Inspection on 11/07/05 for Sharston House Nursing Home

This inspection was carried out on 11th 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

Sharston House Nursing Home 26/09/08

Sharston House Nursing Home 16/05/07

Sharston House Nursing Home 07/03/06

Sharston House Nursing Home 01/12/04

Sharston House Nursing Home 04/08/04

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 SHARSTON HOUSE NURSING HOME Manor Park South Knutsford Cheshire WA16 8AQ Lead Inspector June Shimmin Announced 11 July 2005 09:00 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. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sharston House Nursing Home Address Manor Park South Knutsford Cheshire WA16 8AQ 01565 633022 01565 650656 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) Drew Care Ltd Mrs Mary Brennan Care Home 48 Category(ies) of OP (Old Age) 48 registration, with number PD (physical disability) 1 of places SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 This home is registered for a maximum of 48 service users to include: * Up to 48 service users in the category of OP (old age not falling within any other category * One named service user in the category of PD (physical disability under 65 years) 2 The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 1st December 2004 Brief Description of the Service: Sharston House is a Victorian detached two storey converted property situated in its own grounds one mile from the centre of Knutsford. A large extension has been added to the existing premises to bring the total number of bedrooms to 48. The bedroom accommodation consists of 36 single bedrooms with ensuite toilet facilities and 7 without en suites. There are 3 double bedrooms and one has en suite facilities. These rooms are usually used as single rooms but could also be used as doubles, for instance for married couples. Bedroom accommodation is provided on two floors. There are two passenger lifts and two staircases providing access to all levels. Some ground floor rooms have patio doors providing access to the rear garden. A nurse call system is provided throughout the home. Wheelchair access is possible via the side entrance and to all parts of the home. Shared living space includes three lounges and a dining room. There are sitting areas in the grounds of the home. There is car parking space. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 7 and three quarter hours. 13 residents, 2 relatives, the homeowner, the two deputy managers and 6 staff members were spoken with. Written comments were received from 4 health/social care professionals, 15 residents and 1 relative. A tour of the home was undertaken. Care records for four residents were looked at, as well as records on fire safety, maintenance, recruitment, accidents and medication. What the service does well: What has improved since the last inspection? The owner has taken steps to ensure that residents are not put at risk from coming into contact with hot water from sinks and baths by checking the temperature of hot water. The owner has confirmed that risk assessments are in place for radiators which do not have guards or guaranteed low temperature surfaces. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 6 Records relating to residents are kept in lockable cabinets. The home informs CSCI of any events affecting the welfare of residents. All staff participate in a fire drill twice a year. Procedures relating to the management of medication have improved. 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. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 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 SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 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) 2 and 3 The needs of residents are assessed before they move into the home. The home does not accept residents if their needs cannot be met. The needs of residents are reassessed at regular intervals. EVIDENCE: Information about Sharston House is displayed in the reception area. The pre inspection questionnaire (PIQ) indicated that the current scale of charges is between £450 and £700. Additional charges apply for hairdressing, chiropody, optician, private physiotherapy and newspapers and magazines. Contracts are in place for residents who are privately funded. There is a contract between the care home and social services for residents who are funded by social services. However, the home does not provide a statement of terms and conditions between the resident and the home. This is needed so that residents are aware of the room(s) to be occupied, the overall care and services (including food) covered by the fee, additional services to be paid for over and above those included in the fees, the rights and obligations of the resident and the home, and who is liable if there is a breach of contract and the terms and conditions of occupancy, including period of notice. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 9 Before residents move in, new residents are visited either in their own home or other setting, to make sure that that their care needs can be met. The manager talks to the person and writes notes about their care needs. The resident`s care needs are reassessed when they move into the home. A full written assessment was seen for two residents who had recently moved into the home. Written assessments may also be provided by a nurse or social worker. If a resident`s needs change the home contacts appropriate health and social care professionals to assist in carrying out a reassessment of their needs. The care home does not provide intermediate care. