Inspection on 22/02/06 for Prospect House Nursing Home

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Prospect House Nursing Home 19/11/08

Prospect House Nursing Home 10/01/07

Prospect House Nursing Home 15/07/05

Prospect House Nursing Home 11/11/04

Prospect House Nursing Home 11/05/04

Prospect House Nursing Home 22/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Prospect House Nursing Home High Street Malpas Cheshire SY14 8NR Lead Inspector A Gillian Matthewson Unannounced Inspection 22nd February 2006 10.00 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 Prospect House Nursing Home DS0000018815.V278776.R02.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. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Prospect House Nursing Home Address High Street Malpas Cheshire SY14 8NR 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) 01948 860011 01948 860006 Prospect House (Malpas) Limited Mrs Anne Leslie Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (4), Terminally ill (1) of places Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of service users must not exceed 44 44 service users aged 65 years and above in the category OP may be accommodated 1 service user aged 40 years and above in the category TI may be accommodated 4 service users aged 40 years and above in the category PD may be accommodated 15th July 2005 Date of last inspection Brief Description of the Service: Prospect House is a large detached house situated in a village location The majority of the accommodation is provided in a purpose built extension to the home. The home is located on the village high street and is in close proximity to all the local services, public amenities and local transport.Within the home a passenger lift and staircase provides access to bedroom accommodation situated on the ground and first floor. The second floor is used for administration.Bedrooms are mainly single rooms and there are several larger rooms available to accommodate married couples or those who wish to share. The majority of bedrooms have en suite toilet facilities and all have a nurse call system and TV point.Day space consists of six lounges/ sitting areas and a dining room.There are front and rear gardens. Access to the service is located to the side of the building and is accessible to those with mobility difficulties. Service users have direct access to the rear enclosed garden and paved courtyard.The home is registered to care for persons whose primary care needs are due to physical frailty and infirmity. This service is also registered to provide care for one person who is terminally ill and can provide intermediate care for 1 resident. Nursing care is provided and in accordance with the statutory requirements there are registered general nurses on duty at all times. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over six hours and include a tour of the building, inspection of records and discussion with nine residents, one relative, the registered provider, registered manager and one member of staff. Feedback was given to the registered provider and registered manager immediately following the inspection. Overall, the home provided a high standard of care. What the service does well: The home has an excellent service user’s guide that provides prospective residents with all the information they need to make an informed choice about whether to take up residence in the home. This is supplemented by verbal information provided by the registered manager during the pre-admission assessment and residents are able to stay in the home for trial periods. Residents receive the medication prescribed by their doctor. They are treated with respect and all staff are instructed on how to maintain residents’ privacy and dignity. Residents are helped to exercise choice and control over their lives. They are also provided with a varied, well-balanced diet. Residents are confident that any concerns they raise will be listened to and acted upon. The home provides a clean and comfortable environment for residents to live in, with easy access to outside seating areas and local amenities. Staffing levels are sufficient to meet residents’ needs. Residents’ health, safety and welfare are promoted. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Prospect House Nursing Home DS0000018815.V278776.R02.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 Prospect House Nursing Home DS0000018815.V278776.R02.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, 3 & 5. Standard 6 is not applicable. The home provides comprehensive information to prospective residents in order to help them make an informed choice about where to live. The preadmission assessment procedures and the opportunity to stay for a trial period give prospective residents confidence that the home will be able to meet their needs. EVIDENCE: The home has an excellent service user’s guide, which includes the home’s statement of purpose. This document contains all the information a resident would need to understand how the home operates, the facilities and services that are provided and how to raise any concerns. It is detailed, clearly written and a good reference guide. Residents spoken with confirmed that they or their relatives had been provided with this information. Residents spoken with confirmed that the registered manager visited them prior to their admission to the home to assess their needs and explain how the home could meet those needs. Assessment documents were completed and held in residents’ care files. In addition, residents were also assessed by an Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 9 NHS registered nurse to determine the level of funding to be provided by the NHS. Residents also confirmed that they or their relatives were able to visit the home prior to their admission, and some said they had stayed in the home for a trial period before making a decision to take up permanent residence. Prospect House Nursing Home DS0000018815.V278776.R02.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): 9 & 10 Residents receive the medication that is prescribed by their doctor. Residents are treated with respect and their privacy and dignity are maintained. EVIDENCE: Arrangements for the receipt, storage, administration and disposal of medication were satisfactory. In the main, the recording of medication prescribed and administered were satisfactory, but the recording of the dosage of Warfarin, an anticoagulant, could be confusing to someone who was not familiar with it. One resident was having her dose adjusted weekly by the GP. When the medication was dispensed from the pharmacy the dose was three tablets per day, and this was indicated on the box containing the tablets. When the medication administration record (MAR) sheet was issued from the pharmacy the dose was two tablets per day, and this was indicated on the MAR sheet. The registered manager explained that the resident now had weekly blood tests and the results were emailed from the hospital to the GP, who telephoned the home and prescribed the dosage for the next seven days. This was recorded in the care plan by a nurse in the home, who then wrote on the MAR sheet, in a box above the signature box, the number of tablets for each Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 11 day. There were no instructions in writing from the GP. See Recommendation 1. The service users’ guide, staff booklet and policy documents all emphasised the importance of maintaining residents’ privacy and dignity. Arrangements for privacy within the service included private rooms and secluded sitting areas. Cordless telephones were available and a number of residents had their own telephone line. Residents received their mail unopened. Conversations with residents confirmed that any personal or nursing care was provided within their own rooms or in bathrooms and that staff were very respectful of their privacy and dignity. Screens were available for privacy in shared rooms. Staff were observed to be courteous and caring towards the residents. Prospect House Nursing Home DS0000018815.V278776.R02.