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Inspection on 12/08/05 for Rushden Park Nursing Home

Also see our care home review for Rushden Park Nursing Home for more information

This inspection was carried out on 12th August 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

A continued programme of redecoration ensures that the home is maintained to a good standard providing a homely environment. Extensive work has been done to the garden to provide a very pleasant facility, accessible to all residents. Systems are in place to ensure timely provision of medication in the home.

What the care home could do better:

Resident care plans do not always give staff specific instruction on how to meet assessed needs, making it difficult, particularly for new or agency staff to provide for these needs. There was no evidence that residents had been involved in their initial assessment or in the production of care plans and therefore no agreement from them that the needs identified were actually what they considered to be their needs. Arrangements for the testing of fire equipment and for staff fire training were not adequate, posing a potential threat to resident safety. An unpleasant odour was noted throughout the home. The Home was required to address these issues.

CARE HOMES FOR OLDER PEOPLE Rushden Park Nursing Home Melloway Road Rushden Northants NN10 6XZ Lead Inspector Linda Preen Unannounced Friday, 12 August 2005 at 10:00 th 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. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Rushden Park Nursing Home Address Melloway Road Rushden Northants NN10 6XZ 01933 418777 01933 418666 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) Methodist Homes for the Aged Mr Paul Edward Charles Draper CRH 64 Category(ies) of OP - old age registration, with number of places Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is permitted to utilize all of its available beds for either nursing care or personal care only. 2. That the home is permitted to admit up to 8 service users in the category of DE(E) on the first floor only 3. That the home is permitted to admit up to 6 service users in the category of TI Date of last inspection 3/11/04 Brief Description of the Service: Rushden Park is a 64 bedded purpose built home on the outskirts of Rushden. It provides accommodation for elderly people requiring nursing or personal care, and also has a small number of beds to accommodate elderly people with dementia, and people with a terminal illness. The majority of accommodation is provided in single rooms with en suite toilet and wash facilities. There are 3 double bedrooms. The home is spacious and well maintained. There is access to public transport in order to travel to the town centre. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two hours were spent prior to the inspection reviewing previous requirements and recommendations, comments from residents and relatives and collating information provided by the service. The inspection took place over a period of four hours as part of the statutory inspection programme. Two residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff records, fire records and medication records were seen. 11 comment cards had been received from residents, 4 comment cards from relatives and information was available from a questionnaire completed by the providers of the service. Six of the resident comment cards and all of the relative comment cards were positive concerning the care and facilities provided. Out of the other five resident comments, three were not entirely happy with the activities provided and two with the food. These areas were looked at as part of the inspection. The standard and choice of food was found to be satisfactory although one of the ladies spoken to commented that she preferred plain home cooking and did not always like meat in sauce. Residents spoken to in the lounge areas stated that they enjoyed BINGO and the regular trips out to places of interest. Records of individual hobbies and interests were available in the resident files seen. What the service does well: What has improved since the last inspection? A continued programme of redecoration ensures that the home is maintained to a good standard providing a homely environment. Extensive work has been Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 6 done to the garden to provide a very pleasant facility, accessible to all residents. Systems are in place to ensure timely provision of medication in the home. 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. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 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 Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 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 Residents have their needs assessed prior to admission to ensure that the home may provide care for them. EVIDENCE: Comprehensive pre-admission assessments had been completed for the residents chosen to case track but there was no evidence of resident or advocate input into this assessment. All areas of need were assessed including physical, mental and social aspects. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 Care plans do not always provide sufficient detail to enable staff to provide for all the assessed needs. Medication is managed in a way that promotes resident safety. EVIDENCE: Care plans had been developed for one of the resident’s case tracked but not for the second one who had been in the home for four days. Care plans in place did not always give enough detail to assist staff with care. For example: 1) a care plan for incontinence stated, “Wears pads” but did not specify the type or frequency of change. 2) A resident with a Waterlow score of 23 did not have a care plan in place for the prevention of pressure ulcers, although on inspection was found to have a pressure relieving mattress and cushion in place. 3) A resident who was receiving Oxygen therapy was observed to have a very dry mouth and there was no oral care plan in place. Evidence that discussions had taken place with family members concerning the resuscitation of a resident and also the use of bed rails but there was no evidence that the residents wishes had been ascertained concerning these areas. There was no evidence of resident or their advocate having been consulted in the formulation of care plans. