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Inspection on 15/08/06 for Shottendane Nursing Home

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

This inspection was carried out on 15th August 2006.

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

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

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 at the key inspection visit 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 at the visit and at previous visits, 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. Re-decoration is ongoing at the home. Staff training is ongoing at the home. The home is working towards providing a high standard of palliative care for those Service Users in need of this service. Staff training is being undertaken and the home has signed up to the Gold Standard Framework, Liverpool Care Pathway.

CARE HOMES FOR OLDER PEOPLE Shottendane Nursing Home Shottendane Road Margate Kent CT9 4BS Lead Inspector Sandra Crosby Unannounced Inspection 15th August 2006 10:30 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 Shottendane Nursing Home DS0000026113.V304359.R02.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. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shottendane Nursing Home Address Shottendane Road Margate Kent CT9 4BS 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) 01843 291888 01843 292140 Mr Norman Edward Temple Mr Laurence John Waitt, Nigel John Cripps Tracey Ann Fullagar Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 27 of the beds are registered for nursing patients and 11 for residential clients. Service User, whose date of birth is 15.01.1942 may be admitted for respite episodes of 14 days maximum. To admit one (1) Service User whose date of birth is 25.8.1947. Date of last inspection 10th February 2006 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. Information from the Registered Manager in the Pre-inspection questionnaire indicates that the fees range from £316.00 to £900.00 per week dependent upon individual needs. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key Inspection visit was unannounced and carried out on Tuesday 15 August 2006 between 10.30 and 14.00 and on Wednesday 15 August 2006 between 9.00 and 13.00. The Registered Manager was undertaking a training day on the first day of the visit, and the focus of the visit was the accompanied tour of the home, speaking with Service Users and Staff and viewing the Service User Plans. During the second visit the Inspector spoke mainly with the Registered Manager and viewed various records. The atmosphere of the home was welcoming, calm and relaxed, and the home was clean and orderly at the time of the inspection visit. Care Homes Surveys were sent out late, and those returned to date all comment positively about the home. The Pre-inspection Questionnaire completed by the home and information provided by Service Users and staff at the time of the inspection, has been used in this report. What the service does well: What has improved since the last inspection? The home continues to maintain and provide a good standard of service. Re-decoration is ongoing at the home. Staff training is ongoing at the home. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 6 The home is working towards providing a high standard of palliative care for those Service Users in need of this service. Staff training is being undertaken and the home has signed up to the Gold Standard Framework, Liverpool Care Pathway. 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 DS0000026113.V304359.R02.S.doc Version 5.2 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 Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 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): 1,3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 have been seen at previous inspection visits. Both documents are well presented and suitable for purpose. A completed Enquiry Form, together with pre-assessment information completed prior to admission together with hospital assessment information Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 9 was seen for a recently admitted Service User. The home has provides printed documentation to a good standard. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 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 the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 recording issues were discussed. Personal care is offered in a way to protect Service Users privacy and dignity. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 11 EVIDENCE: Five Service User Plans were seen, and overall the system in use includes all components as required by regulation together with extra documentation appropriate to a nursing home. Discussion took place with the Registered Manager in relation to issues that had been highlighted, especially in relation to the Service User Plan of a newly admitted Service User. The Registered Manager agreed to address these issues. The tissue viability/wound records showed improvement, however for a recently admitted Service Users there were no record in relation to wound management. The Registered Manager agreed to take action in relation to this issue. Medication records were seen and indicated that overall they were appropriately signed and up to date, however the number of gaps seen was discussed with the Registered Manager. The storage of medication was seen to be appropriate to the needs of the current group of Service Users. Nursing staff are to attend a Pharmacy Update session later this month. Observation and discussion with Service Users at the announced inspection visit confirmed that the standard of personal care provided was delivered to a high standard. The Registered Manager discussed that the home is working towards providing a high standard of palliative care for those Service Users in need of this service, and this has included staff training and the home signing up to use the Gold Standard Framework, Liverpool Care Pathway system for setting up individual service user plans and recording. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. An activities person is employed part time at the home, and the records that indoor activities undertaken include bingo, skittles, quiz, crosswords, with occasional outdoor visits recorded to for example Deal and Broadstairs. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 13 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. The food menus were seen, together with observation of the meals provided on one of the 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 DS0000026113.V304359.R02.S.doc Version 5.2 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 the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that Service Users feel that their views are listened to and acted upon. Management confirmed knowledge and understanding of Adult Protection issues that protects Service Users from abuse. EVIDENCE: The home has a complaints procedure, and the Registered Manager confirmed that there had been no formal complaints made since the last inspection. The training matrix indicates that several staff at the home have undertaken training in relation to the Protection of Vulnerable Adults. The Inspector was shown confirmation that a further two staff are to undertake training in the near future. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 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 the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 Nurse in Charge, and two of the care staff. Bedrooms were well appointed and all contained personal possessions of the Service Users. The Registered Manager on the second day of the inspection visit said that a number of the bedrooms had been redecorated and new carpet purchased as appropriate. Service Users spoken to confirmed that they liked their bedroom and that the furniture was arranged to suit their needs. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 16 The laundry assistant at a previous inspection visit provided information about the laundry system in use, and it was seen that all laundry was dealt with appropriately. It was discussed with the Registered Manager that odours had been noted in several bedrooms, and she agreed to address this issue. Information was later received that gave satisfactory reasons as to why the odours had been noticed. There is a good system in place for the disposal of clinical waste. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 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 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. The home uses a thorough recruitment system that ensures that Service Users are supported and protected. Staff training is ongoing at the home. EVIDENCE: The staff rota was seen, and it was indicated on the days of the key inspection visit that there were sufficient staff on duty at that time to meet the needs of the current group of Service Users. The Registered Manager said that a flexibank of staff had been implemented to provided cover as and when needed. Four staff files were viewed and showed that the home carries out a thorough recruitment procedure with good records kept. The training matrix was seen for the home, and indicates that staff training is ongoing at the home. Two members of staff are booked to go on the following training courses Adult Protection, First Aid, Moving and Handling, Food Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 18 Hygiene, Heart Failure Awareness, and one carer has confirmation to attend a six week palliative care course, and on carer is to attend a hand and foot massage course. Five trained nurses are to attend a wound care conference in the near future. It was discussed that training is needed in relation to Health & Safety and Infection Control, and the Registered manager agreed to address this issue. A number of staff have completed the NVQ2 and one carer is due to commence the NVQ2 and three carers are to commence the NVQ3. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 personal allowance monies records have been seen at previous inspection visits, and the Registered Manager confirmed that all necessary records are kept and indicated that a sound accounting system was in place. When examining the staff files, it was seen that written supervision records are kept. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 20 The Registered Manager said that there has been quality assurance questionnaires sent out in June, however the formal paperwork was not completed as yet. The home has received the Thanet District Council Gold Award 2006. Staff have received training in fire safety, and a regular call point fire test was carried out on the first day of the inspection visit. Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A 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 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 X 3 X 3 3 X 2 Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP7 Regulation 15(1)(b) Requirement Keep the service users under review as appropriate Timescale for action plan 16/08/06 2. OP8 17(1)a Sch3 3(n) Previous timescales 04/07/05, 13/02/06 A record of incidence of pressure 16/08/06 sores and of treatment provided to the service user Previous timescales 04/07/05, 13/02/06 The registered person shall make 16/08/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home Previous timescales 04/07/06, 13/02/06 The premises are kept clean, 16/08/06 hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance 3. OP9 13(2) 4. OP26 16(2)(k) Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Shottendane Nursing Home DS0000026113.V304359.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 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 DS0000026113.V304359.R02.S.doc Version 5.2 Page 25 - 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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