CARE HOMES FOR OLDER PEOPLE
Queenswood Care Home Cliffgrove Avenue Chilwell Nottingham NG9 4DP Lead Inspector
Meryl Bailey Unannounced Inspection 11th November 2005 11:30 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 Queenswood Care Home DS0000008735.V263072.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. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Queenswood Care Home Address Cliffgrove Avenue Chilwell Nottingham NG9 4DP 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) 0115 922 1037 0115 943 6245 Methodist Homes for the Aged Mrs Agnes Elizabeth Grognet Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Queenswood is a Methodist Care Home providing personal care and accommodation for a maximum of 41 older people. The home is located in a residential area, one mile from Beeston town centre. The home has a minibus that is used for the service users to access local facilities and for other outings. The home was built for the purposes of a care home and the two-story building has level access. It is totally wheelchair accessible throughout with a passenger lift and other adaptations. All bedrooms are single and have ensuite toilet and shower facilities. There are well-maintained and accessible gardens providing seating areas outside. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one day. 40 current residents were at home. Five staff were present on duty in addition to the manager. Some residents and staff gave their views about the care provided. The communal areas of the home were inspected and one bedroom was also seen. What the service does well: What has improved since the last inspection?
One bedroom has been redesigned to provide ensuite facilities and all bedrooms now have such facilities. An information day for residents and families about preventing falls was held during July 2005. Also, staff are now using clear assessment forms to help them plan actions that will prevent falls. Communal space is better used, with the larger room used as the main lounge. This is more spacious and is adjacent to a tea bar, where service users or their visitors can make drinks. The smaller lounge is used for specific activities. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 6 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. Queenswood Care Home DS0000008735.V263072.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 Queenswood Care Home DS0000008735.V263072.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): These standards were not assessed on this inspection. EVIDENCE: Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 9 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 and 9 A plan of care is in place for each service user, but not all areas of risk have not been addressed. Medication is generally well organised, but attention must be given to strict adherence of procedures at all times to prevent errors. EVIDENCE: The files of three service users were examined and one care plan was found comprehensive and regularly reviewed. Two service users had been more recently admitted and their care plans were developing. There were formal risk assessments regarding the risk of falling and some clear instructions to staff about support required to assist with mobility. An information day for service users, relatives and staff was held at the home on July 19th 2005. Direct advice from a Chiropodist, Physiotherapist, and a Moving and Handling trainer was given. There were records of visits from various health professionals including General Practitioners and district nurses. Accident and incident forms had been completed and filed, but follow up action was not clear. For example, aggressive behaviour of a service user was recorded as a complaint, but there was no risk assessment relating to this and action to be taken to reduce the risk of harm to others must be made clear in the care plan.
Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 10 Medication was stored securely and the trolley was locked away while tablets were being given in the dining room. Records of medication were well maintained, but a staff member administering the medication was observed preparing two service users medication at the same time. Such practice poses a risk of error. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 11 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 and 14 Service users have a range of activities available to them and are encouraged to exercise their own choices. EVIDENCE: Service users’ interests were stated in their care plans. An activities worker is employed and the activities for the current day were listed on the notice board as a timetable. Included were: Gazette Reading; prayer Group Meeting; Partially sighted group; Handicrafts; Video of Natural Wildlife. The partially sighted group were doing puzzles in the smaller lounge. The communal areas had changed in function so that the larger room was used as a main lounge. The video was to be shown in the large room. There were different activities each day. The Queenswood Gazette has been produced twice and was available in large print for each service user. The current issue contained a report of outings and other summer events. There were also comments and reports about and from service users, followed by puzzles. The minibus has been used to take groups of service users on various outings and to the river for boat trips. Some outings are arranged together with another home within the local community. Within the home there have been several celebrations, a barbeque and Summer Fayre. Regular services were held in the chapel on the
Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 12 upper floor and prayer meetings were held wherever appropriate to service users around the home. With use of notice boards, there was clear evidence of full, up to date information given to service users so that they were enabled to make their own choices. Notices were also read out to service users in the dining room. Information regarding external agents and advocates was also given on a notice board. Many of the service users had brought their own furniture and belongings and inventories were held on file. Some maintain control of their finances (see Standard 35). Queenswood Care Home DS0000008735.V263072.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 Complaints are taken seriously and dealt with within appropriate timescales, but the outcome is not recorded clearly. EVIDENCE: All concerns and complaints were recorded in a file showing immediate action taken. However, the final outcomes were not clear. For example, a complaint about a missing item was dealt with by ensuring all staff were aware, but the fact that it had been found was not recorded. Similarly, there was no outcome recorded for a complaint relating to behaviour (see comments under Standard 7). Queenswood Care Home DS0000008735.V263072.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): 19, 24 and 30 service users have comfortable bedrooms with ensuite facilities and all areas are kept clean. EVIDENCE: Communal areas were seen and found to be maintained to a very good standard. Since the last inspection the larger lounge had been converted to use as the main television lounge and the smaller room was used for group activities. Also, one bedroom, which did not previously have ensuite facilities, had been adapted to provide toilet, shower and washbasin. All areas were very clean and odour free. The openings of windows have been restricted, but some were noted to be wider than the recommended 100mm (4 inches) and all windows should be checked to ensure safety and security. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 28 and 30 Service users are cared for by staff who are supported to develop their skills and knowledge and are trained to carry out their tasks. EVIDENCE: Since the last inspection care staff had been trained and most had completed the National Vocational Qualification level 2 in care. The two assistant managers were pursuing level 4. Records showed that all new staff received induction training and there was a clear training programme. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 16 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, 33 and 35 There is a competent registered manager. A quality monitoring scheme is used to seek views about the service and actions are taken to improve the service. Systems are in place to protect service users from financial abuse. EVIDENCE: The manager is experienced and registered with the Commission. She has attained National Vocational Qualification level 4 in care and holds the Registered Managers’ award. The Residents’ Survey was undertaken once a year and the forms, entitled “Seeking our residents’ help – Compliments, complaints & Comments”, were recently circulated. A blank form was available at this inspection. A report of the responses was being prepared. Some service users handled their own finances, but most had granted power of attorney to a relative. The care notes contained information about these arrangements. There was a lockable drawer in each service users’ bedroom,
Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 17 should they wish to look after their own small amounts of cash. Some money for each service user was held individually in the safe with records of transactions kept. Those checked at random were found correct. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 18 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X 3 x X X X 4 X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X X Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 19 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 OP7 Regulation 13(4)(c) Requirement Timescale for action 18/11/05 2 OP9 13(2) Where risks arise from challenging behaviour, ensure a risk assessment is contained in the care plan with clear instructions to staff of actions to be taken to reduce the risks. Ensure staff follow procedures 11/11/05 and prepare and administer medicines to service users one at a time. 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 OP16 OP19 Good Practice Recommendations Add outcomes to the confidential records of complaints and concerns. Check that all windows openings are restricted to 100mm (4 inches) to ensure safety and security. Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Queenswood Care Home DS0000008735.V263072.R01.S.doc Version 5.0 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
