Inspection on 12/07/05 for Regents View Nursing Home

This inspection was carried out on 12th July 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

Regents View Nursing Home 25/11/08

Regents View Nursing Home 30/11/06

Regents View Nursing Home 24/01/06

Regents View Nursing Home 24/02/05

Regents View Nursing Home 30/06/04

Regents View Nursing Home 19/02/04

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

CARE HOMES FOR OLDER PEOPLE Regents View Nursing Home Francis Way Hetton Le Hole, Houghton Le Spring Tyne and Wear DH5 9EQ Lead Inspector Sam Doku Unannounced Tuesday 12 July 2005 at 10.00 am 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. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Regents View Nursing Home Address Francis Way Hetton Le Hole Houghton Le Spring Tyne and Wear DH5 9EQ 0191 526 6776 0191 526 6882 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) Tamaris Healthcare (England) Ltd Mrs Carolyn Janice Bowman Care Home with Nursing 50 Category(ies) of DE(E) Dementia over 65 (50) registration, with number DE Dementia (5) of places Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24 February 2005 Brief Description of the Service: Regents View is a purpose built home in 1995 to provide both nursing and personal care places for 50 older people who have mental health care needs. It stands in grounds that are shared with another care home belonging to the same company. The home is located in a village, in a rural area, among a residential estate and there are local facilities close to the home including shops, post office, bank and public houses. The city centre of Sunderland and the town centre of Houghton-le-Spring is within a short direct bus route from the home. The home itself is constructed in a traditional style of brick and tile and has two floors with passenger lift access to the first floor. The access is level from the ground floor entrance. The car park is located to the front of the building.Bathrooms and communal WC’s have handrails and appropriate lifting equipment for disabled service users. The internal space is generous and there are a variety of lounges and dining areas. Audio and television facilities are provided in these lounges. The grounds are well kept and there is a protected safe area to the rear of the home, in the form of a small sensory garden with a bird stand, enabling service users to meander in relative safety, weather conditions permitting. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection commenced at 7.40 a.m. and lasted for 5 hours 10 minutes. The inspection process involved time spent in to talking to service users, sitting in the lounge and observing staff interaction with the service users, discussions with the manager and care staff, tour of the house, examination of health and safety records and service users personal files, including care plans. What the service does well: The home provides good staffing ratios to meet the needs of the service users. Staff are well-trained and motivated and carry out their duties competently and professionally. The arrangements for getting service users up in the morning are good. Service users were being assisted to get up at times convenient to them. There was no rush to get people up for breakfast. To accommodate this, breakfast was organised in a flexible way to allow service users to have breakfast when they get out of bed. The morning activities were very well organised and peaceful. The home was clean and maintained to a good standard. There was no offensive odour in the home. The home has good assessment procedures in place for determining the care needs of the service users. Social histories which, have been obtained from families have enabled staff to determine the social care needs of those who were not in a position to communicate what their interests are. There is good training programme for the staff to enhance their knowledge and practice. The staff were very professional in the conduct of their duties and showed good knowledge and understanding of the needs of the service users. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 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. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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 Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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) 3, 4, 5. The home has a policy stating that assessments are completed prior to admission, ensuring that the needs of potential service users can be met. Pre-admission information is available to prospective service users and their relatives to enable them to make informed choice about whether or not Regent View could meet their needs. EVIDENCE: The home’s written admission policy states that prospective service users would have their needs assessed by their social worker/PCT Nurse Assessor and also by the home before admission is agreed. This enables the manager of the home to establish if the identified care/nursing needs can be adequately met in the home and that the staff have the skills necessary to meet them. Three service users records were examined and these contained copies of preadmission assessments by social workers/nurse assessors and also assessments that had been carried by the nursing staff of the home. This process is designed to ensure that the home has up to date information about Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 9 the prospective service users and also to assure them and their families that proper steps are being taken to ensure that the needs of the person can be met. Two service users and a visitor confirmed that they were visited by a social worker and also by staff from the home as part of the assessment process. They all said they found the exercise useful as it gave them the opportunity to meet with the staff and ask appropriate questions. It is the policy of the home that all prospective service users are invited to visit the home to meet with other residents and staff. This arrangement is stated in the Service User Guide, copies of which are available to all service users. However, because of the mental frailty of the service users, the manager stated that it has not always been appropriate for prospective service users to personally visit the home before their admission. Such visits are often made by relatives to assure themselves of the facilities available to care for their loved ones. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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, 10. Assessments set out the nursing, social and personal care needs of each service user and plans are formulated to meet them. This has ensured that the care needs of the individuals are met. The service users are treated with respect and dignity by the staff. EVIDENCE: Three service users files were examined and they contained details of their social, personal and nursing care needs. These were set out in the care plans, daily report records and GP/professional visits records. The records showed evidence of visits to GP surgeries, consultant psychiatrists, chiropody treatment, opticians, dentists and other healthcare professionals. In discussions with service users and one relative, they all confirmed that their healthcare needs are met within the home and feel that the staff take active role in promoting this. Three other service users were spoken with regarding privacy and dignity. They all confirmed that the staff respect their privacy, and treat them with respect and dignity. Staff interaction with service users was friendly but professional and staff were observed to treat service users with respect and Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 11 dignity. For example, staff were observed to knock on bedroom doors before making entry. Staff were also noted to speak discreetly to service users when offering assistance with personal tasks. Drugs were safely and securely stored. There are detailed policies on the administration of medicines. However, on arrival for the inspection, it was noticed that the night staff had left the medicines room door wedged open until the morning staff came on duty. Such practices must cease as it presents potential risk to the safety and wellbeing of the service users. The training log sheet shows that all the nursing staff who are responsible for the administration of medicines have had training in the safe handling of medication. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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, 15. The home operates in a way that encourages the service users to exercise choice and autonomy over matters relating to daily activities and health. This promotes a healthy lifestyle for them. EVIDENCE: The service users files that were examined contained details of their social interests. In discussion with staff it was evident that they promote an atmosphere where the service users could continue with their previous lifestyle as much as possible. Staff stated that they would take account of service users past lifestyle and base their care routines on that to suit the individuals. They also stated that they would consult with relatives to gain more information about the service users likes and dislikes. In this way, the staff are providing the opportunity for service users to be consulted about activities thus enabling them to influence and make independent decisions about what social activities they would like. It is not possible to organise planned activities such as outing and bus rides for the service. However, staff stated that they often take individuals out for walks to the village shop. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 13 One relative stated that she is able to visit at anytime convenient to her. The manager stated that the daily routines are organised flexibly to take account of individual likes and dislikes. The routines for getting service users up in the morning and the breakfast arrangements were examples of such flexibility. A four-week rotational menu is in operation in the home. The service users who were spoken with commented positively on the quality and quantity of the meals provided in the home. Examination of past menus indicated that the home provides wholesome and nutritious meals for the service users thus promoting good health. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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, 17, 18. There are satisfactory procedures in place, which protects the service users from abuse. EVIDENCE: There are written policies and procedural guideline on abuse and staff are aware of how to instigate the ‘Whistle Blowing’ policy should this become necessary. The Service User Guide and Statement of Purpose have summaries of the complaints procedure. Copies of these were available to service users and their relatives and thereby providing the opportunity for them to complain if they wish. A number of staff have received training in the Multi Agency Panel for the Protection of Vulnerable Adults (MAPPVA) procedures and also of the home’s whistle blowing policy. Staff were aware of the various forms of elder abuse and how these could be prevented. Such training and awareness amongst staff has been aimed at reducing the likelihood of abuse to service users. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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, 24, 25, 26. Regent View is homely, comfortable and clean, and provides service users with safe and well maintained environment in which to live in. EVIDENCE: The home was designed to accommodate older people, some of whom may have mobility problems. There is good access into and around all areas of the home. The home offers 50 single occupancy rooms with en-suite facilities. There are also specialist bathing facilities and shower rooms. The home is close to local shops, other amenities, and to local transport routes. These have provided the opportunity for service users to continue to exercise independence and choice in the way they are supported to lead their lives in the home. The secluded garden provides good facilities for service users to relax when the weather permits. