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Inspection on 01/07/05 for Shottendane Nursing Home

Also see our care home review for Shottendane Nursing Home for more information

This inspection was carried out on 1st July 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 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

Observation and discussion with Service Users confirmed that the standard of personal care provided was delivered to a high standard. It was observed that staff respect Service Users dignity and privacy, and have a good rapport with Service Users. The food menus, the quality of the food seen, together with the variety of food provided indicates that the Service Users are well catered for and have choices.The standard of the environment within the home is good providing Service Users with an attractive and homely place to live. The large garden areas are attractive and well maintained.

What has improved since the last inspection?

The home continues to maintain and provide a good standard of service.

What the care home could do better:

Ensure that sufficient staffing levels are maintained at all times. All medications to be accurately signed for and administered in accordance with legislation and the policy of the home Improvement could be made in relation to wound care management and records. Undertake regular fire practice drills.

CARE HOMES FOR OLDER PEOPLE Shottendane Nursing Home Shotttendane Road Margate Kent CT9 4BS Lead Inspector Sandra Crosby Announced 01/07/2005 at 9:30hrs 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. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shottendane Nursing Home. Address Shottendane Road, Margate, Kent. CT9 4BS 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) 01843 291888 01843 292140 Mr Norman Edward Temple Care Home 38 Category(ies) of Old Age (38) Terminally ill (5) registration, with number of places Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30/11/04 Brief Description of the Service: Shottendane Nursing/Residential Home is a large detached property, which was constructed in 1910 in the ‘country manor’ style. Following a major conversion programme, it was registered as a nursing/residential home in 1989.Service User accommodation is on three floors, comprising of single and double bedrooms 20 of which have en suite WC and washbasin facilities. Nursing bedroom accommodation is situated on the ground and first floors and residential accommodation is situated on the second floor. The day space consists of two lounges and a dining room on the ground floor and a lounge/dining room on the first floor. There is a small room on the first floor, which can be used either as a quiet room or overnight accommodation for relatives. A passenger lift provides access to all levels. Each bedroom has a TV point and a call alarm and some bedrooms have telephone line points. The home is situated in extensive well-maintained secluded grounds and backs onto farmland. There are ample car parking facilities.The home is situated in a residential area and is approximately two miles from the centre of Margate. Public transport to and from Margate is available a short distance from the home. Margate town has many facilities expected of a seaside town, including beach and promenade as well as banks, library, cinema, railway station, places of worship and shops. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was announced and carried out over two days on Friday 01 July 2005 from 09.30 – 15.45 and on Monday 04 July 2005 from 09.30 – 12.30. During the inspection the Inspector spoke individually with ten Service Users, the Registered Responsible Person, the Manager, the Nurse in Charge, the Administrator and several care staff. Records were seen and an accompanied tour of the premises was made. The majority of the key standards were inspected at this inspection visit. Since the last inspection on the 30/11/04 the registered manager has taken up another appointment, and the Inspector was introduced to the new Manager at the end of the first day of the inspection visit, and as the second day of the inspection visit was the Managers first official day the time was used to make the accompanied tour of the premises and provided the Manager the opportunity of being introduced to the Service Users. The atmosphere of the home was welcoming, calm and relaxed, and the home was clean and orderly at the time of the inspection visit. Thirteen Service User Comment Cards were returned together with eleven Relatives Comment Cards overall indicating that they were satisfied with the services provided at the home. The Pre-inspection Questionnaire and Assessment and Inspection Record completed by the home prior to inspection and the information in the comment cards and provided by Service Users and staff at the time of the inspection, has been used in this report. What the service does well: Observation and discussion with Service Users confirmed that the standard of personal care provided was delivered to a high standard. It was observed that staff respect Service Users dignity and privacy, and have a good rapport with Service Users. The food menus, the quality of the food seen, together with the variety of food provided indicates that the Service Users are well catered for and have choices. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 6 The standard of the environment within the home is good providing Service Users with an attractive and homely place to live. The large garden areas are attractive and well maintained. 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. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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) 1,3,6 The homes Statement of Purpose and Service User Guide provide Service Users and prospective Service Users with the information they need to make a decision about moving into the home. Service Users move into the home knowing that their needs can be met and that their independence will be maximised and promoted. It is not the general policy of the home to admit Service Users on a short-term basis, and this standard was judged as not applicable at this inspection visit. EVIDENCE: The Statement of Purpose and Service User Guide were seen, and the nurse in charge agreed for a small amendment to be made. Both documents are well presented and suitable for purpose. It was seen that a completed Enquiry Form, together with pre-assessment information completed on admission and a hospital assessment information were available for a recently admitted Service User. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 9 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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 The care planning system meets the requirements of the national minimum standards and regulations, however it was found that some information in relation to health matters was not recorded, and that this could be detrimental to the well being of Service Users. The health needs of Service Users in the main are well met, but again not always appropriately recorded. The systems for medication administration are good with clear and comprehensive arrangements being in place to ensure Service Users medication needs are met, however several practice issues were discussed. Personal care is offered in a way to protect Service Users privacy and dignity. