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Inspection on 26/09/05 for Priory Paddocks Nursing Home

Also see our care home review for Priory Paddocks Nursing Home for more information

This inspection was carried out on 26th September 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

Priory Paddocks provides a homely and caring environment. The ethos of the home is centred on providing choice for residents and upholding their dignity. During the tour of the building and introductions to several residents the manager expressed respect and recognition of the life and achievements of the residents living at Priory Paddocks. Priory Paddocks has a worker who provides social activities for residents, a full and varied programme is delivered and enjoyed by residents wishing to participate. A crossword activity was taking place on the afternoon of the inspection, which had twelve residents participating; this was a particularly impressive activity. The training package provided for staff working at Priory Paddocks is very good, and provides staff members with the knowledge they require to perform tasks expected of them in their job role effectively. Four staff have attended a manual handling instructors course enabling them to provide moving and handling training to care staff. National Vocational Qualifications of care staff has met the target of 50% staff to achieve at least NVQ level 2 by the year 2005. Staff spoken to said they were happy in their job and several staff stated that they are all a big family at Priory Paddocks.

What has improved since the last inspection?

A requirement from the last inspection identified that hand towels should be replaced with disposable towels in communal washing facilities. This has been done; all communal washing facilities hold paper towels and paper towel dispensers. Three recently employed staff records were viewed, these all held required documentation with regards to employment. This was a requirement from the previous inspection. Heating in a communal bathroom has been repaired; this was a requirement from the previous inspection. A quality assurance exercise has taken place asking for comments from the staff group with regards to the service they provide and are provided with. This has been analysed, and results were made available to the inspector. An action plan is due to be completed by the management of the home and delivered to the staff group.

What the care home could do better:

Two residents bedrooms were found to have unpleasant odours, one was currently being refurbished and cleaned. The resident in the second room has a pet cat and the manager confirmed that the smell was that of the litter tray and that this is in the process of being solved. There should be no unpleasant odours in the home.

CARE HOMES FOR OLDER PEOPLE Priory Paddocks Nursing Home Priory Lane Darsham Saxmundham Suffolk IP17 3QD Lead Inspector Julie Small Unannounced Inspection 26th September 2005 11:00 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 Priory Paddocks Nursing Home DS0000024475.V254065.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. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Priory Paddocks Nursing Home Address Priory Lane Darsham Saxmundham Suffolk IP17 3QD 01728 668244 01728 668306 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) Mr Andrew Burgess Miss Marian Lloyd Miss Marian Lloyd Care Home 37 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (37) of places Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th March 2005 Brief Description of the Service: Priory Paddocks, previously an Edwardian country house, was converted into a nursing home in 1987 by its present owners, who jointly manager the home. It is situated in the village of Darsham, near the A12 and the local railway station. Village amenities include a public house, a garage and a shop. The home is located next to a farm and is set in two acres of landscaped gardens with a summerhouse and ample parking. During the summer months, residents can take advantage of the patio areas overlooking the gardens. Residents can access all areas of the home and gardens via a stairwell, ramps and a passenger lift. The accommodation consists of twenty-three single bedrooms (twelve with ensuite facilities), seven shared bedrooms (three with en-suite facilities) and assisted bathrooms and toilets. Communal space includes two lounges and a dining room. The home has been decorated throughout in keeping with its original style. The two lounges and dining room evidenced many period features, which lent themselves to creating a warm and homely atmosphere. Pets are welcome at the home, which holds two ‘Cinnamon National Pet Friendly Awards’. The home has its own twelve-seated mini bus, with a battery-operated tailgate, which enables easy access for wheel chair users. The bus is regularly used to take residents on trips and outings. The home is co-owned and jointly managed by Miss Marian Lloyd (Registered Nurse) and Mr Andrew Burgess (Registered Nurse). Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Monday 26th September 2005, between the times of 11.00 – 16.20. The joint manager and proprietor Mr Andrew Burgess assisted the inspection, which was undertaken by Regulatory Inspector Julie Small. Mr Burgess confirmed that service users at Priory Paddocks are referred to as residents; this term will be used throughout the report. Methods, which were used to inspect Priory Paddocks, included viewing three staff records, three resident records and staff training records. Six staff, four individual residents, a group of twelve residents and one visitor was spoken to during the inspection. A tour of the building and observation of work practice was undertaken. All those spoken to stated that they are happy with Priory Paddocks, one resident said ‘I came for three days and stayed a year, I wouldn’t stay if I didn’t like it here’. What the service does well: What has improved since the last inspection? A requirement from the last inspection identified that hand towels should be replaced with disposable towels in communal washing facilities. This has been done; all communal washing facilities hold paper towels and paper towel dispensers. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 6 Three recently employed staff records were viewed, these all held required documentation with regards to employment. This was a requirement from the previous inspection. Heating in a communal bathroom has been repaired; this was a requirement from the previous inspection. A quality assurance exercise has taken place asking for comments from the staff group with regards to the service they provide and are provided with. This has been analysed, and results were made available to the inspector. An action plan is due to be completed by the management of the home and delivered to the staff group. 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. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 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 Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 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): 3, 4, 5 Prospective residents can expect that they will have their needs assessed and can be assured that their needs will be met. Prospective residents have the opportunity to visit and assess the quality and suitability of the home if they wish. EVIDENCE: The manager confirmed the process of admitting residents to Priory Paddocks. When a referral or an interest in living at the home has been received and a bed has been allocated for the individual, the manager will visit the prospective resident in their home. The manager will receive information and record a ‘statement of need’ regarding the residents needs. An interview is completed with the prospective resident and a family member if possible to ensure that Priory Paddocks can meet their needs. Residents are provided with the opportunity to visit the home prior to admittance if they wish. Three recently admitted residents records were viewed, these all contained a ‘statement of need’ completed by the manager. Each file contained ‘new resident checklist’, which is dated and signed when, issues such as the Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 9 statement of purpose, has been provided and assessment have been made. A copy of a blank checklist was provided to the inspector. The manager confirmed that when residents have been living at Priory Paddocks, the manager, the resident and a family member meet to discuss further the residents needs. Three resident files viewed contained care plans for each aspect of the residents day to day living, including pressure area assessment, mobility, sleep, communication, interests and eating and drinking. The care plans provide the need, action required and the goal for each issue. A moving and handling assessment is present in residents files viewed. One resident’s file viewed contained an Registered Nurse Care Contribution (RNCC) assessment, transfer records from hospital and letters from the home regarding the provision of care Priory Paddocks will and is able to provide for the resident. Risk assessments are in place for all three residents. Though the home has no residents who are of another culture than British, the manager confirmed knowledge of provision for other cultures if required. Priory Paddocks currently employs four oversees nurses, who are provided with education from a member of the staff team in the British Culture. The manager has requested that the overseas staff do not speak in a language other than English in the presence of residents and at all times whilst at work, which ensures the nurses practice their English and are ‘embraced’ by their colleagues. Priory Paddocks provides a good training package to its staff group, training records were viewed, which provides the skills required to meet the needs of the resident group, including dementia care, making the most of a modified diet and communication. There was evidence that care plans and needs assessments are completed promptly at Priory Paddocks. One resident’s file was viewed. The resident had been accommodated at Priory Paddocks for two weeks, and care plans, risk assessment and needs assessments were in place for this resident. Priory Paddocks Nursing Home DS0000024475.V254065.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): 9, 10 Residents can expect that their health, personal and social care needs are set out in an individual plan of care and that they are treated with respect and their right to privacy is upheld. EVIDENCE: Three residents records were viewed, these each contained comprehensive needs assessments and care plans to meet their needs. Care plans viewed detailed how staff should work with the resident to meet their health, personal and social care needs. Risk assessment were present in residents records, one risk assessment viewed, was regarding a residents continuous shouting out, risks identified were to the resident and others around them. One resident record showed medication they are taking, all records were appropriately signed, dated and recorded. Residents care plans are reviewed and updated regularly with changing needs. Daily progress records were present in the three residents records viewed, one daily record was completed by care staff and one completed by the management team. This practice offers a clear account of the resident’s day-to-day activities and needs. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 11 Twelve residents were spoken to in a group setting; all agreed that their needs were met at Priory Paddocks. One visitor spoken to said they have no complaints regarding the care their relative receives. The visitor said that they can visit any time and are made to feel welcome. Shared rooms were viewed during a tour of the building, all shared rooms are provided with a curtain to ensure the privacy of an individual resident when they wish or if they are receiving personal care. Two residents were observed to be using a personal telephone in the privacy of their own room. The manager was observed knocking on resident’s bedroom doors and asking permission to enter during the tour of the building. The manager was also observed discretely asking one resident if they knew their dress had risen and asking if they would like to pull it down. One resident was observed to be asking the manager about their finances, the manager reassured the resident and explained that they would need to arrange a meeting with their solicitor about this. Two staff were observed assisting a resident who was receiving help with their personal care, the door was knocked before entering and the staff ensured that they entered without opening the door wide and giving other view of the room. Observation of staff interaction with residents showed that residents are addressed in their preferred form of address, some were called Mr, Miss or Mrs, some were called by their first name, and one resident was observed to be called by a ‘nick name’. Interaction between residents and staff was observed to be respectful. One resident spoken to said that their privacy is respected at Priory Paddocks. The twelve person group spoken to also agreed that their privacy and dignity is respected. Training records viewed showed that staff receive training on issues such as death, dying and bereavement, principles of care, needs of service users and TOPSS (now Skills for Care) induction and foundation training, all of which provide staff with the knowledge of how residents should be treated with respect at all times. Priory Paddocks Nursing Home DS0000024475.V254065.