Inspection on 28/06/05 for Rashwood Nursing Home

This inspection was carried out on 28th June 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.

Other inspections for this house

Rashwood Nursing Home 09/05/07

Rashwood Nursing Home 24/01/06

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 Worcester WR9 OBP Lead Inspector Nick Richards FINAL - Unannounced 28 June 2005 - 08:45 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 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 E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rashwood Nursing Home Address Wychbold Droitwich WR9 OBP Telephone number Fax number Email 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 CRH(N) 53 Dementia - over 65 Older people Physical disability - over 65 Terminally ill 3 53 53 2 Category(ies) of DE(E) registration, with number OP of places PD(E) TI RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02 March 2005 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 E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours, and was carried out to assess how the home was addressing the requirements from the previous inspection, to establish how effective care was during the morning period and to find out what residents thought about the service being provided by the home. A tour of the premises took place and staff and care records were inspected. Seven staff on duty and nine of the forty-eight residents were spoken to. What the service does well: What has improved since the last inspection? What they could do better: Further attention needs to be provided to the recording of medication administered to residents by nursing staff. By further developing recording, residents welfare and protection can be further enhanced. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 6 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 E52 S65063 Rashwood V235512 280605.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 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 standard(s) 1, 2, 3 and 4. The admission procedure remains comprehensive to ensure that there is a proper assessment prior to people moving into the home. This helps to ensure that care needs can be met. Residents and their representatives are provided with suitable information prior to admission to ensure that an informed choice can be made. EVIDENCE: The admission procedure was effective to guide staff on the actions to be taken to ensure that new residents’ needs are properly assessed and planned for. Individual records are kept for each of the residents, and inspection of the records for five residents had full assessment information recorded. Staff members on duty were spoken to, and knew about the care needs of the residents. Residents who were interviewed (people who had been resident within the home for a long period and people who had only been resident for a short period of time) all said that they felt that the home was effectively meeting their care needs, and were very pleased and content with the range of services being provided for them. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 9 The homes Statement of Purpose and Service User Guide are satisfactory and readily available to people – providing residents and prospective residents with details of the services the home provides, and enabling an informed decision about admission to be made. Some residents said that they did not particularly care about the Statement of Purpose or the Service User Guide because they were so pleased with the home. The home does not contract to provide Intermediate Care, therefore Standard 6 is not applicable to the home. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 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 standard(s) 7, 8, 9 and 10. There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet residents’ needs. The health needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: Individual plans of care are available, and progress has been made to ensure that all aspects of health, personal and social care needs are identified and planned for. Plans were detailed, up to date and had been regularly reviewed. Plans relating to people with diabetes had been developed since the time of the previous inspection, and effectively explained how care needs were to be addressed, and what the expected outcome would be for care and nursing staff. Significant events in the home had been recorded, daily entries into case records had been made and entries available gave an indication of the actual care given. Residents spoken to were happy to confirm that their care needs were being met by staff within the home in a dignified and respectful way. Staff were seen providing care sensitively and discretely to residents, and RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 11 discussions with staff confirmed that they were aware of residents’ care needs, and how the care was to be provided. Nursing staff were observed administering medication to residents. Medication was administered safely and sensitively to ensure that the right medication was administered to the right person, at the right time and in the right dose – thereby promoting the safety and well-being of residents. The homes medication records were examined, and were, generally, being managed well. However, there were a few occasions when nursing staff had failed to record the administration of medication onto the medication charts, and when some medication that had been prescribed on a variable dose basis had been administered, nursing staff had, at times, failed to record the actual dose administered. This lapse in record keeping poses a potential risk to the health and safety of residents. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 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 standard(s) 12, 13, 14 and 15. Meals are well managed, creative and provide daily variety and flexibility for people living in the home. Contact with family and friends was openly maintained. EVIDENCE: A number of people living in the home were spoken to and everyone who commented on the food said how good it was and that they welcomed the daily choices offered. Menus were inspected and found to be balanced and interesting and meal time arrangements are also flexible enough to accommodate individual preferences. Catering staff demonstrated a detailed knowledge and understanding of individual residents’ dietary preferences and requirements. Care staff were seen providing direct assistance to people with their lunch in a sensitive and relaxed manner. During the inspection, some relatives were seen visiting people, and staff greeted visitors politely. Residents spoken to said that they could receive visitors at any time of the day, thereby maintaining links with family members. Residents confirmed that there were “no restrictions” on visiting. