Inspection on 20/12/05 for Sable Cottage Nursing Home

This inspection was carried out on 20th December 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

Sable Cottage Nursing Home 13/11/06

Sable Cottage Nursing Home 26/07/05

Sable Cottage Nursing Home 11/01/05

Sable Cottage Nursing Home 23/06/04

Sable Cottage Nursing Home 23/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Sable Cottage Nursing Home Chester Road Kelsall Cheshire CW6 ORZ Lead Inspector A Gillian Matthewson Unannounced Inspection 20th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sable Cottage Nursing Home Address Chester Road Kelsall Cheshire CW6 ORZ 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) 01829 752080 01829 752098 Mrs Celia Ann Minshaw Mrs Julie Cummings Care Home 38 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (15), Old age, not falling within any other of places category (23), Physical disability (1) Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 38 service users including:* Up to 23 service users in the OP category (old age not falling within any other category) * Within the 23 OP beds up to 1 agreed service user in the PD category (physical disability under 65 years of age) may be accommodated * Up to 15 service users in the DE(E) category (old age with dementia) *Within the 15 DE(E) beds up to 2 service users in the DE category (dementia under 65 years of age) may be accommodated The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 26th July 2005 2. Date of last inspection Brief Description of the Service: Sable Cottage is a care home providing both nursing care for 23 older people and personal care for 15 people with dementia (Rainbow Unit), two of whom may be under 65 years of ageThe home is located in a quiet residential area in the village of Kelsall, which is eight miles from Chester. Local amenities such as shops, churches, pubs and restaurants can be found within a short distance of the care home. It is served by local transport. The care home has a pleasant and well laid out garden to the side of the building, which is accessible from the dining room. There is car parking to the rear of the care home.The premises are purpose built and comprise three floors. Nursing care is provided on the two lower floors and a separate unit on the top floor is provided for people with dementia. The care home provides a number of communal living areas. Sable Cottage nursing care unit provides 19 single en suite rooms, plus one double with adjoining bathroom and two double rooms with en suite. The Rainbow Unit provides 15 rooms, all having en suite facilities. A passenger lift and staircases provide access to all levels. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over three and a half hours and included a tour of the building, inspection of records and discussion with five residents, one visitor and five staff. All residents were positive about the home and said that the staff were very caring. One resident said ‘I love it here, everyone is very good, I like my room and we have lovely dinners.’ Another said ‘ It’s delightful here’. The visitor said that the care was very good but that Rainbow unit wasn’t as clean since one of the domestic assistants had left. Feedback was given to the registered provider and management team immediately following the inspection. What the service does well: Residents are all assessed prior to admission to ascertain their needs and wishes and these are incorporated into a detailed plan of care. The medication arrangements ensure that all residents receive their prescribed medications at the appropriate times. Care is delivered by a team of well trained staff, who take care to preserve residents’ privacy and dignity. The home employs an activities coordinator and all staff are involved in providing opportunities for residents to participate in activities both inside and outside the home. Meals are well balanced, varied and nicely presented. Complaints are handled appropriately and systems are in place to minimise any risk of harm to residents. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: None of these standards were assessed at this inspection. Standard 3 was assessed as being met at the previous inspection and Standard 6 was not applicable because the home does not provide intermediate care. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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 the following standard(s): 7, 9 & 10. On admission, residents are involved in drawing up plans of care that provide detailed instructions to staff on how to meet their health, personal and social care needs. In the main these are updated as needs change. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents receive their prescribed medication. Personal support is offered in a way that promotes and protects residents’ privacy and dignity. EVIDENCE: Plans of care had been devised for all identified needs, which set out in detail the action needed to be taken by staff to ensure that all aspects of the health, personal and social care needs of the residents were met. The majority of plans were reviewed monthly and updated as required. There was evidence of involvement of residents and their relatives in care planning and everyone on the nursing unit had the care plan in their room. Care plans demonstrated that residents’ personal and oral hygiene were maintained. All residents were assessed as to their risk of pressure sores using the Braden risk assessment tool and appropriate equipment was identified and provided. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 10 The home had a falls prevention strategy in place. One resident, who was identified as being at risk of falls, had a care plan in place that documented control measures to reduce the risk. This had been evaluated monthly, but the evaluation did not identify whether the resident had fallen in the previous month or if the control measures in place were effective. Residents were assessed in relation to their nutritional needs. One resident had a care plan in place relating to nutrition. The resident had lost four kilograms in weight in the previous two months, but this was not identified in the evaluation of the care plan and no further actions had been identified to ensure that adequate nutrition was maintained. See Recommendation 1. There was a satisfactory policy in place for receipt, recording, storage, handling, administration and disposal of medicines. Arrangements for storage, recording, administration and disposal of medication were satisfactory. Residents confirmed that their privacy and dignity were respected at all times. Customer care was taught as part of the induction training programme. Nursing and personal care were administered in the privacy of the resident’s own room or in the bathroom and all examinations were conducted in private. Residents could have a telephone in their room if they wished. Privacy screens were provided in double rooms. Standard 8 was assessed as being met at the last inspection. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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 the following standard(s): 12 & 15 Residents are encouraged to maintain control over their lives, maintain links the local community and participate in an an active social life, if they wish. Meals are nutritious and balanced and offer a healthy, varied diet. EVIDENCE: Residents could choose when to rise and retire, and were assisted by care staff to wash or bathe and dress in the morning. The registered person employed an activities coordinator and there was an activities plan posted on the notice board, however this plan could change in accordance with the wishes of the residents. There was an individual social activities record and plan in each resident’s file. The activities coordinator organised entertainers and outings, which had recently included shopping trips to Chester and Ellesmere Port, a visit to Blackpool lights and a trip to the theatre. On the day of the inspection several residents were going to see a pantomime at Winsford Civic Hall. All special occasions were celebrated in the home and there was a newsletter compiled by the activities coordinator. A carol concert had been arranged for 22nd December and a Christmas party on 23rd December. The local mobile library visited the home every month. There were also monthly quiz mornings and Holy Communion. The home had a pet cat, a parrot and three rabbits. The registered provider also brought in her dog to visit residents. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 12 Breakfast was served between 8am and 11am, lunch was at 12.30pm, the evening meal at 5pm and supper at 8.30pm. Menus rotated on a four weekly basis and there was always a second choice on the menu. Residents confirmed this when in discussion with the inspector. The main meal was served at lunchtime, with a lighter meal in the evening. There were policies on nutrition in the home. Residents’ likes, dislikes and special diets were recorded and the chefs were aware of those who required a special diet. Food for special occasions such as birthdays and anniversaries was provided. Residents could choose to eat in their rooms or in the dining room. They could also eat on the patio in fine weather. Lunch on the day of inspection was salmon in rosemary sauce or bacon and leek flan, followed by rice pudding. Residents had been asked to choose from the menu the day before, but staff and residents confirmed that they could ask for other alternatives if they wished. Staff were observed serving food and providing discreet assistance as required. Residents spoken with said the food was very good and they were looking forward to their Christmas and Boxing Day meals. (The menus for these were displayed in the home.) Standards 13 & 14 were assessed as being met at the last inspection. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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): 16 & 18. Complaints are handled appropriately and residents have confidence that their concerns will be taken seriously. Satisfactory systems are in place to minimise the risk of harm to residents. EVIDENCE: There was a satisfactory complaints policy and procedure on display and a complaints leaflet was made available to residents and their relatives. The complaints procedure was also printed in the Statement of Purpose. Residents said they would inform the registered manager or deputy manager if they wished to raise any concerns or complaints and felt confident they would be listened to. The home had received one complaint this year, which had been resolved. There were satisfactory policies and procedures on adult protection and whistle blowing. Staff received training on abuse awareness during induction and all staff had received further training in September. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 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): 19, 22 & 26. In the main the standard of the environment within the home is good, providing residents with an attractive and homely place to live. However, standards of cleanliness on Rainbow unit have declined since the last inspection. EVIDENCE: The home was nicely decorated, furnished to a good standard and well maintained. There was an ongoing programme of maintenance, redecoration and refurbishment. Bedrooms were redecorated for each new resident. The garden and patio area were kept tidy, safe and attractive. There was a range of equipment and adaptations in the home, including grab rails along corridors, specialist beds, pressure relieving mattresses, raised toilet seats, wheelchairs and hoists (bath and freestanding). The care home had a passenger lift and a call system in all bedrooms. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 15 The standard of cleanliness on Rainbow Unit had declined since the previous inspection. The bedrooms and the main lounge were clean but the dining room and the small sitting area outside the dining room were not of the same standard as the rest of the home. The carpets were stained and the dining furniture needed wiping down. At lunchtime there were still crumbs on the dining room tables from breakfast and the area around the sink and in the fridge were marked with dried spillages that had not been cleaned properly at the time. There was also a strong odour of urine in one bedroom and the underside of the bath hoist was badly stained. See Requirement 1. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 16 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): 27 & 30. Staffing levels and staff training ensure that residents are protected and well cared for. EVIDENCE: The home was providing accommodation for 15 people in Rainbow Unit and 20 people in the nursing unit. The home had a full complement of permanent staff. There were three staff working in Rainbow unit from 8am to 10pm. In the nursing unit there were four staff from 8am to 4pm and three staff from 4pm to 10pm, with an additional member of staff to help with the evening meal. From 10pm to 8am there were four staff throughout the home. There was always a first level registered general nurse on duty. In addition, the home employed a full time administrator, a handyman three days a week, a chef every day and two chefs on three days a week for baking cakes and pastries, a cleaner on each floor and a kitchen assistant and laundry assistant from 8am to 4pm. The home had high standards in relation staff training. All staff underwent an induction process linked to Skills for Care standards. The home actively encouraged ongoing personal development for all staff and had an excellent training programme. Staff who attended external training were expected to disseminate the information to other staff. Training attended since the last inspection had included moving and handling, fire safety, nutrition, oral hygiene, continence awareness, tissue viability, customer awareness and communication and dementia care. One nurse had attended training in Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 17 administering influenza vaccinations. Copies of training certificates were kept on file. All staff, including domestic staff, had a training and development file. Staff were encouraged to complete a personal journal, reflective diary and a learning log. The management of the care home acknowledged achievement with an in house annual awards ceremony. The home had achieved the Investors in People award with additional accreditation for providing staff with opportunities to maintain a work/life balance. Standards 28 & 29 were assessed as being met at the last inspection. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 18 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): EVIDENCE: None of these standards were assessed at this inspection. Standards 31,33, 35, 36 & 38 were assessed at the last inspection and no requirements were made. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 2 STAFFING Standard No Score 27 3 28 X 29 X 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 20 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 OP26 Regulation 16(2)(k) 23(2)(d) Requirement The registered person must ensure that all parts of the home are kept clean and free from offensive odours. Timescale for action 31/12/05 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 OP7 Good Practice Recommendations Monthly evaluations of care plans should make reference to other relevant information, such as whether a resident has lost weight or had any falls. Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Sable Cottage Nursing Home DS0000018816.V272841.R01.S.doc Version 5.0 Page 22 - 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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