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): 12, 13, 14, 15 Residents can expect that the lifestyle experienced in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. Residents can be assured that they will maintain contact with family, friends, representatives and the local community if they wish. Residents are supported in exercising choice and control over their lives. Residents receive a balanced diet in pleasing surroundings. EVIDENCE: Three resident’s records viewed showed residents preferences regarding their leisure and day to day living activities. Records evidence where residents have participated in social activities organised by Priory Paddocks activity staff and where they have declined to participate. Activities highlighted in records include a singer, going out to lunch, shopping and visits to local areas. A group of twelve residents were observed working on a giant crossword, which was displayed on a flip chart, with the activity staff, who wrote answers on the crossword, and a ‘friend’ of Priory Paddocks, who read out the clues. All residents participated in the crossword; everyone appeared to be enjoying the activity. When the residents had completed the crossword they were keen to Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 13 start another. The staff ensured that all residents were able to hear the clues and see the flip chart. The activity staff was spoken to, they listed all the activities they provide for the residents and took time to explain that residents are able to choose if they participate or not. The activity staff showed photographs of an outing to a local area and cushions that residents had made and sold at a fete Priory Paddocks had held. The inspector was taken to two residents rooms, the residents were present, to show the plant pots they had made. One resident said they had enjoyed doing this, and pointed out the cats on the plant pot, which the resident said they liked. On entrance to the building there was a notice observed inviting staff, residents and visitors to a Priory Paddocks car boot sale to raise money for activities. The manager confirmed that the home holds various sales in order to raise money. During a tour of the building, resident’s rooms reflected their interests, some had lots of compact discs and stereo equipment, and some had books, puzzles and artwork. One resident was listening to music on stereo equipment, one resident was listening to the radio through earphones and one resident was reading the newspaper, all in the privacy of their bedrooms. One resident has a powerful lamp installed to allow them to read. The manager said that the light was installed by the home as the resident had had problems with reading their books. One double room houses a married couple that live at Priory Paddocks. One resident was sitting in their room looking out of the window, they said that they usually prefer to lie on their bed where they are comfortable, but have decided to get up and look out at the beautiful views. The resident confirmed that their choice is respected with regards to what they do on a daily basis. One resident’s records viewed show correspondence from Priory Paddocks regarding the care of their relative. One visitor spoken to confirmed that they could visit their family member when they wish and are always made welcome. The visitor saw their relative in the communal lounge, but said that they can visit in their relative’s room if they wish. Twelve residents spoken to in a group setting said that they could choose what they do in their lives and are happy with being supported in making choices. One resident spoken to said that they preferred to have treatment for an illness at Priory Paddocks rather than the hospital; the manager and the resident confirmed that this has been agreed. A tour of the building showed that residents bring their personal possessions with them when they move into Priory Paddocks and display them in their bedrooms. Residents are provided with a copy of their care plan. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 14 During a tour of the building, several residents were observed to have tea, coffee or a jug of juice nearby. Staff were observed refreshing these throughout the day. Lunchtime was observed during the inspection, some residents chose to eat their meal in their room, some in the dining room and some in the lounge. The dining room and lounge are large attractive and light rooms, with plenty of seating and space for residents to enjoy their meals. ‘Plate guards’ were observed to be used by some residents. Two residents were helped to eat their meal by staff, who were attentive, sitting down and remained with the resident until they had finished eating their meal. Two residents were observed to be waiting for help with their meal, but had been served their meal while they were waiting. The manager confirmed that this would be heated and accepted that residents should be served hot meals. The menu for lunch was viewed, which was on a large chalkboard, displayed in the dining area. There was a choice of three meals, steak and onion pie, toad in the hole and pasta and leek in a cheese sauce, there was also a choice of three deserts. The meals looked appetising and the residents appeared to be enjoying their meals. A group of twelve residents spoken to said the food was very good at Priory Paddocks. One of the group of the residents said the food was not bad, but could be improved particularly the way the beef is cooked. One resident spoken to said they enjoy the food at Priory Paddocks and have something different each day; they particularly like Friday when they had fish and chips. Three resident’s records viewed show nutrition and pressure charts, the manager confirmed that fluid intake of a resident can effect their pressure areas. Staff training records show that staff members are provided with food hygiene, making most of a modified diet and healthy diet for the elderly (screening for malnutrition) training courses, which show that the staff are provided with the knowledge of why residents should receive a healthy and appetising diet. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 15 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): 18 Residents can expect that they are protected from abuse. EVIDENCE: Three resident files viewed provide risk assessments for their daily living. One resident’s records show a risk assessment for their continuous shouting out. The risk assessment includes the effect the residents shouting may have on other residents and methods of protecting all involved. One member of staff spoken to said they know who to go to if they have concerns regarding abuse of a resident. The staff member said that they had just completed the adult protection unit in their NVQ and is aware of POVA, No Secrets and Whistle blowing, and confirmed that Priory Paddocks have procedures for dealing with abuse and whistle blowing. One member of staff spoken to said that they know who to report any issues of abuse that may occur. They said that the home provides several training courses on the protection of vulnerable adults, and feels that the staff are trained well with regards to issues of abuse and protection. The staff member confirmed they are aware of the whistle blowing procedure, what it is and when it may be used. Staff training records viewed show that staff receive training on dealing with challenging behaviour, which provides staff with an understanding of why residents may be aggressive towards them and what action to take, and prevention of abuse, which provides knowledge on how staff can offer protection to residents. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 16 Three staff records viewed show that all newly recruited staff have received a criminal records bureau check (CRB). Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 17 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): 20, 21, 24, 25, 26 Residents can expect that they have access to safe and comfortable indoor and outdoor communal facilities and they have sufficient and suitable lavatories and washing facilities. Residents can be assured that the home is clean, pleasant and hygienic. EVIDENCE: During a tour of the building, two large lounge areas were viewed which were clean, attractive and light. Several residents were sitting in the lounge areas, which provided ample comfortable seating. The dining room is large with sufficient space for residents to enjoy their meals. All lighting is sufficiently bright enough to allow residents to read if they wish. Furnishings are domestic in character and are of good quality. Priory Paddocks provides lovely grounds, which has a seating area with a large automatic sun shelter, which opens when the sun is shining. This provides residents with a comfortable place to sit, and entertain visitors if they wish, Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 18 without direct sunlight. All communal areas at Priory Paddocks are accessible to those who may use wheelchairs or walking frames. There are twelve bedrooms, which provide en-suite facilities. These all have double doors and are accessible to those who may use wheelchairs or walking frames. Bedrooms, which do not provide en-suite facilities, have a hand washbasin and there is a toilet nearby, which has hand wash gel and disposable towels and a towel dispenser. There are toilets near to the lounge and dining areas. All toilets have signs on the door. Priory Paddocks has several bathing areas, all are suitably heated, one has a Parker bath, and others provide showers or baths. The home has six hoists, which may be used to assist residents to use the bathing facilities. All bathrooms have hand wash gel and disposable towels. There is a sluice room on each floor, both providing clinical waste disposal bins, hand wash gel and disposable towels and sufficient disposal equipment. The upstairs sluice provides a steriliser. Both sluice rooms are separate from resident’s toilet and bathing facilities. Seven shared bedrooms are provided with a curtain to ensure residents privacy. Resident’s bedrooms are comfortably furnished; adjustable beds are available to those who receive nursing care. Residents can bring their own belongings to Priory Paddocks if they wish. All bedrooms viewed, had carpets, low windows, which could be opened, to allow residents to look out to the grounds, sufficient storage and seating. All residents’ rooms had sufficient heating and lighting, one resident’s room was provided with a powerful lamp to allow them to read. All residents rooms viewed had various memorabilia, including ornaments, photographs and paintings. Radiators have guards, which are in keeping with the décor of the home. Priory Paddocks is clean and largely free from offensive odours. One bedroom viewed had an unpleasant odour; this room was in the process of being decorated. One bedroom had an unpleasant odour, the resident in this room has a pet cat, the manager confirmed that the odour came from the litter tray and they are in the process of solving this issue. The manager was aware of the unpleasant odours and confirmed that the issues are being resolved. The laundry room has a domestic and a commercial washing and drying machine. The manager stated that bedding and towels are ‘sent out’ to be laundered. Only residents clothing is laundered at Priory Paddocks. The laundry area is situated so it does not intrude on residents. Hand wash gel and disposable towels are provided in the laundry. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 19 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 Residents can expect that the numbers and skill mix of staff meets their needs and that staff are trained and competent to do their jobs. Residents can be assured that they are in safe hands and are protected by the homes recruitment policy and practice. EVIDENCE: The staff rota was viewed, this showed that there is sufficient numbers of care staff and nursing staff on duty at all times. The manager confirmed that they have faced problems with recruiting domestic staff; two were met during the inspection. The tour of the building revealed that they work hard to achieve the cleanliness and tidiness of the home. Care staff are encouraged and supported in achieving their NVQ level 2 award. There are two qualified assessors who work at Priory Paddocks providing staff with fair access to assessment. One staff member coordinates TOPSS (now Skills for Care) induction and foundation training and NVQ training; a local NVQ assessment centre is also used. The NVQ and induction and foundation coordinating staff were spoken to, they had a clear understanding of the needs of the staff group and how the development of the staff impacts on the service they provide to residents. One staff member was spoken to who has only one unit to complete before they achieve their NVQ level 2 awards. They said they were looking forward to completing it and had found it useful in their work role. There are currently twenty seven care staff working at Priory Paddocks, including four overseas nurses. Eight staff have achieved their NVQ award, six Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 20 staff have almost completed their award and one member of staff is due to be commencing their award shortly. This places Priory Paddocks to achieving the 50 of staff to have achieved at least NVQ level 2 award by 2005. Staff at Priory Paddocks are provided with a pay increment on achievement of their NVQ award, which demonstrates a clear commitment to meeting the targets and the development of the staff group. Documentation was viewed showing the unit achievement of each staff member working on his or her NVQ award. Three recently employed staff member’s records were viewed. The records provided a checklist of receipt of information including photographs of the individual, application forms, CRB checks, and photographic identification. Two staff records provided two written references, one staff record provided one written reference, but had previously been employed at Priory Paddocks and the manager was identified as a referee. Training records were viewed; these show a good training package for staff working at Priory Paddocks. Staff are provided with a cash incentive if they attend at least seven training sessions each year. This shows a clear commitment to the development of staff and improvement of service provision to residents at Priory Paddocks. Training provided to staff, include TOPSS (now Skills for Care) induction and foundation programme, food hygiene, effective communication, death, dying and bereavement, fire safety, principles of care, needs of service users, first aid, infection control and prevention of abuse. Four staff have recently attended a moving and handling instructors course, which enables them to provide on going training to the staff team. The whole staff group are currently being provided with a set of eight dementia and confusion sessions, which concludes with a test and provides individuals who are successful with a nationally recognised certificate. Staff training is fully supported at Priory Paddocks; staff spoken to said they feel well trained and informed to do their job well. Priory Paddocks is currently building an annex, which when complete, will provide a training suite for staff to attend training. The training centre will be used to deliver orientation, induction, foundation, ongoing and NVQ training. It will also be used to support the adaptation of overseas nurses and as a resource centre with Information Technology facilities and nurse’s equipment. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 21 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): 32, 36, 37 Residents can expect to benefit form the ethos, leadership and management approach of the home. Staff are appropriately supervised. Residents can be assured that the homes record keeping policies and procedures safeguards their rights and best interests. EVIDENCE: The manager confirmed that care staff are provided with at least four formal one to one supervisions each year. Regular team meetings, staff handover sessions, which occur four times each day and training sessions also provide staff with group supervision. Two staff spoken to said that they receive adequate support and feel they can talk to managers for support at any time. Staff members spoken to said that the management team at Priory Paddocks are approachable and supportive. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 22 The staff at Priory Paddocks regarding the management and their working conditions completed a recent quality assurance exercise; this was viewed at the time of the inspection. All comments were positive; an action plan is being developed by the manager and will be presented in a future team meeting. Staff are very well supported with development and training, this is evident through the training records viewed and discussions with staff. All records viewed were up to date and in good order. All records were stored in a secure place in the manager’s office. The manager demonstrated a clear commitment to equal opportunities of the staff group, with regards to overseas workers and other staff members. Observation of the interaction between the manager and residents and the manager and staff was open and respectful. It was evident that the manager regularly communicates with staff and residents from the ease in which they communicated during the inspection. Training records which were viewed show that staff are provided with training which includes first aid, health and safety, fire safety, food hygiene, infection control and moving and handling. A tour of the building showed that there is appropriate storage available for substances under COSHH. Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 3 3 X X 3 3 3 STAFFING Standard No Score 27 X 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X X 3 3 X Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 24 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. Standard Regulation Requirement Timescale for action 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 Priory Paddocks Nursing Home DS0000024475.V254065.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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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