Inspection on 24/01/06 for Rashwood Nursing Home

This inspection was carried out on 24th January 2006.

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

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

Other inspections for this house

Rashwood Nursing Home 09/05/07

Rashwood Nursing Home 28/06/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Rashwood Nursing Home Wychbold Droitwich Worcestershire WR9 0BP Lead Inspector C Presley Unannounced Inspection 24th January 2006 16:00 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 Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Rashwood Nursing Home Address Wychbold Droitwich Worcestershire WR9 0BP 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) 01527 861258 01527 861848 Elizabeth Finn Homes Ltd Mrs Ann Eveline Lodge Care Home 53 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (53), of places Physical disability over 65 years of age (53), Terminally ill (2) Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That service users accommodated within the category of TI are aged 40 and above. 28th June 2005 Date of last inspection Brief Description of the Service: Rashwood is a 53-bedded care home. The proprietors are The Elizabeth Finn Trust, and the manager is Mrs Ann Lodge. The home is divided into three main wings, each with its own lounge and dining area. One wing provides personal care for residents requiring some help with activities of daily living, while the other two wings are for residents who predominantly require nursing care. Facilities and services available for residents include a hair salon, physiotherapy, an activities co-ordinator and a mini bus service. All rooms are single with en-suite facilities. The services offered include long-term, convalescent, palliative and respite care. The home is a large country house, which has been extended. It is set in extensive and well-maintained grounds, and is located in Wychbold, near Droitwich. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place during the late afternoon. This visit focused on standards not inspected at the last inspection visit and requirements from that report. Time was spent with the registered manager and the clinical nurse manager. What the service does well: 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. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 6 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 Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 7 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): 5 Resident’s are admitted on a trial basis, which gives both parties time to ensure residents are happy with the care provided and the home can meet their needs. EVIDENCE: A number of residents are admitted using the homes respite facility and stay on if they are unable to return home. All residents are admitted on a trial basis, which ensures their needs, can be met and the home is the right choice for long-term care. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 8 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 Medication recording has shortfalls, which place residents at unacceptable risk. EVIDENCE: A number of medication charts were examined the following shortfalls were noted; Pulse readings when giving digoxin were not always recorded. There were signature gaps on the medication chart and no code was used; it was unclear whether the medication had been given or omitted; this was of particular concern for medication such as warfarin. Hand written medication on charts was unsigned by the trained nurse There was evidence of medication being hand written even though the drugs had not been dispensed or received by the home. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 9 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): None of the standards in this section of the report were inspected at this visit; for further information refer to previous inspection report EVIDENCE: Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 10 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): None of the standards in this section of the report were inspected at this visit; for further information refer to previous inspection report EVIDENCE: Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 11 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): None of the standards in this section of the report were inspected at this visit; for further information refer to previous inspection report EVIDENCE: Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 12 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): None of the standards in this section of the report were inspected at this visit; for further information refer to previous inspection report EVIDENCE: Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 13 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): 35 & 38 The home is well managed by the registered manager within a risk framework, which ensures residents, staff and visitors to the home are kept safe. EVIDENCE: There is a facility for residents to have their money kept in a safe in the home if they choose. Records were seen and were audited. Health and safety issues are addressed as they arise. The registered manager ensures equipment is regularly tested to comply with current health and safety legislation. The registered manager was planning a fire drill with the night staff the following morning at 07.15am. All staff attend fire training at least three times a year with drills in between. The clinical manager ensures all staff are fully aware of their responsibilities regarding infection control. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 14 Staff have received food hygiene training and there is a trained nurse and first aider on duty at all times. The maintenance man is the health and safety officer and has had the appropriate training. Legionella risk assessments are in place and tanks are chlorinated at least yearly. Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 15 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 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 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 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x 3 Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 17 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 OP9 Regulation 15 13 (2) Requirement All medication administered to residents must be accurately recorded onto medication administration record charts. Requirement outstanding from last inspection Medication that is hand written must be signed by a registered nurse and medication must not be written up until the prescription is received by the home and is checked Pulse readings must be taken when digoxin is given If medication is omitted for any reason codes must be used on the medication record Timescale for action 24/01/06 2 OP9 13 (2) 24/01/06 3 4 OP9 OP9 13 (2) 13 (2) 24/01/06 24/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Rashwood Nursing Home DS0000065063.V276931.R01.S.doc Version 5.1 Page 19 - 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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