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 10 Some residents were observed to have bed rails in place that did not have covers to protect residents from the risk of entrapment or injury. A requirement was made in this respect Systems for the ordering, administration, storing and disposal of medication were seen and found to be satisfactory. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Social activities and meals are both well managed and provide variation and interest for the people living in the home. EVIDENCE: Records of resident’s life history and preferences concerning hobbies and interests were available in the files seen. Residents spoken to were enthusiastic concerning the twice- weekly BINGO and the regular coach trips out. One resident stated that she had enjoyed a recent trip to the zoo and also to some gardens. Relatives are welcome to visit at any time and some were in the building at the time of the inspection. The registered manager reported that one gentleman likes to come to the home on a daily basis and assist with her care, and when spoken to, this lady stated she was looking forward to him coming. Menus provided as part of the pre-inspection questionnaire, demonstrate that a varied nutritious diet is provided and that a choice of meals is available. Residents spoken to confirmed that they were offered choice in the afternoon for the next day and all except one stated that the food was very good and served in good portions. One lady spoken to said that the food was all right but that she preferred plain roast dinners rather than food with sauces etc. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 12 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) These standards were not assessed on this occasion. EVIDENCE: Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 13 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, 23, 24, 26 Individual and communal facilities are maintained and furnished to a high standard but an unpleasant odour did not make this a pleasant place in which to live. EVIDENCE: A limited tour of the environment was undertaken. All areas of the home seen were well decorated and furnished to a high standard. Individual residents rooms were bright and airy and there was evidence of personalisation in the form of pictures, ornaments and small items of personal furniture. A pleasant landscaped garden is available for resident’s use, with seating areas, water features and level access to allow all residents to enjoy this facility. The home was clean and tidy but there was an unpleasant odour throughout the home, which did not make the home a pleasant place to live. A requirement was made in this respect. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 14 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, 29, and 30 Staffing arrangements take residents needs into consideration. EVIDENCE: Staffing levels are calculated according to the Residential Forum Guidance and are based on the dependency levels of the residents. A selection of staff files was seen and theses demonstrated that recruitment practices are satisfactory with evidence of references and Criminal Records Bureau clearances being available. Staff spoken to confirmed that they receive regular supervision and that the Registered Manager is available at all times for support. The pre- inspection questionnaire records that 12 of the 38 care staff currently hold a National Vocational Qualification in care, which is equivalent to 31.5 of staff with this award. In addition to this, staff have received training and updates in Moving and Handling, Food Hygiene, Fire, infection control, dementia and nutrition as well as specialist needs of residents. Staff spoken to confirmed that this training had been provided, and demonstrated an awareness of the needs of the individuals case tracked. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 15 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) 32, 36 and 38 The home is conducted in a way that puts the needs of the residents first. Arrangements for fire training do not protect residents fully in the case of a fire. EVIDENCE: Service users knew the manager and spoke of him as being helpful. Staff said that they felt him to be a good supportive manager and one that they could go to with any issues. As previously stated they confirmed that they receive regular formal supervision. Records of the testing of fire alarms and emergency lighting were reviewed and there was no evidence that these are being tested at the required intervals. Fire drills held on two occasions in 2004 and also on the 4th August 2005, identified that senior staff required an update in fire training. Despite this, concerns were raised that the deputy manager had no record of fire training since November 2002.This could put residents and staff at risk in case of fire. Requirements were made in this respect. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 16 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 3 x x x 3 x 2 Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 17 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 7 Regulation 15(1) &15(2)c Requirement Timescale for action 1/10/05 2. 3. 26 38 16(2)k 23(4)c 4. 38 23(4)d Care plans must be developed to ensure that all resident needs are identified and that guidance on specific individual requiements is provided. Evidence that residents have been consulted in the formulation and review of these plans must be available. Efforts must be made to 1/10/05 eliminate the unpleasant odour in the home. Fire alarms and emergency 11/9/05 lighting must be tested at the required intervals and records of these tests must be available for inspection. All staff must receive fire training 1/10/05 at least once a year. 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 3.1 Good Practice Recommendations Evidence should be available that residents or their advocate have been involved in the assessment of needs. C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 18 Rushden Park Nursing Home 2. 8.1 All residents who have bed rails should have these padded to reduce the risk of entrapment. Rushden Park Nursing Home C51 C08 S12639 Rushden Park V244274 120805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB 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. 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