Inspection on 13/06/06 for Primrose Hill Care Home

This inspection was carried out on 13th June 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

Primrose Hill Care Home 07/08/07

Primrose Hill Care Home 17/10/05

Primrose Hill Care Home 10/05/05

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 Key Unannounced Inspection 13th June 2006 08:30 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 Primrose Hill Care Home DS0000050384.V293009.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. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Primrose Hill Care Home Address Thames Road Huntingdon Cambridgeshire PE29 1QW 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) 01480 450099 01480 454499 Abbey Healthcare Homes Limited Linda Clare Martinez Care Home 60 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (60), of places Physical disability (5) Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age range of service users with the category of PD (physical disability) is 55 to 65 years of age 17th October 2005 Date of last inspection Brief Description of the Service: Primrose Hill is a purpose built nursing and residential 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 middle floor being a dedicated unit for twenty-three older people with dementia. Each floor contains a large dining/sitting room, two smaller sitting rooms and appropriate bathroom, toilet and shower room facilities. The weekly fees for the home vary between £650 and £700, depending on residents’ needs. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s key inspection for the year 2006/7. It was unannounced. The inspector spoke with five residents, one visiting relative, three members of staff, a student nurse on placement at the home, the administrative assistant and the manager. She also had her lunch with the residents and attended a staff meeting. A brief tour of the home was undertaken and a range of documents was viewed. The inspector also received thirteen comment cards requesting feedback about the home, completed by residents and their relatives. Most respondents were pleased with the overall service provided at Primrose Hill, although one resident felt that bedrooms could be cleaner and another wished for more bingo. One requirement and three recommendations have been made as a result of this inspection. What the service does well: What has improved since the last inspection? This home continues to improve with every inspection (thanks largely to the hard work of the manager) and now offers a good service to the people who live there. The recent purchase of a minibus is a welcome addition, and residents have benefited greatly for the chance to go on trips and excursions away from the home. Nineteen care staff (75 ) have now completed the NVQ level 2 in care which will ensure that residents are looked after by properly trained and competent staff. This is a huge improvement since the last inspection where only one member of staff had completed this award The number of complaints received by the Commission for Social Care Inspection about this home have reduced dramatically in the last year Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 6 indicating that there has been a vast improvement in the overall service provided at Primrose Hill. 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. Primrose Hill Care Home DS0000050384.V293009.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 Primrose Hill Care Home DS0000050384.V293009.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): 1,2,3,5, 6 The outcome in this group of standards is good. The home’s admission procedures are thorough and help residents decide if the home is right for them. EVIDENCE: The home has a Statement of Purpose and Resident Guide that give good information about the home and the services it offers (large print version of these are available to assist visually impaired residents). There is also a brochure available that is given out to residents and their families when they visit. This brochure can also be emailed to prospective residents and their families on request. A copy of the most recent inspection report is available in the entrance way to the home. Visits to the home are encouraged and one visitor told the inspector that although her mother didn’t visit before moving in, she and her brother had. Three residents files were viewed and each contained a comprehensive preadmission assessment completed by the manager, and also contracts that clearly stated what the terms and conditions of residence were. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 9 The home does not provide intermediate care for residents so standard six does not apply. Primrose Hill Care Home DS0000050384.V293009.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): 7,8,9,10 The outcome in this group of standards is good. Care plans set out in detail the action to be taken by staff to ensure that all aspects of health and personal care needs of residents are met. Residents’ health is monitored closely and there is access to a range of health care services. EVIDENCE: Three residents’ care plans were viewed and all contained up to date and detailed information about residents’ health and personal care needs. The plans were reviewed regularly and were kept in residents’ bedrooms, thus allowing residents and their families to view them easily. On admission to the home all residents are referred to a GP who conducts an initial assessment of their needs. Nutritional and pressure risk assessments are completed monthly for each resident, and residents are weighed regularly. Food and fluid charts are completed for residents who require them. The local dietician, and speech and language therapist currently see three residents who are on a PEG feed. A chiropodist and aromatherapist visit fortnightly and an optical health care company visit every six months to test residents’ eyes. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 11 The home has comprehensive policies and procedures in place in relation to medication, and only nursing staff administer it. Drug storage and medication administration records were checked and found to be satisfactory. All residents who completed comment cards prior to the inspection stated that staff maintained their privacy and treated them well. Comments included ‘Everyone is lovely here and I am always treated well’ and ‘everybody is kind’ and ‘staff are very caring to my mother’. One resident was particularly appreciative of her ensuite bathroom and the privacy that gave her. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 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): 12,13,14,15 The outcome in this group of standards is good Activities provide residents with stimulation and interest. The meals in the home are good offering both choice and variety and catering for special needs. EVIDENCE: The home has a busy and well-advertised activities schedule in place, run by an enthusiastic activities co-ordinator who works 20 hours a week. There are also visits from a number of local community groups such as the WI, PAT dogs and a ladies’ choir. A mini bus has recently been purchased and there have been trips out to Duxford Imperial War museum and to the Mayor’s lunch in Huntingdon. A summer fete is planned for the 24 June, as is a trip to Wood Green animal shelter. Residents are able to choose how they spend their day and one resident told the inspector he likes to get up early and spend his day visiting other residents in the home, or enjoying a cigarette in the garden. There is always a choice of menu for lunch and on the day of inspection this was Cornish pasty, pork and apple stew or chickpea stew. In the morning there is a choice of cereal, prunes, fresh fruit, yoghurt or a cooked breakfast. One resident commented ‘sometimes I don’t like the food but they always find me Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 13 something I like’. However, one resident told the inspector ‘my cooked breakfast was a bit cold this morning’. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 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): 16,17,18 The outcome in this group of standards is good Residents can be assured that complaints will be responded to appropriately and thoroughly. The practices of the home ensure that residents are protected. 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 displayed on the notice board in the main entrance. Residents also have an enlarged laminated copy of the procedure in their bedrooms. The home has received three complaints since the last inspection. A record of these complaints was kept, as was the action taken to resolve them. One relative stated on a comment card ‘ I have made one complaint and that was dealt with promptly and resolved’. Residents are able to participate in political processes and a number used their postal votes in the recent May elections. The home has a satisfactory policy in place in relation to adult protectionAvoidance of Abuse (13/11/04) and this contains information about local reporting guidelines. Most staff have undertaken training in the protection of vulnerable adults. There have been two issues regarding the protection of vulnerable adults in the home recently. The manager responded quickly and effectively to these incidents, following all procedures correctly and providing additional staff to ensure residents’ safety. Primrose Hill Care Home DS0000050384.V293009.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, 20,21,26 The outcome in this group of standards is good. Residents live in a comfortable and safe environment where there are good infection control measures in place to protect them. 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 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. However there is no separate area for staff meetings or training to be held. This means that one of the residents’ lounges has to be used, and residents are asked to vacate this lounge when a meeting is held. A new dementia care unit has been created in the middle floor for twenty-three residents. There are a number of aids in place to help residents find their way Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 16 around such as pictorial representations of toilets on bathroom doors and a picture of each resident on their bedroom door. However, long similar looking corridors in this unit reduce staff’s ability to supervise residents and also reduce residents’ orientation. As this unit is on the middle floor there is little opportunity for residents to easily access the garden for fresh air and sunshine without the assistance of staff. Ways of improving this environment were discussed with the manager. There are appropriate infection control measure in place at the home: plastic gloves and aprons for staff to wear are available in each resident’s bedroom; liquid soap and paper towels are available in all communal toilets and bathrooms, and a alcohol gel is available on each floor for staff and visitors to use. Primrose Hill Care Home DS0000050384.V293009.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): 27,28,29,30 The outcome in this group of standards is adequate. Staffing numbers are appropriate to the needs of residents. However, the home’s recruitment procedures do not ensure that residents are fully protected. EVIDENCE: Staffing levels are generally satisfactory and scrutiny of the duty rota showed them to be maintained. However, it was of continuing concern that some staff work excessive hours: in the week beginning 05/06/06 one member of staff worked 75 hours, another 63 hours and another 62 hours. Although these staff are actively willing to work these hours the dangers of allowing them to do so were, once again, discussed with the manager. Interactions observed between staff and residents on the dementia care unit were mostly positive and respectful, and staff intervened quickly and sensitively to a resident when he became aggressive which diffused the situation. On the day of inspection itself the unit was staffed by staff, for whom english is not their first language. Although their care practices were excellent, it was of concern that these staff may not be in the best position to communicate effectively with residents and lack a shared cultural experience and history that is vital when engaging with people with dementia. Records viewed showed that staff receive a range of training specific to the needs of older people and 19 care staff (75 ) have now completed the NVQ level 2 in care. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 18 The personnel files of three recently recruited staff members were viewed. Although each staff member had been CRB checked it was of concern to note that the references supplied were out of date and were not easily verifiable, as they had been written by referees from overseas. All these staff had worked in care homes in the UK prior to working at Primrose Hill, but references from these establishments had not been sought. Primrose Hill Care Home DS0000050384.V293009.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): 31,32,33,34,35,36,38 The outcome in this group of standards is good .The home is run in the best interests of its residents and staff are well supported. EVIDENCE: The manager is qualified, experienced and is clearly committed to improving standards at the home. Staff spoke highly of her approachability and management style. The inspector has also received many positive comments about her professionalism from social services colleagues. Records showed that staff receive regular supervision and those interviewed stated they felt well supported. A sample of residents’ cash sheets and fee payments were checked and found to be in good order. The inspector suggested however that standard receipts are issued for all fee payments received by the home. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 20 Feedback about the service is actively sought from residents and visitors to the home. As well as regular staff and residents/relatives meetings, ‘quality assurance’ leaflets are available in the entrance hall for visitors to fill in. These request comments about the cleanliness of the environment, the quality of staff and care planning .The inspector viewed 11 completed forms, most of which indicated that the respondents were satisfied with the overall quality of care. Records concerning portable appliance testing, gas safety, fire checks, lift and hoist servicing were viewed and found to be in good order. Primrose Hill Care Home DS0000050384.V293009.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 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 2 3 x x x 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 x 3 x 3 Primrose Hill Care Home DS0000050384.V293009.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 OP29 Regulation 7,9,19 Requirement Two up to date and relevant references must be sought for all prospective employees. Timescale for action 13/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP20 OP27 OP34 Good Practice Recommendations Long corridors in the dementia care unit should be made more interesting and homely for residents. Staff should not be allowed to work excessive hours. Standardised receipts should be issued for all payments made to the homes. Primrose Hill Care Home DS0000050384.V293009.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Primrose Hill Care Home DS0000050384.V293009.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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