Inspection on 13/12/07 for Shawside Nursing Home

This inspection was carried out on 13th December 2007.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Shawside Nursing Home 25/07/07

Shawside Nursing Home 07/11/06

Shawside Nursing Home 05/01/06

Shawside Nursing Home 21/06/05

Shawside Nursing Home 09/12/04

Shawside Nursing Home 17/05/04

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 Shawside Nursing Home 77 Oldham Road Shaw Oldham Lancashire OL2 8SP Lead Inspector Michelle Haller Unannounced Inspection 13th December 2007 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 Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 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. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shawside Nursing Home Address 77 Oldham Road Shaw Oldham Lancashire OL2 8SP 01706 882290 01706 290770 taylorve@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Ltd 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) Care Home 150 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (57), of places Physical disability (120), Physical disability over 65 years of age (120) Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. The manager to be supernumerary at all times. No more than 90 places to be used for nursing care. No service users under 55 years of age to be accommodated into the home. One named service user above 39 years of age may be accommodated in the home. A minimum of 630 nursing staff hours must be provided each week. A minimum of 630 care hours must be provided on Beech House each week. One named service user under the age of 65 years to be admitted to Beech house in the category DE(E). The home is registered for a maximum of 150 service users to include: *up to 57 service users in the category of OP (Old age not falling within any other category). *up to 120 service users in the category of PD (Physical disability under 65 years of age). *up to 120 service users in the category of PD(E) (Physical disability over 65 years of age). *up to 30 service users in the category of DE(E) (Dementia over 65 years of age). 25th July 2007 Date of last inspection Brief Description of the Service: Shaw Side is a care home that provides 24-hour residential and nursing care for up to 150 service users. Care First Health Care Limited, a part of BUPA, owns the home. Shaw Side is situated on the outskirts of Shaw and is approximately three miles from Oldham town centre. Local shops, libraries, GP surgeries and pubs are available in Shaw centre, which is about a ten-minute walk away. Bus services are available close by. The home provides accommodation in five separate units or houses. Car parking facilities are provided close to each house and garden areas are Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 5 accessible both at the front of the home and at the rear of each house. All bedrooms are single, none have en-suite facilities. Accessible toilets are situated close to bedrooms and communal areas. Some of the bedrooms have patio windows that open onto the garden areas, all bedrooms overlook the grounds. Each house has its own assisted bathing facilities and walk-in showers are also available. A copy of the home’s last inspection report was available from the main reception of the home. Communal lounge and dining areas and a small servery are available in each house. Kitchen facilities and laundry facilities are located within the main reception buildings. The current weekly fees range from £350 dependent on the package of care required. Further details regarding fees are available from the manager. Additional charges are made for hairdressing, newspapers and other personal needs. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. One inspector and expert –by experience completed this key inspection for the Commission for Social Care Inspection (CSCI). This visit was unannounced which means the manager of the home was not informed that we were coming to inspect. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. The inspection included spending some time in each of the four units, looking at care files, records, correspondence and other documents which are kept in respect of people living in the home and receiving dementia and residential care. A number of people were interviewed including people living in the home and their relatives to see what they thought about the care and service they received. We also spoke to members of staff and asked them about their training. The project manager who is currently managing the home in the absence of a registered manager was also involved in this inspection. Information received about the service prior to the inspection such as letters of complaint or concern and telephone calls have also been used as evidence for the inspection process. The monthly providers report, also called ‘Regulation 26 report’ and the improvement plan that was completed by the BUPA management team in response to the previous key inspection on July 27 2007, were also taken into consideration during the inspection process. The previous CSCI inspection report is available on request. The charges at Shawside range from: £350 plus top up from the PCT. What the service does well: The management team responds well to concerns of statutory agencies and cooperates fully with the inspection process, and is keen to implement and develop the best practice in all aspects of social and health care. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 7 The service has a robust admissions process, and effective assessment and care planning systems are in place. These will promote good health and positive wellbeing for people using the service. People living in the home were generally complimentary about staff, reporting that they do listen and try to do what is requested. People said ‘ ’She’s getting all the care she needs.’ People feel that the home has a nice atmosphere and commented ‘ I come very day and there is always a nice atmosphere in the lounge.’ All the staff in this house are helpful and very caring and work as a team.’ The management operate an open door policy for people and their relatives who reported. People appeared to be well cared for with attention to details such as hair and nail care and clothing was co-ordinated. Residents said that staff listened and respected their wishes in relation to personal care and socialisation. Visitors were welcome into the home. Complaints were treated seriously and investigated properly as the home’s procedures requires. Employment recruitment practices were safe so staff who may have posed a risk to residents were not employed. What has improved since the last inspection? The monitoring of the service is now completed monthly visits (Regulation 26) and a copy of this report sent to the Commission For Social Care Inspection. The management of people’s pressure areas has improves significantly in all aspects of practice. Evidence is now in place of when the sore starts and what steps are being taken by staff to prevent/improve the wound, and this is fully documented. This has resulted in the manager and visiting health care Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 8 professionals being sure that the staff understand what needs to be done, how and why. Documentation concerning referral to healthcare professionals for further advice has improved although further improvement is necessary. The manager must make sure that infection control polices, guidelines and procedures continue to be put into practice by all staff and provide evidence that this is being monitored. There were no complaints about clothes been lost during this inspection. Staff have received protection of vulnerable adults training. What they could do better: The management of BUPA must ensure that the person leading the home is suitably qualified and competent to do so. Recruitment to this position is important and this position needs to be filled so that the staff have stable leadership which improves the outcomes for people living at the home. The manager must ensure that all parts of Shawside are clean and fresh so that people live in air that is clean. The manager should continue to monitor people’s satisfaction with the meals provided at Shaw Side. The manager should also make sure that the activities offered can meet the needs of all individuals people in the home. Complaints are listened to, but the manager needs to have effective systems in place to make sure that what they put right, stays right. Please contact the provider for advice of actions taken in response to this Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 9 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 10 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 Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that new people are only admitted to the home following a full assessment of needs that has been carried out by people trained to do so. EVIDENCE: Shawside has completed the transition between two assessment and care planning systems. Four files were examined and each contained a detailed assessment of needs that had been completed prior to or very soon after admission to the home. The most recent admission had been fully assessed and information included a profile of the day and night routines and preferences, general health needs including pain management, moving and handling needs, mood and emotional wellbeing, nutritional status, communication and family involvement. In most cases social interest and historical information had also been documented in detail. Notes also Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 12 confirmed that person and their relatives were able to be involved in the initial assessment process. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that at Shawside the health and personal care that people receive is based on their individual needs and that the principles of respect, dignity and privacy are put into practice. EVIDENCE: At the previous inspection there were major concerns relating to pressure area care in the home. On this inspection the number of people with pressure areas in the home had reduced and the treatment, assessment and monitoring for those at risk of developing pressure areas had been much improved. There were detailed assessment and monitoring records such as turn charts, evidence that people had been referred to the specialist nurses at the first sign of any problem. Training has been provided in relation to maintaining skin integrity, nutritional requirements and recognising the early signs of pressure sores. There was also clearer instructions for staff in how to use equipment such as pressure relieving mattresses and cushions. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 14 A detailed description of any skin problems was recorded and the area checked on each day. Pictures were taken at the beginning of any concerns so that an accurate record of develops and progress could be maintained. The manager stated that the home now had a nurse who worked closely with the community based tissue viability nurses. This meant that best practice and new ideas would be shared more quickly. One omissions noted during the inspection was that the expected setting for individuals using pressure relieving mattresses were not readily available, although it was stated that the settings were checked daily. It was agree that the expected setting should be charted and confirmed each day. These improvements must be sustained. The Quest assessment and care planning process has been fully integrated and implemented. This system prompts staff into completing very detailed and comprehensive needs led assessment and corresponding care plans. The process uses a scoring system that, if used properly, will also ‘trigger’ the development of specialist risk assessments and involvement of other professionals in areas of concern. These areas relate to health, social care and maintaining independence and safety such as moving and handling, diet, mental health, infection control, sensory needs, dental health, podiatry, medication issues and continence needs, communication and all other aspects of life including relationships. This process was fully examined and assessed as fit for purpose. Staff were complementary about the new assessment and care plan system (Quest). They said ‘It took a long time to put in place but anyone can come and read it and know the person.’ Care plans were, in the main, detailed, descriptive and provided staff with clear instructions about the actions were to take. For example- ‘Needs an enriched diet so add cream to porridge and cheese in soup’, and ‘When feeding. ………maintain eye contact.’ The care plans had been reviewed and signatures and comments confirmed that people and their relatives were involved in this activity. The system does prompt staff to record professional visits and this was not always completed however it was clear from letters, reports, correspondence and prescriptions that people had regular access to general practitioners, dentists, podiatrist and relevant routine and specialist health care and check ups including hospital outpatient appointments. The quality of information provided in daily records has improved in that, in the main, they provided a good picture of experiences people have had. There were good descriptions of the actions staff had taken, visits and other Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 15 intervention. In some cases it was possible to assess the success of the support provided and peoples response to the care provided. These reports also related to care plans and were always written a respectful manner. There remains room for improvement as some personal history assessments and daily records lacked detail. However there has been a great improvement in the information recorded and the manager stated that the introduction of the key worker system would promote further improvements. A number of medication record sheet were examined and no omissions were noted and medication was stored correctly. Controlled medication was properly accounted for and two members of staff witnessed that it was administrated. Infection control was procedures were observed and staff were observed putting on aprons and washing their hands prior to dealing with food. No personal care was observed. The interaction between people and staff was observed throughout the day and people continue to be treated with respect and kindness. Staff routinely provided support in a dignified manner asking them what they wanted, and preparing them for any procedures that needed to occur, for example at meal times and prior to moving and handling procedures. Comments about the care and support were positive people said ‘She gets all the care that she needs all the carers seem ok and as far as health is concerned she is looked after with medication and everything else.’ And ‘They are very on the ball with the doctor and the doctors themselves are good and are prompt.’ Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are three activities co-ordinators who work for 21 hours each employed at Shaw Side. The activities calendar displayed in the units indicated that pastimes included games dominoes and cards, manicure and hand massages, one to one sessions, karaoke and ‘Sing-a-long with Frank’; a Church service, library, visit from a dog petting organisation, reminiscence, big bingo and arts and craft. There were photographs of people currently living in the home participating in the activities on display. An artist also runs painting sessions in watercolours on a monthly session and some people had their paintings displayed in the home and their bedrooms. Many of this work was to a very high standard and clearly enjoyed by the participants. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 17 The units visited had been nicely decorated in preparation for Christmas. During the morning reminiscence session and games session were taking place on two units. In the reminiscence group there were nine people actively taking part and another person observing, and in the bingo session there were six people playing the game and a resident was calling the numbers. Both activities were being enjoyed and people were discussing the items in the memory box and what prizes they would like to win from the bingo. Staff appeared to take an active interest in the opinion and experiences of those participating. And the expert by experience (ex-by-ex) described this as ‘ …quite interactive.’ Staff also told the ex-by-ex that ‘a “Forties Room” was being created with baskets of items for residents to “rummage” through and stimulate their memories.’ The daily records that were examined did provide some insight into the activities enjoyed over the previous week included reading, painting, making cards and watching television. The records maintained by the activities cocoordinator were not examined on this inspection. The routines in the home is flexible and people who were interviewed observed that participation was voluntary and flexible, one person noted: ‘She doesn’t seem to join in but used to sit I her room though recently she has started to come into the main lounge.’ Special occasions are celebrated ‘For her birthday they usually have a cake and buffet’ and ‘there are lots of social events including birthday parties, using large board games, fairs and someone comes around doing the ladies nails.’ Some institutional practices were observed for example the use of the television. This was on all the time and the sound set too low for people to hear- when asked whether she liked the new wide screen television one person replied ‘I can’t hear it or choose what goes on’. And another person said ‘I like it when I can hear it’. In the afternoon a brass band from a local school played in the home and this was clearly enjoyed by the large number of people who came to listen, however the television remained on in the background. An activities coordinator was interviewed and she assessed that BUPA were keen to provide meaningful activities and recreation. In her experience the organisation had funded different initiatives including links with other organisations and the purchase of equipment and materials. The social history and life story information that has been collated for each person demonstrates the management’s commitment to providing individualised and person centred activities and more evidence is needed to Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 18 demonstrate that this is happening. For example it was noted that there were no activities made available for younger residents even though they were able to say for themselves that they were dissatisfied with what was on offer. One person commented to the ex-by-ex “Everyone is older than me”. The ex-by-ex felt that this person ‘Did not appear to be stimulated by the social games.’ In relation to social activities the ex-by-ex concluded ‘The Social Activities on the whole were very good, but still everything is Group orientated as there did not appear any individual one to one activities on the agenda.’ People are supported to maintain good relationships and contact with their families and friends. It was noted that family contact was documented and a lot of information about people had been gathered through staff spending time with the person and their relative and communication with relatives appears appropriate. As there is an emphasis on assessing the involvement of relatives it might be beneficial if the effect of not having visitors were considered when this is identified. Comments included ‘You can visit anytime and I always get informed if ill or anything problem.’ And people felt that the routines were flexible ‘mum says that they are flexible she can go to bed in the afternoon if she feels tired’. The mealtimes observed were pleasant experiences. The lunchtime meal was, homemade mushroom soup, lasagne with garlic bread, or omelette, and for desert – muffins or strawberry mousse. The ex-by- ex noted that where she observed a mealtime- ‘The choice for lunch was a specified three course meal with no choices. The only alternative was a sandwich.’ The lack of choice at lunchtime has been identified as problem at the previous inspection. However this was in contrast to the choices observed on the other unit. Here it was noted that people were offered the main choice or omelettes, and the soft diet was fish in cheese sauce. Each item was observed and the lasagne was sampled. The meals looked very well presented and the lasagne was hot and tasty. The soft diet was particularly well presented and looked very appetising. Over lunch people made appreciative sounds and one person commented ‘Ohh it tastes nice.’ The menus are changed each week on a monthly rotation and have been revised since the last inspection in July 2007. The menu for the day of this inspection was: breakfast – porridge, cereal, fruit, toast and jam or cooked breakfast, fried or scrambled egg, hash browns, tomatoes or beans. Lunch- mushroom soup to start, lasagne or omelette or Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 19 fish in cheese sauce; followed by muffins or strawberry mouse. Teatime- spicy fish stew or chicken thighs and Rice pudding for desert. The head chef visited the unit during the meal and he was knowledgeable about his job and seemed interested in preparing tasty and nutritional meals for people living at Shawside. Weight charts and food records indicated that meals and snack were readily available and people frail and undernourished people gained weight following admission to the home. No negative comments were made about the food, people said ‘She never complains about the food.’ a resident observed ‘The food is good I get what’s given and it’s always alright.’ The ex-by-ex observed ‘……, the food for lunch, although very little choice, was very good in quality’. At lunch it was observed that care staff provided support to those who needed assistance. The dining areas were clean and furniture was pleasant to use and free of stains. Staff were respectful, helpful and patient at all times. This comment summarises the lifestyle experienced by some people living at Shawside ‘‘The food is good I get what’s given and it’s always alright. Very good, they’re very good, not bad at all. There are things going on and we join in. People come and visit when they can during the day or night.’ Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People are informed about how to complain or comment about the home and overall felt to be listened to. Procedures are in place to protect people living in the home from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who commented stated that they were aware of how to make a complaint ’If I had any concerns I would speak to the staff in charge at the time but I have never had to make a complaint.’ And ‘There are things that crop up but I feel I can mention them straight away and they are dealt with.’ The complaints record was examined and the information confirmed that complaints were dealt with fairly and transparently. Complaints are analysed by BUPA head office so that any patterns can be recognised and appropriate corporate interventions put in place. The manager confirmed that approximately 90 of staff had now completed Protection of vulnerable adult training, and this included kitchen and domestic staff. Both members of staff who were interviewed had recently completed Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 21 adult protection training provided by Oldham local authority learning partnership. They felt that this had raised their awareness about the actions and omissions that could be considered abuse. Both were clear about the actions they would take if they were to witness inappropriate behaviour and felt more confident in how to tackle such issues. A flow chart was also on display in the office outlining the steps staff should take if they suspected or witnessed abuse. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Furniture, fixtures and fittings are homely and provides a comfortable place to live, although additional steps are required to make the environment free of unpleasant odours.. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of all the units in use at Shawside was completed. There was a smell of stale urine present on the units and in one particular bedroom. This was discussed with the person in charge of the home on the day of inspection. The ex-by-ex commented ‘On being shown round the four different Houses, the first thing that hit me was the strong smell of urine.’ Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 23 Most fixtures and fitting looked clean and were free from unpleasant stains. The manager stated that refurbishment programme has begun in the home and some new carpets had been fitted. Observations made on the units throughout the inspection process indicated that, the physical layout of the lounge areas did not always meet peoples. This was because people watching television did not seem able to have the sound up to an audible level as this was a distraction to other activities. Aids and adaptations such as handrails and heightened toilet seats were in place, and people were observed mobilising and using the facilities independently and with assistance. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People at Shawside benefit from staff who are trained, skilled and in sufficient numbers to support them and meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of this inspection the home was fully staffed. The staffing ratio on one unit was checked. There were 23 people living on the unit, five care staff including the unit manager and two domestics were on duty until 16:00. In the evening four care staff were on duty and a domestic worked until 18:00hrs. Three care staff are on duty over night. On the day of inspection a young work-experience person was also on duty, she was speaking to people and assisting with activities. In the main people using the services felt that there were sufficient staff on duty. Observations included ‘Every thing in the home runs smoothly’ and ‘Though staff change constantly there are enough and they have gathered a lot of information. And they have the information ready to hand for example a carer could say what she had for lunch as a chart is filled in.’ Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 25 Staff files were examined and each contained job application, references, start date and up-to-date criminal record bureaux checks and POVA firsts. There were no gaps or missing items in the records examined. BUPA have established specialist nurses who will become experts in pressure wound care and who will cascade their knowledge to staff at Shaw Side and also be able to provide prompt nursing intervention and guidance so that situations do not deteriorate, this role is ongoing and has proved successful to date. The training records confirmed that the following training had occurred had been provided: continence promotion and the management of incontinence; dementia care; people handling and risk assessments facilitators refresher; managing violence; nutrition; ‘yesterday, today and tomorrow training in dementia care; male catheterisation; record keeping and care planning; assessment and administration of medicines; professional communications; key skills in communication; BUPA care home induction and fire safety. The provider stated in the improvement plan completed in October 2007 that all unit managers had received up dated training in pressure area care. This has improved the quality of life for people living in the home as there is now less risk of them developing pressure sores and they are also more likely to receive prompt attention at the first sign of a problem. It is essential that the improvements in this area be sustained. The home has also introduced a BUPA initiative called ‘Personal Best’. This is as staff development protocol that challenges staff to improve their knowledge, practice and relationships with people using the service and each other. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 26 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. The management systems have improved and promotes an acceptable standard of care for people living at Shawside. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has been without a registered manager for some months, and BUPA have put into place a project manager to drive up standards until a permanent manager is appointed is run the home. This person had proved to be competent and effective in improving the standard of care in the home. She had introduced systems that have reduced the risk of pressure sores Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 27 developing and ensured that appropriate treatment is provided when they do occur. This person has also forged good relationships with local statutory services including the Oldham Metropolitan Borough Councils training unit and social services and the Primary Care Trust. She cooperates with the inspection process and is concerned that people receive the care they need in manner that is, principled and humane. She ensures that staff are competent and aware of the conduct expected of them, she has worked hard to improve the conditions in the home, including the physical environment. It is essential that this person continues to work closely with other senior managers in BUPA and that the systems that have been introduced are made robust and imbedded, so that these improvement can be sustained. BUPA is in the process of completing the quality audit that includes a customer satisfaction questionnaire and questionnaire for visiting professionals. There were no concerns in relation to managing peoples money in the previous inspection and this system has not changed. A number of accounts were checked at random and these balanced. The home has a handyman who takes responsibility for maintenance of services and equipment- he is about to complete additional professional training so that he can test small electrical appliances. At the inspection in July 2007 all equipment and safety maintenance and servicing matters had been dealt with appropriately. Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 28 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 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 2 x x 3 Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? Yes 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 OP31 Regulation 8 Requirement A manager must be appointed to the home and who makes application to be registered with the Commission For Social Care Inspection. (previous time scale 30/10/07 not met) The manager must make sure that the home is free from unpleasant odours people can benefit from living clean and untainted air. Timescale for action 01/04/08 2 OP26 23 (d) 01/04/08 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. Refer to Standard OP15 OP12 Good Practice Recommendations Meals should be monitored by the management to make sure that they are serving is what people want to eat The activities need to be kept under review so that people living at the home are stimulated and interested in what is DS0000025453.V357483.R01.S.doc Version 5.2 Page 30 Shawside Nursing Home going on around them. 3. OP7 The manager should ensure that all information and records are consistently detailed and developed to a high standard this will ensure that people receive equal access to effective and personalised support. The management need to make sure that when they resolve complaints, that systems are in place to prevent a reoccurrence of the complaint. 5. OP16 Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Shawside Nursing Home DS0000025453.V357483.R01.S.doc Version 5.2 Page 32 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!