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 16 Heating and lighting in individual bedrooms was adequate at the time of the inspection. The type of heating system installed is of the kind that allows individuals to control the room temperature to suit personal preferences. Individual rooms have good ventilation and natural lighting. This ensures comfortable surroundings for the service users. Window restrictors have been fixed to all windows and all radiators have suitable covering. Checks of hot water at randomly selected bathing outlets confirmed that hot water did not exceed 43°c. There are grab rails in toilets, bathrooms and corridors to assist with mobility and to promote independence. Other equipments such hoists and assisted baths have been provided to further enhance the quality of the service for the benefit of the service users. The home has written policies and procedures relating to safe handling of hazardous materials for staff to follow. The manager indicated that staff have had training in health and safety, infection control and food hygiene. At the time of the inspection the home was noted to be clean and free from offensive odour. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. The above safety measures, practices and policies ensured that service users live in safe and comfortable environment. However, it was observed that some rooms, which did not have door guard were wedged open with tables and chairs. This is in contravention of fire safety practices and must cease. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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, 30. Service users are supported by well-trained and competent workforce. Staff receive appropriate supervision and training which ensured that all aspects of individual service users needs are met. EVIDENCE: The staffing rotas were examined and found to be sufficient in numbers to meet the care needs of the service users. Examination of past rotas showed evidence of staffing levels being consistently maintained. The home has a clear policy on recruitment and the manager confirmed that the home follows these policies rigorously. All the staff have been given terms and conditions of employment and job description. The manager confirmed that all staff have had CRB checks done, and evidence of these were made available for inspection. Most of the staff working in the home have been there for a considerable number of years thus providing a stable care environment for the service users. The staff training log contained details of the training provided for the staff which included moving and handling, first aid, fire safety training, food hygiene, challenging behaviour management, falls prevention and protection of vulnerable adults awareness training. A number of care staff have completed NVQ 2 training and arrangements are in place to extend this to all staff. New staff are provided with induction training followed by foundation training within Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 18 the first six months of employment. The emphasis on providing suitable training to the staff has positive impact for the service users. The good practice models observed on the day of the inspection was evidence of the good training provided. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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, 36, 38. The manager is appropriately qualified and experienced. She ensures that service users benefit from a well run home. The health, safety and welfare of the service users are always promoted and protected. EVIDENCE: The manager is a Registered Mental Nurse and a Registered General Nurse. She has NVQ level 4 in management and long experience of working in nursing homes and with older people with mental health problems. The staff who were spoken with indicated that the manager runs the service for the benefit of the service users and has positive relations with the staff. Similar comments were also made by two of the service users and a relative. Staff commented that they have regular one-to one supervision from the senior staff and are able to approach the management to discuss any issues relating to both personal and professional matters. This ensures that the staff Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 20 are aware of the changing care needs for the service users and of any new approach to meeting their needs. There are comprehensive maintenance checks carried out on the fabric of the building. Certification and records are kept of all systems including PAT tests, gas servicing and electric wiring, lift and hoist servicing, fire alarms, tests and drills, and emergency lighting. The handyman maintains a record of testing of hot water but the record did not provide details of the actual temperatures taken during the testing. Such records should be maintained for monitoring purposes. The company has produced detailed Health and Safety policies and procedures and copies of these were made available for inspection. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). The training provided for the staff on health and safety ensures that the staff maintain safe working practices which safeguard the safety and wellbeing of the service users. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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 x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 2 x 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 3 3 3 3 3 x x 3 x 2 Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 22 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. 2. Standard 9 38 Regulation 13(2) 13(4)(a) Requirement The medicines room must be kept locked at all times when it is not in use. Fire doors must not be kept wedged-open as this is a potential fire risk. Timescale for action 12 July 2005 12 Jylu 2005 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 38 Good Practice Recommendations A record of actual water temperatures should be maintained for monitoring purposes. Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Regents View Nursing Home B52-B02 S18204 Regents View V219483 120705 Stage 4.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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