CARE HOMES FOR OLDER PEOPLE
Purley View Nursing Home 20 Brighton Road Purley Surrey CR8 3AB Lead Inspector
Alison Ford Unannounced Inspection 15th December 2005 11:15a 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 Purley View Nursing Home DS0000019039.V270829.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. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Purley View Nursing Home Address 20 Brighton Road Purley Surrey CR8 3AB 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) 020 8645 0174 020 8763 2456 Glancestyle Care Homes Limited Mrs Anna Marie Cunningham Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th August 2005 Brief Description of the Service: Purley View is a care home registered with The Commission for Social Care Inspection to provide nursing care for up to thirty-nine older people. It is situated in Purley with easy access to both road and rail links and close to the centre of town. The rear of the property offers off street parking for up to eight cars and there is metered space around the home. The home offers accommodation over three floors, in twenty-seven single bedrooms and three shared rooms all of which have en-suite facilities. A passenger lift ensures accessibility to all parts of the home. There is a large communal lounge, on the ground floor, which also provides a dining area and a pleasant rear garden where residents can sit in the fine weather. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the homes second inspection of the year 2005/2006 and was an unannounced visit, taking place over two and a half hours. The Registered Manager was not on duty however, two senior nurses and the homes maintenance man were there, in addition to the care staff, and they are thanked for their assistance. At this inspection, a partial tour of the premises was undertaken along with an examination of a sample of care plans. Certificates of worthiness of equipment were also seen. Many of the thirty-one residents currently living in the home and one relative, who was visiting, were spoken to and the lunchtime meal was served during the visit. The Commission has received one anonymous complaint about this service since the last inspection, which was not upheld. Over the course of both inspections all of those standards considered by The Commission to be key to the inspection process have been assessed and this report should be read ion conjunction with the one produced following the previous inspection on 17th August 2005. What the service does well:
The residents in this home consider that they live in a safe well-managed environment and all of those that were spoken to were appreciative of the care that they receive, the homes manager and her staff team. All the residents, met during the inspection process looked clean and well cared for. Comments were made by both residents and relatives that “staff were very friendly” “they were very happy here” “ “staff treat the residents well ”and that “residents always look well cared for.” A comprehensive pre-admission assessment ensures that the physical healthcare needs of residents will be met and care plans accurately reflect the care that is currently being delivered. Activities suitable for the needs of the residents are provided and at the time of this visit preparations were underway for Christmas festivities. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 6 Residents expressed their satisfaction with the meals served in the home and alternative choices would always be made available. All of those spoken to were confident that the management team would deal with any concerns that they might have promptly and appropriately. An extremely good quality assurance monitoring tool is in place to gain the views of residents and their relatives however obtaining a good response to the audit process is often difficult with relatives often reluctant to return questionnaires. 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. Purley View Nursing Home DS0000019039.V270829.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 Purley View Nursing Home DS0000019039.V270829.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): 3,6 A comprehensive pre-admission assessment, undertaken by a senior staff member, ensures that resident’s physical, healthcare needs can be met in an environment, which will promote their independence and wellbeing. This home does not offer intermediate care; this standard does not apply. EVIDENCE: The care plans of four residents were seen, one who had recently been admitted, and all of them contained full and comprehensive assessments of their physical needs. These then form the basis for subsequent care planning. Staff training within the home is given a high priority to help to ensure that these needs will be met. In order to provide an insight into the problems experienced by residents, especially those with dementia, relative’s help is being enlisted to try and produce a “life history “ of residents. A completed one was seen and it
Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 9 provided an exceptionally good record, and allowed staff caring for him to appreciate his previous life. It is recommended that an effort should be made to encourage more relatives and friends to participate in compiling these records although it is recognised that some of them way not wish to do so. Purley View Nursing Home DS0000019039.V270829.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): 7,8,10 Each resident has a care plan, regularly updated, to ensure that they reflect the support currently required. Residents can be confident that they will be treated with respect and that measures are in place so that their privacy and dignity will be maintained. EVIDENCE: The care plans of four residents were seen. They were comprehensive and contained evidence that they continue to be regularly reviewed. Each resident has an allocated named nurse and a key worker. Assessments are undertaken to identify indicators, which highlight those at risk of developing pressure sores, and appropriate interventions are taken. Photographic evidence is used to support the treatment of wounds within the home. Residents confirmed that they are treated kindly and in an appropriate manner and staff were observed interacting well with them. Personal care is delivered in resident own rooms. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 11 Purley View Nursing Home DS0000019039.V270829.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): These standards were not assessed at this visit. EVIDENCE: Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents in this home are confident that any concerns or complaints that they might raise would be dealt with promptly. EVIDENCE: There is a simple and clear complaints procedure in place and a copy was seen in the entrance hall. The complaints book was seen and one issue had arisen since the last inspection. This had been dealt with promptly and recorded in great detail. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This home provides a clean and comfortable environment with specialist adaptations in place, which suits the needs of the residents who live there. EVIDENCE: A partial tour of the home was undertaken. The home provides comfortable accommodation for its residents, which is in keeping with the surrounding area, and a redecoration programme has commenced. Areas that have been completed look much brighter and airier. Specialist adaptations have ensured that all areas of the home are accessible to residents and assisted baths and toilets suitable for wheelchair users are throughout the home. All areas of the home were clean and free from odour on the day of the inspection.
Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 15 Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 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 Residents in this home can be confident that there are sufficient well-trained and qualified staff on duty so that their healthcare needs will be met. EVIDENCE: On the day of the inspection staffing levels met those previously agreed and nursing and care staff were supported by a cook and their assistant and two domestic staff a laundry person and a maintenance man. Staff turnover in the home is low and provides continuity of care for the residents. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 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 Residents can be sure that there are systems in place to ensure that their views are taken into consideration and that maintenance procedures are sufficient to promote their health and safety. EVIDENCE: There are residents meetings monthly and the minutes were seen. There is also a quality assurance monitoring system in place. Audits are undertaken that are in line with The National Minimum Standards, results are collated and letters are sent to relatives highlighting the issues raised and how they will be addressed. Unfortunately the initial responses to the requests for information are not always returned however it was felt that the system exceeded the required standard. The home does not take responsibility for the finances of any of the residents.
Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 18 A selection of maintenance certificates was seen and was in order. One resident had commented that water in the shower was too cold however all water temperatures are checked weekly and records showed that they are satisfactory. Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X X 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 4 X 3 X X 3 Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 20 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 Purley View Nursing Home DS0000019039.V270829.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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