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Inspection on 01/11/05 for Shire Lodge Nursing Home

Also see our care home review for Shire Lodge Nursing Home for more information

This inspection was carried out on 1st November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

The service users needs were being met. Care plans were written to a very high standard, and gave specific information. Healthcare assessments were recorded in all instances. The management of medication was satisfactory. Service users privacy and dignity was respected at all times, and service users were afforded choices at all times. Staff communicated with service users in a pleasant and appropriate manner at all times. Each service user had a social assessment completed, and the provision of activities was acceptable. Positive feedback was received from a relative who was visiting in the home. The premises were well maintained, and clean and tidy at the time of the inspection. Staffing levels and staff training were maintained to an acceptable standard. Quality assurance monitoring was undertaken regularly.

What has improved since the last inspection?

The amount of information in the assessment had improved.

What the care home could do better:

The statement of purpose should include information about the smaller sized rooms. Communal toiletries should not be used. Radiator covers must continue to be fitted to protect service users. Recording of service users valuables could be more robust. One accident was not recorded in the accident book.

CARE HOMES FOR OLDER PEOPLE Shire Lodge Nursing Home 281 Rockingham Road Corby Northants NN17 2AE Lead Inspector Mrs Sarah Smart Unannounced Inspection 1st November 2005 08.45 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 Shire Lodge Nursing Home DS0000012640.V263279.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. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Shire Lodge Nursing Home Address 281 Rockingham Road Corby Northants NN17 2AE 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) 01536 200348 01536 447873 Birchester Medicare Limited Mrs Sharon Lorraine Goodall Care Home 50 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (50), of places Physical disability over 65 years of age (40), Terminally ill over 65 years of age (40) Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Of the 50 residents, up to 20 may be in the category of Personal Care only in the categories OP, DE(E) and PD(E). In the category Personal Care only 3 named residents may be accommodated in the category Physical Disability PD under the age of 65 years. Four named service users who are below the age of 65 years. To accommodate one named service user who is under the age of 65 years within the category of DE (E) 16th June 2005 Date of last inspection Brief Description of the Service: Shire Lodge is situated in a converted and extended farmhouse, located on the outskirts of Corby. The home is within walking distance of community resources, which include churches, shops, and pubs and offers accommodation for 50 service users. Accommodation to service users is provided across two floors, the home is divided into several areas each area consisting of bedrooms and lounge/dining facilities. The home has a rear garden which is accessible to service users and car parking to the front. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 08.45 and 12.45. Preparation for the inspection included reading of the previous inspection report, and requirements, and took approximately 1 hour. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, staff rota, quality assurance, accident records, provision of activities, a tour of the premises, service user monies, previous requirements made, and staff and service user interviews. Two service users were case tracked. Three staff members, plus the manager, were interviewed at length, and several others briefly, whilst three service users and one visiting relative were spoken to in detail. What the service does well: What has improved since the last inspection? The amount of information in the assessment had improved. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 6 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. Shire Lodge Nursing Home DS0000012640.V263279.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 Shire Lodge Nursing Home DS0000012640.V263279.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): 1 and 3 partially, 4. Information gathered during admission is satisfactory, and service users needs are met. EVIDENCE: The statement of purpose was not viewed on this occasion, however during the tour of the premises it was noted that two of the bedrooms occupied by service users are below the sizes stated in the National Minimum Standards. This should be included in the statement of purpose. A previous recommendation had been met in relation to service users assessments. Although the same document was being used, additional headings had been added, to ensure that the person completing the form is prompted to include all of the required information. From the records viewed, care practices observed and staff and service user interviews during the inspection, it was evident that the service users needs are currently met. Shire Lodge Nursing Home DS0000012640.V263279.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): 7,8,9,10 Service users health and personal care needs are met to a high standard. EVIDENCE: Care plans for two service users case tracked were written to very high standards. The care plans contained specific information, service users choices, and very clear guidance to staff providing the care. One care plan viewed described how a service user with dementia, would demonstrate she was in pain. Staff stated that they refer to the care plans. One service users file stated that she did not have the ability to agree the care plans, and the manager demonstrated that efforts were being undertaken to obtain agreement from other service users or their relatives in relation to their care plans. The care plans were regularly and timely reviewed. Healthcare assessments were recorded in all instances, and reviewed timely. In only one instance the score was scored incorrectly in relation to the service users weight. A sample of medication was viewed. The management of all medication, including controlled drugs was satisfactory. Staff were observed providing care to service user in one area of the home. The service users privacy, dignity and choices were respected at all times. