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Inspection on 16/06/05 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 16th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

The statement of purpose and service user contract are very informative documents. The home were able to meet the needs of the service users in their care, and staffing levels were sufficient on the day of the inspection. Healthcare assessments were satisfactory, and staff had a good knowledge of the service users in their care. Risk assessments were in place. Medication recording ands storage was satisfactory. The provision of activities was appropriate. The management of the home was acceptable, and good standards of communication were noted between staff of all levels, and service users. The provision of food was satisfactory.

What has improved since the last inspection?

The information given in care plans had improved, meeting the previous requirement.

What the care home could do better:

The recording of pre-admission, and on admission assessments was not clear, and not reviewed. Service users privacy and dignity was not respected on one occasion. Service users safety is seriously compromised by the lack of radiator covers throughout the home, meaning that a service user could potentially fall against a hot radiator, risking being burnt. Recruitment procedures could be more robust to ensure service users are protected. Accident records should contain reviews 12 and 36 hours after the accident. The complainant`s satisfaction following a complaint investigation should be recorded.

CARE HOMES FOR OLDER PEOPLE Shire Lodge Nursing Home 281 Rockingham Road Corby Northants NN17 2AE Lead Inspector Sarah Smart Unannounced 16 June 2005 10.00 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shire Lodge Nursing Home Address 281 Rockingham Road Corby Northants NN17 2AE 01536 200348 01536 447873 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) Birchester Medicare Limited Mrs Sharon Lorraine Goodall Care Home with Nursing 50 Category(ies) of PD(E) Physical Disability - Over 65 (40) registration, with number TI(E) Terminal Illness - Over 65 (40) of places DE(E) Dementia - Over 65 (10) OP Old Age (50) Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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). 2. In the category Personal Care only 3 named residents may be accommodated in the category Physical Disability PD under the age of 65 years. 3. Four named service users who are below the age of 65 years. 4.To accommodate one named service user who is under the age of 65 years within the category of DE (E). Date of last inspection 25th November 2004 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 C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.30 and 13.00. The pre-inspection questionnaire had not been sent out or completed and will be included in the next inspection report. 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, sample of policy review, staff rota, staff files, quality assurance, staff supervision, accident records, complaints records, previous requirements made, and staff and service user interviews. Two service users were case tracked. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst three service users were spoken to in detail. What the service does well: The statement of purpose and service user contract are very informative documents. The home were able to meet the needs of the service users in their care, and staffing levels were sufficient on the day of the inspection. Healthcare assessments were satisfactory, and staff had a good knowledge of the service users in their care. Risk assessments were in place. Medication recording ands storage was satisfactory. The provision of activities was appropriate. The management of the home was acceptable, and good standards of communication were noted between staff of all levels, and service users. The provision of food was satisfactory. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 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 Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 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) 1,2,3,4 Service users are supplied with adequate information to make their choice about moving into the home. EVIDENCE: The statement of purpose was written to a very high standard, and contained all of the information outlined in schedule one. The document was available at reception for the service users and in information packs for prospective service users. Service users contracts are stored at the head office of the company, which is not on the site of the home. Such contracts were viewed on 25th April during inspection of the sister home. The contracts were written to a very high standard, and contained valuable information above the expected level. Such additional information included covers medical and personal requirements, personal mobility, and termination of residency and insurance details. The manager of the home advised that she assesses prospective service users before offering a placement at the home to ensure that their needs can be met. This assessment is recorded, but not in a structured way. The assessment is not then reviewed upon admission, or subsequently when the service users condition change. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 9 However, from case tracking the two service users, speaking to staff and service users, and observing care practices, the needs of these service users were met during the inspection. Staff demonstrated a good knowledge of the service users in their care, and service users stated that their needs are met. One service users husband stated that he is happy with the care received by his wife. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 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) 7,8,9,10 Health and personal care needs are met. EVIDENCE: Care plans were viewed for the two-service users case tracked. These were written to a high standard, and informed the reader of the service users needs, and how to meet them. Care staff stated that they are encouraged to read the care plans. Evidence was included of service user or the relatives’ involvement in their writing. The previous requirement in relation to care plans had been met. Healthcare assessments were thoroughly and accurately completed. Where the results from these assessments indicated that additional intervention or equipment was needed, this was noted to have been implemented. One service users weight had decreased monthly over the past few months, and the manager stated that he was due to be weighed again this week. A sample of medication was viewed. The recording and storage of medication was satisfactory. During observation carried out in one of the lounges, service users privacy and dignity was not respected for example a staff member was undertaking shaving two female service users without changing the razor. In addition the poor practice observed was a cross infection risk. This was brought to the Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 11 attention of the manager immediately who stopped the practice. Therefore a requirement has not been made, although the manager should ensure that staff understand the consequences of their actions in this situation. