Inspection on 10/05/05 for Primrose Hill Care Home

This inspection was carried out on 10th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Primrose Hill Care Home 07/08/07

Primrose Hill Care Home 13/06/06

Primrose Hill Care Home 17/10/05

Primrose Hill Care Home 14/09/04

Primrose Hill Care Home 14/06/04

Primrose Hill Care Home 25/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Primrose Hill Care Home Thames Road Huntingdon Cambridgeshire PE29 1QW Lead Inspector Janie Buchanan Unannounced 10 May 2005 @ 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Primrose Hill Care Home Address Thames Road, Huntingdon, Cambridgeshire, PE29 1QW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01480 450099 01480454499 Abbey Healthcare Homes Ltd To be registered Care Home 60 Category(ies) of Dementia-over 65 years (16), Old Age-not registration, with number falling within any other category (60), Physical of places Disability (5) Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The age range of service users with the category PD is 55 to 65 years of age Date of last inspection 14 September 2004 Brief Description of the Service: Primrose Hill is a purpose built home for older people in the outskirts of Huntingdon that has been registered with the Commission for Social Care Inspection since November 2003. It is owned by Abbey HealthCare Homes Ltd who operate a number of homes for older people throughout the country. The home offers 60 single ensuite bedrooms all of which meet the required minimum standards of 12 square metres. Accommodation is provided on three floors with the top floor being a dedicated unit for sixteen older people with dementia. Each floor contains a large dining/sitting room, two smaller sitting rooms and appropriate bathroom, toilet and shower room facilities. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s first inspection for the year 2005/6. It was unannounced. This was a combined inspection with a manager with the social services contracts department. The inspectors each spent 6.5 hours at the home and talked with five residents, one visiting relative, two members of care staff, the activities co-ordinator and the manager. The inspectors also met with a group of four domestic staff at their request. They undertook a brief tour of the home and viewed a range of documents. One additional visit has been made since the last unannounced inspection and information following this visit can be obtained from the CSCI office on request. What the service does well: What has improved since the last inspection? What they could do better: Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 6 Prospective residents should be pro-actively encouraged to spend a full day at the home as part of their formal admission and assessment process. This would allow staff the opportunity to assess prospective residents fully, as well as giving residents the opportunity to experience life in the home. The home’s complaints procedure should be more widely available to residents so that they know how complaints may be made and who will deal with them. All staff must be given the opportunity to meet with their line manager to discuss aspects of their practice and training needs. More care staff must achieve their national vocational qualification in care award so that they have the skills and knowledge to look after older people. 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. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,5 Information available about the home is satisfactory although more must be done to make it widely available to prospective residents so that they have information they need, in a suitable format, about whether or not they want to live there. EVIDENCE: Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 9 The home has a Statement of Purpose and Service User that give detailed information about all aspects of the home. A copy of the most recent inspection report is not included in the guide but it does state that copies of the report are available on the notice board of the home and also on request from the manager. Neither the Service User Guide nor the Statement of Purpose are currently in a suitable format for residents and they should be produced in large print or audio format for visually impaired residents. Residents interviewed by the inspector stated that they had received no written information about the home before being admitted. One resident told the inspector: ‘I was dumped here and knew absolutely nothing about where I was’. Although residents are welcome to visit the home before they move in, very few actually do so. The inspector suggested that the manager invites all residents to spend a full day at the home as part their assessment process. This would ensure that residents’ needs could be fully assessed, and also give residents a chance to experience life at the home. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 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 standard(s) 7,8,10 The health care needs of residents are well met and monitored closely by staff at the home. However some practices in the home do not promote residents’ privacy and right to confidentiality. EVIDENCE: All residents are registered with one of three local GP practices, a chiropodist visits every two weeks and an optical health care company visit regularly to conduct eye tests. The health care needs of residents were well documented in their care plans and there was a record of visits by health care professionals. The care plans were generally up to date, detailed and regularly reviewed. Although not all the plans had been signed by the resident, they were being kept in residents’ bedrooms so that residents and their families can view them at any time. A comprehensive health assessment for each resident is completed on admission and Waterlow, weight and nutrition scores are monitored closely, as are residents’ food and fluid intake. The home has equipment necessary for the prevention and treatment of pressure sores, although the manager stated that no resident currently has a sore. The activities co-ordinator holds regular ‘chairobics’ sessions with residents to promote their exercise and physical activity. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 11 Although all the bedrooms have a telephone point available many residents have chosen not to install a private telephone line and there is no access to a public telephone in the home. In one instance, the manager reported that she had had to lend her personal mobile telephone to a dying resident who wanted to ring her daughter. This is unacceptable and the home must provide residents with access to a telephone for use in private. Daily handovers take place at the nurses’ stations on each level and whilst the inspector was touring the building she could easily overhear staff at this desk talking about residents’ health and personal care needs. The manager must rethink the position of this station to ensure information about residents is kept confidential. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 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 standard(s) 12,15 Social activities and meals are well managed and provide stimulation and interest for people living in the home. EVIDENCE: The home employs a specific activities co-ordinator for 20 hours a week and there is a busy and well-publicised activities schedule in place. Activities are varied and include arts and crafts, cooking, film and reminiscence sessions. One resident reported that there was something to do every day and that she particularly enjoyed the singing and the bingo. The inspector viewed a sample of menus that indicated meals in the home are good, offering both choice and variety for residents. Lunchtime on the day of inspection was relaxed and unhurried, with residents being given plenty time to eat. She also witnessed a number of residents being fed by staff: this was done discreetly and sensitively. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 Complaints are taken seriously and responded to appropriately by the manager. However the complaints procedure must be more widely advertised to residents so they know what do to if they want to raise concerns. EVIDENCE: Details of how to complain are contained in both the Service User Guide and the home’s Statement of Purpose and the complaints procedure is also displayed on the notice board in the main entrance (although this is hard to read and placed at a height inaccessible to wheelchair users). Despite this, residents interviewed by the inspector were unaware of the procedure and were uncertain of what to do if they had any concerns. In light of this, the manager agreed to issue each and every resident with a copy of the complaints procedure in an accessible format. The home has received a number of complaints, however, from both health care professionals and family members concerning the quality of care at the home. These complaints were investigated and responded to appropriately and action taken in their light has led to significant improvements in care practices at the home. However, their number and nature continue to be of concern. Residents are able to participate in the political process and the manager stated that 50 of them voted in the recent election. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,22,23,24 Residents live in a clean and well-maintained environment with specialist equipment in place to promote their mobility and independence. EVIDENCE: Primrose Hill is a large, spacious, modern and ‘hotel style’ home that has been purpose built to meet the needs of older people. The premises were observed to be clean, bright and well maintained, with good quality furnishing and fittings in place. Each of the three floors has its own dining room and two sitting rooms. A smoking room is available for both staff and residents on the first floor. There are a total of four assisted bathrooms and three level access showers and all bedrooms have ensuite facilities. Residents’ rooms were comfortable and personalised. The home has a range of aids and equipment such as grab rails, hoists and raised toilet seats available to promote residents’ safety and independence. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,03 Training for staff has improved significantly for care staff since the last inspection, however training for domestic staff must improve so they too have the knowledge and skills to properly protect themselves and residents. The home’s recruitment procedures for staff have not been robust and have not provided adequate protection for residents living in the home. EVIDENCE: Staffing levels and staff skills mix in the home are adequate to meet the needs of residents: eleven staff are on duty throughout the day for 60 residents, and six staff are on duty at night. Residents commented that staff responded quickly when needed. One resident told the inspector ‘ you’ve only to ring the bell and they come immediately. Staff reported that they felt staffing levels were adequate and they had time to complete their tasks. 85 of the staff are from overseas, primarily India and the Philippines, and concerns have been raised by family members and care professionals about their lack of a shared cultural history with the people they look after. Training for care staff has improved since the last inspection and there has been recent training in nutrition and the elderly, dementia care, PEG feeding, infection control and the protection of vulnerable adults. However, only one member of staff has completed an NVQ level 2 in care and the home has failed to meet the standard that 50 of its staff have this award by 1 April 2005. Training for domestic staff is poor and apart from one session on using cleaning products none of these staff have training in infection control, health and safety, or moving and handling. One domestic assistant told the inspector Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 16 she was aware that some residents had MRSA but that she had been told nothing about this infection. The home’s recruitment and selection procedures have improved since the last inspection but still need to be more rigorous in order to protect residents. Four staff are currently working at the home without their CRB checks having been completed and the manager has only recently been aware of the need to check staff against the POVA register. Bank staff are not issued with terms and conditions of their employment. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36 The manager is competent and experienced in care of older people. However the management structure of the home does not adequately reflect the size of the home, or the volume and complexity of managerial tasks to be undertaken. EVIDENCE: The manager is a registered general nurse with over 20 years experience in a variety of nursing settings, although this is her first post as a manger of a residential establishment. An application to register her with the CSCI has been received. She is clearly committed to improving standards in the home and appears well respected by staff. She has recently started her registered manager’s award and is currently registering with the Commission for Social Care Inspection. The manager is responsible for a huge range of tasks including assessing all prospective residents, organising training, supervising and recruiting staff as well as overseeing the day to day running of the home. The manager stated that she has been working excessive hours recently to fulfil her many management functions and that she has no one to whom to delegate these to. Most care establishments of this size usually employ a deputy to assist the manager in her role. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 18 Regular meetings are held with care staff at the home but these should be extended, and held at suitable times, to include all staff such as domestic and kitchen assistants. Regular supervision must also be given to these staff. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x 2 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x x STAFFING Standard No Score 27 3 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 x 2 3 x x x 2 3 x Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 20 yes 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 28 Regulation 18(1) Requirement The registered person must ensure persons employed to work at the home receive training appropriate to the work they are to perform. 50 of staff must have achieved NVQ level 2 in care The registered person must ensure persons employed to work at the home receive training appropriate to the work they are to perform. Domestic assisstants must receive training in health and safety, moving and handling and infection controil The registered person shall ensure that persons working at the home are approriately supervised. This must also include domestic assisstants Timescale for action 1 October 2005 2. 38 18(1) 1 October 2005 3. 36 18 (2) 1 October 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 1 Good Practice Recommendations The Statement of Purpose and Service User Guide should I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 21 Primrose Hill Care Home 2. 3. 4. 5. 6. 7. 8. 9. 5 10 10 16 20 29 32 33 be made available in a suitable format for intended residents such as large print and audiotape. This is outstanding from the last inspection Prospective residents should spend a day at the home as part of their pre-admission assessment process. Residents should have easy access to a telephone for use in private Daily handovers between staff should be held in an area where information about residents cannot be overheard A copy of the homes complaints procedure should be given to each resident in a format suitable for them Risk assessments should be completed for those residents who smoke Bank staff should receive terms and conditions of employment Regular meetings should be held for all staff members. The management structure of them home should be reviewed to ensure that the manager has adeqaute support to fulfill her role. Primrose Hill Care Home I53 I03 50384 PRIMROSE HILL V224937 100505 STAGE 2.doc Version 1.30 Page 22 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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. 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