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 10 Staff were noted to communicate with the service users very effectively, in a pleasant and sensitive manner. This was particularly evident with a service user who was finding it difficult to settle into the home having been admitted the day before the inspection. Shire Lodge Nursing Home DS0000012640.V263279.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): 12,13,14 The provision of activities is satisfactory. EVIDENCE: The service users files contained detailed social assessments, and the care plans stated the service users individual preferred activities. Service users were observed to be assisted by staff to prepare for a bazaar being held over the weekend. Service users in Tudor Hall, the dementia wing, were being encouraged to read books or magazines, or pass a soft ball between them and staff. One relative was in the home at the time of the inspection. He stated that he was happy with the care provided, that the staff treat his relative in an appropriate manner, and the food and room occupied were satisfactory. Observation was carried out in Tudor Hall during this inspection. Service users were observed to be afforded choices by staff, and were not unnecessarily restricted. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. EVIDENCE: These standards were not assessed during this inspection. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 The premises were satisfactory. EVIDENCE: Several areas of the home have been redecorated, and all of the maintenance work has been carried out, and is up to date. All areas of the home are accessible to service users, including the back garden. All of the communal areas of the home were viewed. These were all being used by service users. The bathroom on Tudor Hall was viewed. The toilet cistern had a large amount of tape around it, which looked somewhat unsightly, however the inspector was advised that this is because a service user has been known to remove it, and drop it onto the floor. The bath and window cill had numerous, unnamed, and what appeared to be communal toiletries on them. A sample of service users rooms were viewed, and noted to have been personalised by the individual. All areas of the home were clean and tidy, and housekeepers were seen around the home, during the inspection. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 14 Radiator covers were the subject of a previous requirement, and whilst some have been covered, a large number remain uncovered, and therefore posing a risk to service users. The requirement has been restated. Two shared rooms did not have any privacy screens in place, however the manager stated that portable screens are used in these areas. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,30 Staff are adequately trained, and employed in sufficient numbers. EVIDENCE: The duty rota was viewed. This demonstrated that staffing levels during the morning shift are one trained nurse and 7 carers. During the afternoon there is one trained nurse and six carers, with an extra staff member working a twilight shift. One nurse and three carers are on duty at night. These staffing levels are considered sufficient for the number and needs of the service users currently in the home. Training records were viewed. The home employs several staff who are trained trainers. A thorough and complete training matrix is maintained. Staff requiring training updates had been identified, and this will be carried out at a mutually agreed time. A high percentage of staff have, or are undertaking, National Vocational Qualification. The staff of duty on Tudor Hall at the time of the inspection advised the inspector that they had been employed for a relatively short period of time, however, their knowledge of caring for people with dementia, and skills with the service users in their care were demonstrated to a high standard. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38 Management of the home is satisfactory. EVIDENCE: Quality monitoring is undertaken, and the results were available in the home. Questionnaires are distributed to service users, relatives and staff on a six monthly basis. Service users finances and associated records were viewed. the management of finances and service users valuables within the home was satisfactory, and service users have access to money at all times. Robust records are not held when valuables or money is transported to the head office, or when service users remove valuables etc from the safe keeping within the home. The inspector strongly recommends that such records are implemented. One accident had not been recorded in the accident book. The issue surrounding radiator covers has been addressed in standard 25. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 17 Two fire doors were wedged open at the time of the inspection. These were removed at the time by the manager. Therefore a requirement has not been made. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 3 X 3 3 2 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 23(2)(p) Requirement Action must be taken to address the risks of burning in the event of a service user falling against an uncovered hot radiator. A date for completion of this work must be forwarded to the Commission for Social Care Inspection. Timescale for action 15/12/05 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. 2. 3. 4 Refer to Standard OP1 OP21 OP35 OP38 Good Practice Recommendations The statement of purpose should advise the reader that the home has rooms below the sizes stated in the National Minimum Standards. Toiletries should not be used communally. Valuables stored by the home should be recorded in and out of the home on each occasion. All accidents should be recorded in the accident book. Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Shire Lodge Nursing Home DS0000012640.V263279.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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