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 11 EVIDENCE: Three Service User Plans were seen, and overall the system in use includes all components as required by regulation. There was discussion in relation to preassessment information stating that the person had a pacemaker and this information had not been brought forward onto the service user plan. There was also reference seen to daily monitoring of skin viability and daily catheter washouts with no supporting written evidence in the service user plans to say that these practices were being undertaken daily. The tissue viability/wound assessment chart did not follow the dressing procedure plan, and a reference to a swab being taken had not been carried out. There was also reference to pain at site seen recorded, but no action taken to address this. Medication records were seen and indicated that they were mainly appropriately signed and up to date. A couple of inaccuracies were found and discussed. The medication storage seen was considered appropriate for the current group of Service Users. One out of date medication was seen in the cupboard and the Nurse in Charge confirmed that this would be returned to the pharmacy. Controlled drug medications were checked and were double signed and accurate to the numbers of tablets held. Observation and discussion with Service Users confirmed that the standard of personal care provided was delivered to a high standard. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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) 12,13,14,15 Service Users indicated that the lifestyle they experience in the home met their expectations. Service Users are able to maintain contact with family and friends together with access to the local community as they wish Service Users are enabled to exercise choice and control over their lives The meals in the home are good offering both choice and variety, and catering for special diets EVIDENCE: It was seen that lifestyle at the home was relaxed and that Service Users were able so far as is possible to carry on their lifestyle expectations. Visitors were seen around the home during the time of the inspection visit, and Service Users talked about family and friends that visited them at the home. It was seen from the accompanied tour of the home and talking to Service Users that choices in relation to for example whether they spend their time in their bedroom or in the communal areas, whether they join in activities, whether they spend time in the lovely garden areas. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 13 The food menus were seen, together with observation of the meals provided on both days of the inspection. Service Users gave positive comments about the food provided and were aware that alternatives were available. It is indicated that the home maintains a high standard in relation to variety and presentation of food. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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 The home has a satisfactory complaints system with evidence that Service Users feel that their views are listened to and acted upon. EVIDENCE: The complaints procedure for the home was seen, and the complaints book was viewed. Complaints are appropriately entered together with the action taken. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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) 19,26 The standard of the environment within the home is good providing Service Users with an attractive and homely place to live. The large garden areas are attractive and well maintained. The home was clean and pleasant at the time of the inspection visit. EVIDENCE: An accompanied tour of the premises was made with the Manager and Nurse in Charge. Bedrooms were well appointed and all contained personal possessions of the Service Users. Service Users spoken to confirmed that they liked their bedroom and that the furniture was arranged to suit their needs. The laundry assistant provided information about the laundry system in use, and it was seen that all laundry was dealt with appropriately. It was discussed with the Manager that the laundry area needed to be re-painted and re-tiled as appropriate in order to maintain infection control standards. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 16 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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 Staff are multi-skilled ensuring good quality care and support, and staff morale is good resulting in a workforce that works positively with Service Users. Staffing numbers are sufficient for most of the time to meet the needs of the current group of Service Users, however it was found that at occasionally the home had insufficient staff on duty to meet the needs of Service Users. EVIDENCE: Overall the staff rota seen confirmed that there were sufficient staff on duty, however the staff numbers were not always maintained all of the time. This issue was discussed with the Responsible Person, and the Manager who agreed that this situation would be addressed. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 38 Service Users benefit from a well run home, and on the whole the health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The Fire Log Book was seen, and on the whole the regular monitoring checks had been recorded. It was agreed that the weekly call bell tests would now be undertaken every week, and that a fire practice drill be undertaken as soon as possible as the records showed one had not taken place since July 04. The Manager was advised to contact the Fire Safety Officer in relation to the use of equipment to enable bedroom doors to remain open. The accident records were seen and indicated that they were appropriately recorded and cross-referencing was seen to the daily records in the individual service user plans. Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 19 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 20 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 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 2 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 21 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. 2. Standard 7 8 Regulation 15(1)(b) 13(1)(b) Requirement Keep the service users plan under review The registered person shall make arrangement for servicers users to receive where necessary, treatment, advice and other services from any health care professional. A record of incidence of pressure sores and of treatment provided to the service user The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home The registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users To ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as practicable, service users, are aware of the Timescale for action 04/07/05 04/07/05 3. 4. 8 9 17(1)(a) Schedule 3 3(n) 13(2) 04/07/05 04/07/05 5. 27 18(1) 04/07/05 6. 38 23(4)(e) 04/07/05 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 22 procedure to be followed in case of fire, including the procedure for saving life. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 26 Good Practice Recommendations Bring laundry area up to required standard by re-painting and re-tiling as necessary Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Shottendane Nursing Home H05 H56 S 26113 Shottendane NH V227212 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. 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!