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 13 An Activities Organiser is employed within the home, and activities are specific to the likes, dislikes, tastes and preferences of residents, which includes attendance at church services, a poetry group and shopping trips. The home benefits from operating a licensed bar for residents, which is run by volunteers. A “House Committee” is also involved in organising activities for residents. Activities within the home are flexible and varied. The home does not actively get involved in the management of residents’ finances. Residents or their appointed representatives maintained control over residents’ financial affairs. Access to external agents i.e. solicitors or social workers is promoted and facilitated by the home whenever necessary – in the interests of residents. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 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 standard(s) 16 and 18. Complaints are handled objectively and residents are confident that their concerns will be listened to, taken seriously and acted upon. A vulnerable adults procedure is available to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a simple and clear complaints procedure, and the complaint records indicated that this is followed. A copy of the complaints procedure had been given to all residents, and was available to visitors and relatives. Residents spoken to were confident that concerns could be raised with the home. A procedure for responding to allegations of abuse is available. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. Investment within the home continues to ensure that a high environmental standard is maintained, creating a comfortable and safe environment for those living there and visiting. EVIDENCE: RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 16 The bedrooms are all single occupancy with en-suite facilities. Communal toilets and bathrooms are available throughout the home. Separate lounge and dining room facilities are provided on each floor of the Home. Systems were in place for the management of infection control, and the home was clean, tidy and free from offensive odours. Each bedroom seen had been furnished with residents’ personal possessions, thereby generating ownership and a sense of autonomy for individuals. The standard of the environment within the home is good, providing residents with an attractive and homely place to live. Residents confirmed that they appreciated the physical environment. Hot water temperatures have been risk assessed and had been regulated to prevent people being accidentally scalded when they have a bath, and radiators had been guarded and restricted to prevent people being accidentally burnt through intentional or unintentional contact All the windows located above first floor level had been restricted to prevent people from being injured through falling out of the windows (accidentally or deliberately). RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Staffing levels and competencies are suitable to ensure that residents’ needs are identified and effectively met. EVIDENCE: There were suitable nursing and care staff on duty to provide care and support for the 48 people who were resident in the home at the time of inspection. In addition to nursing and care staff, there were also ancillary staff on duty to support service provision. During the visit, call bells were activated, and staff responded speedily to them. The duty rotas confirmed that the staffing levels were stable, with little evidence of staff being absent through short-term sickness. Training has been provided to staff, and includes infection control, first aid and moving and handling. Training was identified as a result of the needs of residents, to ensure that care delivered was appropriate to and in response to the needs of residents. Many staff had undertaken and completed National Vocational Qualification Level 2, and at the time of the inspection, more than half of the care staff within the home had been trained to NVQ level 2 or 3. Residents said that they were “very impressed” with the staff, and rated them “fairly high”. One resident said, “the staff are most generous in their help”, RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 18 said that staff were “very responsive” (to requests and needs) and “any signs of ailment, they are quick off the mark to attempt to remedy it”. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 36. There is clear leadership, guidance and direction to staff to ensure residents receive consistent care, resulting in practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The registered manager is competent and appropriately qualified and experienced to manage the service. Staff and residents spoke very highly of her, and significant diligence and action has been undertaken to maintain and further improve the quality of the service provided by the home since the time of the previous inspection. Residents clearly expressed their opinion that the home was being run in their best interests. Staff were being supervised in a positive manner. One member of staff had been allocated the role of supervising care staff, who were receiving formal RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 20 supervision (to ensure that they are providing care to residents appropriately and safely) six times each year. Supervision records were commendable. The home is undertaking regular quality assurance exercises on various aspects of the homes functioning to ensure that (a) quality is maintained and (b) to improve standards whenever possible – thereby enhancing residents’ quality of life and well-being. RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 4 x x RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? 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 9 Regulation 15 Requirement All medication administered to residents must be accurately recorded onto medication administration record charts. Timescale for action Immediate and ongoing 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. Refer to Standard Good Practice Recommendations RASHWOOD NURSING HOME E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 23 Commission for Social Care Inspection The Coach House Address 2 Address 3 Address 4 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 E52 S65063 Rashwood V235512 280605.doc Version 1.40 Page 24 - 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. 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