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 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) 13,15 The meals offered are varied and nutritious and staff are familiar with service users likes and dislikes. EVIDENCE: Lunch on the day of the inspection looked appetising, and consisted of fish fingers, green beans, and potatoes, followed by bananas and custard. It was observed that the kitchen staff have a copy of each service users nutrition care plan, which includes their likes and dislikes in every case. The cook uses this information when providing alternative meals to the service users from the main meal planned. The service users at the home have limited ability to voice their choices in relation to meals. This results in service users only being offered an alternative if they are known to dislike the planned meal. Service users spoken to stated that the food is nice The activities organiser was working with some service users during the inspection. One relative stated that he is made to feel welcome in the home. Service users stated that they go out into the garden. The manager stated that the service users have the controller to determine what programme is watched on the television. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Complaints and protection issues are handled appropriately. EVIDENCE: Staff spoken to demonstrated a good knowledge of the complaints procedure. The complaints policy was included in the statement of purpose, and contained all of the required information. The home has received two complaints since the last inspection, which have been resolved. The documentation in relation to these complaints did not include the complainant’s satisfaction to the outcome, and it is recommended that such information is included. Staff spoken to demonstrated a good knowledge of the action to be taken in the event of an allegation of abuse. The home has a copy of the inter-agency policy on abuse. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 25 Service users safety is compromised by the lack of low surface temperature radiator covers. EVIDENCE: It was observed that radiators throughout the home do not have low surface temperature covers in situ. The manager demonstrated that risk assessments have been carried out, however these documents indicated that a risk is present when the radiators are in use. No further steps have been taken to address this risk. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Recruitment procedures are not robust therefore compromising the care to service users. EVIDENCE: The staff rota indicated that there is one trained nurse on duty 24 hours per day. In addition to this there are 8 care staff on a morning shift, 6 on an evening shift, with a further staff member joining the team at 5pm. There are three carers on duty at night. From observation, and speaking to staff and service users during the inspection staffing levels were appropriate on the day of the inspection. In addition there are catering, administrative and housekeeping staff employed. A sample of staff files were viewed. One staff member had been employed without a Criminal Records Bureau check being undertaken. This staff member had not worked unsupervised at this time, and the manager immediately requested a Protection of Vulnerable Adults first check. The staff file belonging to an overseas staff member did not contain a photograph or a copy of the individual’s passport or visa. Only one of the staff files contained a contract of employment. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 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 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) 31,38 The Manager is suitably qualified and experienced to ensure Service users safety is maintained. EVIDENCE: The manager has recently completed her NVQ 4 qualification in management, and an assessor’s course. The manager is also a qualified nurse with many years experience in the care of the elderly. A good rapport was noted between staff at all levels during the inspection. Accident records were viewed. The number of accidents in the home was relatively high. The accidents were analysed, and there were no trends apparent. Reviews of accidents after 12 and 36 hours were rarely completed. Staff clearly demonstrated knowledge as to which service users should use wheelchair footrests, and which shouldn’t, in which case the necessary documentation was in place. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 17 The home has introduced various risk assessments for all service users including fracture and fall risk assessments. Service users identified to be at high risk of fractures are referred to the General Practitioner for advice. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 4 2 3 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 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x 1 x STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 2 Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 25 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. Robust recruitment procedures must be adhered to. Timescale for action by 31.8.05 2. 29 19 by 31.7.05 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. Refer to Standard 3 38 16 Good Practice Recommendations The service user assessment should clearly cover all areas outlined in this standard, and be reviewed. Accident reviews should be recorded 12 and 36 hours after the accident occuring. Complainants satisfaction following a complaint should be recorded. Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Shire Lodge Nursing Home C51 C08 S12640 Shire Lodge V229630 260505 Stage 4.doc Version 1.30 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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