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Some progress has been made with care plans but further improvements are needed to make sure that all residents’ care needs are met effectively. The system for managing the residents’ medications is safe but some minor improvements are needed. Residents’ rights to privacy and dignity are upheld. EVIDENCE: All residents have a care plan. Four care plans were read and were all of a good standard and had addressed all care needs. Several minor issues were discussed at the inspection. The plans had been drawn up within five working days of residents` moving into the home, which is good practice. The plans indicated that regular contact had been made with various health care professionals. Appropriate risk assessments were provided. Care plans had been reviewed monthly. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 11 Staff spoken to, were knowledgeable about the care needs of residents. Staff act to prevent vulnerable residents from developing pressure ulcers. Specialist mattresses are supplied by the home and risk assessments identify those most at risk. The pre- inspection questionnaire (PIQ) indicated that three residents had pressure ulcers. One GP commented “I am especially impressed by their ability to get pressure sores healed and prevent recurrence even in the most debilitated patients.” Medication is well managed. Medication administration records were fully completed and stocks of several drugs checked and found to be correct. Residents said that staff members treated them with respect. They said that staff knocked on their door before entering and that their privacy was respected. It was noted during a tour of the building that a “toilet list” was lying in a public area. Also the chiropodist was carrying out treatment of a number of residents in a lounge. To respect residents` privacy, this treatment should be carried ou either in individual bedrooms or in a clinical treatment room. This was discussed with both the chiropodist and the management team. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Standards of catering are good. Individual and group social activities are provided and where possible residents can express choice about their daily lives. Visitors are welcomed at the home. EVIDENCE: The house co-ordinator at Sharston House offers a variety of social activities on a one to one or group basis. The PIQ indicates that the following activities are provided: visits to garden centres, trips, supermarket, May Day celebrations in Knutsford, musical evenings in Knutsford and visits by schoolchildren to perform concerts. The house coordinator keeps a written record of the activities enjoyed by various residents. This has several entries for each month. A weekly activity schedule is displayed in the hallway. Activities for the previous week included a games afternoon, a visit by the mobile library and afternoon tea at a local garden centre. There was a big display of memorabilia from the Second World War in the reception area to commemorate the end of hostilities. A religious service is held at the home at least monthly to give communion. Residents can express choice in their daily lives in many ways. They can join in the activities if they wish. Several residents prefer to stay in their own rooms or to eat there. Several residents take a daily newspaper. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 13 Visitors said they were made to feel welcome. One visitor was staying for lunch. Only one written comment was received from a relative and this was complimentary. All were satisfied with the overall care provided. The standards of catering at the home are good. Residents said “portions too big,” “very good,” “food lovely.” The residents who completed comment cards all liked the food. The daily menu is displayed and showed ample choice and was balanced. Special diets are catered for. Drinks and snacks are given when wanted. The main meal of the day is served at lunch. Mealtimes were as follows: Breakfast Lunch Evening meal Supper 8am to 10am 12 midday to 1pm 4 to 5pm 8 to 9pm Breakfast is continental in style. Supper includes hot drinks, biscuits, sandwiches, crisps and cereals. The lunch was seen as steak and kidney pie with peas, carrots and chips or mashed potatoes. The alternative was salmon fish cake. Dessert was semolina pudding with jam sauce or fresh fruit. The evening meal menu was poached egg on toast or corned beef and pickle sandwich followed by butterscotch mousse. Much of the food is home made rather than pre prepared. The preferences of individual residents were written on a `wipe clean` board in the kitchen. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Sharston House has a satisfactory complaints procedure. Residents and relatives are aware of the procedure and know who to speak to if they have concerns. The home provides information about protecting residents from abuse and staff are aware of what to do in the case of suspected abuse. EVIDENCE: Four minor complaints have been received since the last inspection. All four complaints have been investigated and resolved by the home manager. The complaints procedure is displayed in the hallway of the home. Contact details of the CSCI are given should anyone wish to contact them about any issues of concern relating to the home. Staff undertake training in the protection of vulnerable adults as part of their induction and also during NVQ training courses. During discussion staff were able to describe the actions they would take in the case of suspected abuse. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 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, 22, 24, 25 and 26 The owner has taken adequate steps to ensure that residents live in a well maintained environment. Overall, Sharston House maintains high standards of cleanliness. EVIDENCE: The PIQ did not indicate what improvements had been made to the environment since the last inspection. However, it was noted that the standard of the décor and furnishings was generally good. During a tour of the building no major issues were noted in relation to maintenance. A slight malodour was noticed in one bedroom but otherwise the home was kept clean and fresh smelling. A number of rooms were viewed and these had been personalised by residents. Residents said that they were satisfied with the standard of décor of their rooms. Various aids and adaptations at the home assist residents with varying degrees of disability. The pleasant gardens and seating areas are accessible to residents. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 16 The owner said that risk assessments were in place for all uncovered radiators or radiators which did not have a guaranteed low temperature surface. The temperatures of hot water outlets such as wash basins and baths were being checked by the maintenance man so that residents were not being put at risk of possible scalding. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 Staffing levels at Sharston House are satisfactory. Recruitment procedures are thorough. Staff are well regarded by residents and relatives. Staff are supported to undertake training relevant to their role. EVIDENCE: The PIQ indicated the same level of staffing as at the previous inspection. Two Registered Nurses and seven care assistants are on duty between 8am and 2pm. This reduces to two registered nurses and five care assistants between 2pm and 8pm. At night there is one registered nurse and 3 care assistants on duty. The care home does not use agency staff. A written comment from a care professional said: “all members of staff that I have come in contact with have all shown a very caring attitude towards all residents whom they treat with respect and dignity.” A relative wrote “good staff with a very difficult job.” Visitors spoken with were very happy with standards of care at the home. A number of staff have worked at the home for many years, which provides continuity of care for residents. Records for recruitment were complete, demonstrating a thorough approach to recruitment. Staff said that they are supported to undertake training. The PIQ indicated that staff have undertaken mandatory training in subjects such as fire safety and moving and handling as well as other training relevant to their roles. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 18 Seventeen care assistants have achieved NVQ qualifications. Future training courses have also been scheduled. The home has recently introduced an induction course which is accredited with a nationally recognised training organisation. The induction takes place over six weeks. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 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) 33 and 38 Sharston House is a well managed home. safety and wellbeing of residents. EVIDENCE: The registered manager has been in post since 1989 and is well respected by residents, staff and care professionals. One written comment made was “excellent manager.” The manager is supported by two able and experienced deputy managers. All managers are first level Registered Nurses. The owner is very involved in the running of the home and visits about twice a week for 5 hours on each day. The owner provides a written monthly report about the home which is very brief and not very informative. It does not indicate which residents and staff have been spoken to. The care home carried out a survey in November/December 2004 to find out what residents and relatives thought about the home. Twenty of the forty-five questionnaires were returned. The majority of comments were positive and complimentary about the home. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 20 Management act to ensure the The owner and manager have taken action to respond to any issues raised by the questionnaires. The manager has ensured that residents and relatives are aware of the inspection and given the opportunity to contribute to the findings of the inspection if they wish. A letter from the environmental health officer indicated that the kitchen and food storage areas were satisfactory. The kitchen was found to be clean and tidy during the inspection. However, a dusty fan was in operation in a food preparation area. The kitchen staff checked the temperatures of fridges, freezers and hot foods every day to make sure that they fell within acceptable limits. Accident records were up to date. They showed that staff took appropriate action to reduce the risk of further accidents. During a tour of the building a tub of cleaning materials was seen in an unlocked cupboard. The PIQ indicated that the home was well maintained and equipment and installations serviced on at least an annual basis. Fire records were satisfactory. Staff had undertaken regular training to ensure they knew what to do in the case of fire. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 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 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x 3 3 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 2 SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 38 38 Regulation 13 13 Requirement Dirty fans must not be used in any part of the home and particularly in the kitchen area. Hazardous materials must be kept secure at all times. Timescale for action 11/07/200 5 11/07/200 5 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. 2. 3. Refer to Standard 2 10 26 Good Practice Recommendations A statement of terms and conditions should be provided between the owner of the home and the resident. Lists relating to the personal care needs of residents should not be left to public view. Chiropody should be conducted in private. Steps should be taken to address the malodour noted in one bedroom. SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich Cheshire, 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 SHARSTON HOUSE NURSING HOME F51 F01 S18784 Sharston House V227859 110705 Stage 4.doc Version 1.30 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. 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