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): 14 & 15. Residents have control over their lives and are offered a well balanced diet that suits their tastes. EVIDENCE: Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 13 The contract identifies that the home is conducted to maximise the individual’s autonomy and choice. This was confirmed by residents. One resident said that she could get up when she liked. “I get up when I feel like it and ring down and someone brings my breakfast.” Another resident said that she had been bed bound on admission, but when she was able to get up hadn’t liked the way the room was laid out because she couldn’t see out of the window from her armchair. The staff had rearranged the furniture to her satisfaction. The home provides three meals a day and snacks and drinks are available at all times. On the afternoon of the inspection the cook was asking residents what they would like to eat the following day. Two choices were offered for each meal, but residents could ask for something else if they didn’t like the choices on offer. The tables in the dining room were nicely set with a centrepiece of a vase containing a fresh flower. The food was also well presented. Residents spoken with said that the food was very good. One resident said that she liked to have mangoes for breakfast, and although they were not on the menu the home bought them in specially. Prospect House Nursing Home DS0000018815.V278776.R02.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 & 18 The promotion of the home’s complaints procedure gives residents confidence that any complaints will be addressed and staff training makes it clear that any form of abuse will not be tolerated. EVIDENCE: The home had a satisfactory complaints procedure, which was displayed on the notice board and in the service user’s guide. Residents spoken with said they would know who to complain to if they were not happy with any aspect of the service. There had been no complaints since 2003. Staff were provided with verbal and written information at induction about how to treat residents with respect and the standards of care expected of them. They were informed that any deviation from this could result in disciplinary action. The home had a copy of Cheshire County Council’s ‘No Secrets’ policy and procedures, a satisfactory in-house whistle blowing policy and a copy of a video on abuse in care homes, although not all staff had seen it. The home’s adult abuse policy was rather brief, and contained very limited information on types of abuse and reporting procedures. See Recommendation 2. Prospect House Nursing Home DS0000018815.V278776.R02.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, 21 & 26. The home provides residents a pleasant, comfortable and well-maintained environment in which to live. EVIDENCE: The location of this service is within a small rural town on the main street and in close proximity to all local services, amenities and public transport. The house was maintained to a high standard and a maintenance schedule was available and audited weekly. The internal dimensions of the house and the use of space created several areas for residents to spend time in company or alone throughout the day. The grounds were tidy and safe and allowed access for residents and visitors. A tour of the premises that included communal areas, bathrooms and some bedrooms confirmed a high standard of cleanliness and hygiene throughout the home. A new rise and fall bath had been installed on the ground floor. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 16 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 Staffing levels are sufficient to meet the residents’ needs. EVIDENCE: There were 37 residents at the time of the inspection, some of whom required minimal assistance with the activities of daily living. The registered manager was supernumerary. The home provided two registered nurses and five care staff from 7am to 2pm plus an additional three hours care to help those residents who required assistance with feeding, one registered nurse and four care assistants from 1.30pm to 8.30pm, and one registered nurse and three care assistants from 8pm to 7am. There were also catering, laundry, domestic and administrative staff in addition to these numbers. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 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 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): 33, 35 & 38. The home regularly reviews its performance through consultations with residents and their representatives. The registered manager ensures, as far as is possible, the health and safety of residents and staff. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 18 EVIDENCE: Policies and procedures were reviewed and updated on an ongoing basis. Any changes were cascaded to the relevant staff. All residents and their representatives were invited to an evaluation meeting every eleven weeks, where the care plan was reviewed and updated as required and their views on the service were sought. In addition, relative questionnaires were sent out annually and all responses included in the service user guide. On examination the relative questionnaires are based on open and general questions regarding overall satisfaction. The inspector suggested that these questionnaires should be based on more direct and subject specific questions, for example; information, care, activities, choice, meals, environment. Also, residents were not requested to complete the questionnaires. See Recommendation 3. As a matter of routine the financial affairs of residents are not managed by the service. All expenditure undertaken on behalf of residents was paid for by the service and then invoiced to the resident or their representative. During this inspection a wide range of records were provided for examination. These included a record of lift inspections, landlord’s gas safety check, portable appliance testing, electrical installation inspection, servicing of mechanical equipment and fire log book. All equipment had been checked and serviced at the required intervals. In the previous year staff had received training in fire safety, first aid, moving and handling, food hygiene and infection control. Staff had also attended fire drills at frequent intervals. There were no hazards or risks identified at this inspection. Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 X 3 X 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? N/A 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. 1 2 Refer to Standard OP9 OP18 Good Practice Recommendations GPs should be requested to email or fax dosage instructions for anticoagulants, which could be kept with the MAR sheets. The adult abuse policy should be expanded to include all types of abuse and reporting procedures and all staff should view the video on abuse in care homes during their induction. The registered person should consider asking more direct and subject specific questions within the quality assurance questionnaires and distribute them to residents as well as relatives. 3 OP33 Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Prospect House Nursing Home DS0000018815.V278776.R02.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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