Inspection on 06/02/06 for Retired Nurses National Home

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Retired Nurses National Home 16/09/09

Retired Nurses National Home 22/08/07

Retired Nurses National Home 31/01/07

Retired Nurses National Home 14/07/05

Retired Nurses National Home 01/03/05

Retired Nurses National Home 10/08/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Retired Nurses National Home Riverside Avenue Bournemouth Dorset BH7 7EE Lead Inspector Gloria Ashwell Unannounced Inspection 6th February 2006 10:15 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 Retired Nurses National Home DS0000003976.V282151.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. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Retired Nurses National Home Address Riverside Avenue Bournemouth Dorset BH7 7EE 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) 01202 396418 01202 302530 Trustees, Retired Nurses National Home Limited Mrs Elaine Brace Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52) of places Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th July 2005 Brief Description of the Service: The Retired Nurses National Home is a long established care home located in a purpose built building on the outskirts of Bournemouth. The home enjoys a semi-rural situation, yet is within walking distance of a local superstore (food, clothing, electrical goods, newspapers/magazines etc.) Local buses are available less than half a mile from the home, travelling to Bournemouth, Christchurch and beyond. The home stands within extensive attractive grounds offering numerous seating areas. Car parking is available for visitors. The home is registered to accommodate up to fifty-two older people. Ramps are available to assist access to the home. Accommodation is arranged on the ground and first floors, with a passenger lift and stairs between floors. All bedrooms are for single occupancy; thirty-five bedrooms have en suite hygiene facilities. There are sufficient communal bathrooms and WCs available on each floor. There is a spacious dining room and two sitting rooms. The home has its own chapel, reading room and hairdressing salon. It is a registered charity and has recently extended the criteria for permanent admissions to include some other medical professions, as well as nurses. Trustees have overall responsibility for the functioning of the home, which is managed on their behalf by Mrs. E. Brace. 24-hour personal care is provided, as well as all meals, laundry and domestic services. A range of activities is available, including crafts, a reading group, quizzes and gentle exercise to music. Occasional outings are arranged. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection took place on 14 July 2005; since that inspection one complex complaint against the home has been received; the outcome has not yet been determined. The inspector spoke to 9 residents, and together with the Deputy Manager considered other evidence relating to the National Minimum Standards, as described in this report. Additional information used to inform the inspection process included monthly reports regularly sent to the Commission by the registered provider. In recognition of the circumstances and history of this home, which is known to routinely meet most National Minimum Standards this inspection was relatively brief in duration (lasting 3 hours 15 minutes) and focussed on discussion with residents and assessment of only the most essential standards. Standards assessed and found met during the previous inspection were not reassessed during this inspection; this report should therefore be read in conjunction with the report of the previous inspection. What the service does well: The Retired Nurses National Home has a thorough admissions procedure. Managerial staff undertake pre-admission assessment of prospective residents to ensure that only people whose needs can be met are offered places in the home. The home encourages prospective residents and their relatives to visit and assess the facilities and services on offer, before making decisions about admission. The health needs of residents are well met, with evidence of good support from community health professionals, such as GPs, district nurses, chiropodists etc. There are systems in place to ensure that medication is handled safely. Residents wishing to manage their own medication may do so. Residents are well cared for and treated with courtesy, respect and dignity. The need for privacy is also understood. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 6 The manager is qualified and experienced in care and management and provides clear leadership throughout the home. Managers and staff have developed good relationships with residents and this results in a relaxed, supportive and caring environment in which residents feel secure and comfortable. The home has quality assurance procedures in place and actively seeks the views of residents, relatives and staff to make sure the home is run in the best possible way. Residents have the opportunity to choose their own lifestyle within the home and their individual preferences and routines are respected. A variety of activities are made available within the home and occasional outings are arranged. Residents can have visitors whenever they like and are able to come and go as they please. They are encouraged to make decisions about how they live their lives. Meals are varied, wholesome and nutritious. Residents commented favourably about the food provided. Special diets are catered for and residents say they only have to ask and the chef will deal with any special requirements, likes and dislikes etc. The home is well maintained, comfortable and safe for the residents living there. Residents enjoy access to a variety of communal areas, including attractive, well-maintained grounds, with a variety of seating available. There is easy access to the home and grounds for wheelchairs and less able residents. Bedrooms are comfortably furnished and individually personalised, with residents able to bring their own furniture and belongings if they wish. Sufficient staff are employed to meet the current needs of residents. Staff are well motivated and enthusiastic in their work. Comments made by residents included “We’re very lucky here; I love my home”, “They’ll do anything you ask them to”, “They’re excellent, all of them, domestics, gardener, carers, manager – give them a gold star!”. What has improved since the last inspection? In accordance with requirements and recommendations made in the last report arrangements for the provision of information about contractual obligations and related matters to new residents have been improved, to ensure they receive all necessary details in advance of admission to the home. The home has improved record keeping associated with care planning to provide staff with sufficient information to properly meet each resident’s known needs and staff recruitment systems to ensure that persons unsuited to working with vulnerable people are not employed and that residents are not placed at risk of harm or neglect by such persons. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 7 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. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 8 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 Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 9 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 (Standards 1, 2 & 5 were assessed and found met at the previous inspection) Standard 6 is not applicable because the home does not provide intermediate care. When a new resident moves into the home they are provided with a statement of terms and conditions giving knowledge of the fees and what they do and do not cover. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them; the home then writes to the prospective resident confirming the ability to properly care for them. EVIDENCE: Following pre-admission assessment, if the home decides to offer a place to a new resident, the manager then writes to the person stating that the home will be able to meet their assessed needs. With the letter was sent a contract and statement of terms and conditions of occupancy, stating the number of the bedroom the resident had selected, to ensure no misunderstanding occurs. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 10 Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 11 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 (Standards 8, 9 & 10 were found met at the previous inspection) The standard of health, personal and social care is very good and is delivered in accordance with a written plan of care ensuring staff have information necessary to provide correct care to each resident. EVIDENCE: Residents feel well cared for; comments included “It’s very good”. Staff to whom the inspector spoke were aware of each resident’s health and social care needs. Doctors visit residents unable to attend their surgeries for consultation. As necessary, individual residents in the home are visited by other health professionals e.g. nurse specialists, opticians, chiropodists. . Risk assessments form the basis for comprehensive and clear care plans and daily records describe the care of each resident. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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): (All these Standards were assessed and found met at the previous inspection) EVIDENCE: Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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): 18 (Standard 16 was assessed and found met at the previous inspection) The home does not have an appropriate policy/procedure for the prevention of abuse and although arrangements have been made for the near future, staff have not received training in this subject. In consequence they do not have sufficient knowledge to properly protect residents from risks of abuse. EVIDENCE: The Head of Care showed to the inspector a written procedure which provided incorrect guidance, directly conflicting with the accepted procedures as described in the Department of Health document No Secrets: www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/Publication s The inspector explained the significance of the inaccuracies and the risks at which they placed residents. This report contains an associated requirement, and the recommendation that at the earliest opportunity the registered manager and staff undertake training in the understanding of abuse, and its consequent management. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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): Standards 19, 20, 24 & 26 were found met at the last inspection. EVIDENCE: Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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): 29 & 30 (Standard 27 was found met at the last inspection) Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training to ensure they are competent to carry out their jobs. The home meets the recommended standard for at least 50 of care staff to hold a National Vocational Qualification in care. EVIDENCE: The records of a recently employed staff member were examined and found to contain required information, indicating the use of a reliable recruitment procedure, including provision of 2 written references and CRB/POVA disclosure prior to commencing employment in the home. Arrangements for staff training are generally good; arrangements are currently underway to obtain training via a ‘distance learning’ system on subjects including first aid, adult protection and fire safety. All new staff undergo induction training, in accordance with the standards of ‘Skills for Care’ (previously known as TOPSS). Almost all of the care staff hold a National Vocational Qualification in care. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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): 38 (Standards 31, 32, 33 & 35 were found met at the last inspection) The home has implemented written policies and procedures to promote resident’s rights and well-being. In general the premises is well maintained and equipment is checked and tested to ensure that service users are protected from accident and harm, but confirmation must be obtained regarding the safety of the electrical installation. EVIDENCE: Staff work in accordance with a collection of written policies and procedures to ensure continuity of approach and safe working practices. At all times there are staff on duty in the home with knowledge of how to deal with accidents and health emergencies. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 17 The home has recorded a comprehensive risk assessment of the premises; the Head of Care informed the inspector that all identified risks are being minimised/managed. The home provides staff with fire safety training, holds periodic fire drills and tests/checks fire safety equipment at the required frequencies. There was documentary evidence indicating that in general the premises and equipment are maintained in a safe condition to ensure residents, staff and visitors are protected from harm and injury, including records indicating the safety of the water supply, passenger lift and gas installation. Records indicated that during May 2001 the contractor who assessed the safety of the electrical installation described it as “unsatisfactory” and provided the home with 3 pages of identified shortcomings; there was no written evidence that the necessary remedial work had been completed so a related requirement is included in this report. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 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 1 X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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 OP1818 Regulation 13 Requirement The home must develop, implement and thereafter properly adhere to effective and appropriate Adult Protection procedures. There must be written evidence confirming the safety of the electrical installation. Timescale for action 08/03/06 2. OP38OP38 13 01/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1818 Good Practice Recommendations At the earliest opportunity the registered manager and all staff should undertake training in the understanding and prevention of abuse. Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Retired Nurses National Home DS0000003976.V282151.R01.S.doc Version 5.1 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. 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