her room rather than mix with the other service users and staff co-operated with this request. Prestwood (Main House) Nursing Home DS0000022361.V280975.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, 17 and 18 A satisfactory complaints procedure was in place and service users felt that they were listened to and action was taken to resolve their issues. Service users were supported and enabled to participate in the electoral process and were protected from abuse by the home’s Adult Protection procedure and training on abuse awareness. EVIDENCE: Both the Commission and the home had not received any formal complaints since the last inspection. Service users confirmed that they did not have any complaints but felt if any complaints were raised, the registered manager and staff would make every attempt to resolve them as far as possible. One relative raised some issues during the inspection and the registered manager confirmed that these would be looked into and actioned. The registered care manager confirmed that service users were able to take part in the electoral process by postal vote if they so wished. Local Councillors attended the home during election time and spoke to the service users, also arranging transport to take them to the polling station if required. There had been no incidents or allegations of abuse received by the home or the Commission for Social Care Inspection. The home had an Adult Protection procedure and all staff undertook regular abuse awareness training. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 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 the following standard(s): 21, 23 and 25 Sufficient toilet and washing facilities were available and rooms were suitable to meet the needs of the service users. The home provided a comfortable and clean environment for the benefit of the service users. EVIDENCE: Toilets and washing facilities were satisfactory throughout the home and very clean. The dimensions and layout of the rooms within the home were suitable to meet the needs of the service users. Rooms were comfortable and individually personalised, wardrobes were restricted, radiators covered and emergency lighting was in place throughout the home. The corridors were found to be free from obstruction and well lit and the home provided a safe environment for those who lived there. Both the ground floor and the lower floor had been redecorated throughout and new carpet put down in the corridors on the same floors, which had created a bright and fresh setting for the service users. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 Staffing levels were sufficient to meet the needs of the service users. Service users were cared for by skilled and trained staff that were competent to carry out their roles. EVIDENCE: There were 45 service users living in the home on the day of the inspection. The registered care manager, also the Director of Nursing Services was on duty all day plus two registered nurses and 10 care assistants in the morning, and one registered nurse and eight carers in the afternoon. On night duty, there was one registered nurse and three carers. These staffing levels were deemed satisfactory for the number of service users living in the home at the time. The inspector examined the training records detailing the type and frequency of training undertaken by the staff within the home. Statutory training had taken place for all staff throughout 2005 – examples of this were: manual handling 25.11.05, safe working practices in April and June 2005, Fire Safety Awareness May and October 2005, Fire Drill December 2005, COSHH June 2005 etc. Other training which had taken place was: Continence Management October 2005, Infection Control May 2005, First Aid at Work February 2005, Bereavement October 2005 and Cultural Awareness March 20005. Abuse Awareness training also took place for all staff annually. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 16 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, 34, 35, 37 and 38 The registered care manager was an experienced professional and of good character. Financial accounting and recording within the home was robust to safeguard service user’s financial interests. Records held were accurate and secure and policies and procedures were in place to protect the rights of the service users. The health, safety and welfare of the service users and staff needed to be more stringent to provide on-going protection for everyone in the home. EVIDENCE: The Director of Nursing, also the registered care manager of the home was a qualified nurse and very experienced in managing her responsibilities and staff to meet the needs of the service users in the home. Good relationships between the registered manager and the service users were observed and it was clear that she knew them well. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 17 Suitable accounting and financial procedures were in place and individual service user financial records were inspected. All written records of transactions were maintained and appropriate records and receipts were kept. Policy and procedural documentation was examined and found to cover a wide range of topics to enable staff to improve their knowledge. The registered manager confirmed that these documents were in the process of being reviewed. During the inspection, it was noted that door wedges were being used to prevent fire doors from closing and it is a requirement of this report that this practice ceases and either doors are closed or retainer door guards that meet the requirements of the Fire Authority are put in place to ensure the safety of the service users and staff. Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 18 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 X 10 X 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X X 3 X 3 X 3 X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X 3 3 X 3 2 Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 19 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 OP38 Regulation 23 (4) Requirement Door wedges to be removed from all fire doors to prevent them closing to ensure the safety of the service users and staff. Timescale for action 16/02/06 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 Prestwood (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 20 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 (Main House) Nursing Home DS0000022361.V280975.R01.S.doc Version 5.1 Page 21 - 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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