Inspection on 21/06/07 for The Shrubbery Nursing Home

This inspection was carried out on 21st June 2007.

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

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

Other inspections for this house

The Shrubbery Nursing Home 17/01/07

The Shrubbery Nursing Home 25/07/06

The Shrubbery Nursing Home 22/12/05

The Shrubbery Nursing Home 05/09/05

The Shrubbery Nursing Home 08/02/05

The Shrubbery Nursing Home 18/07/04

The Shrubbery Nursing Home 03/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Shrubbery Nursing Home, The Birmingham Road Kidderminster Worcestershire DY10 2JZ Lead Inspector Chris Potter Key Unannounced Inspection 21st June 2007 09:15 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 Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shrubbery Nursing Home, The Address Birmingham Road Kidderminster Worcestershire DY10 2JZ 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) 01562 822787 01562 68122 Minster Care Homes Limited Nicholas Michael Peake Care Home 33 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (33), of places Physical disability (33) Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection January 2007 Brief Description of the Service: The Shrubbery Nursing Home is a Grade II listed building set in large gardens and approximately half a mile from Kidderminster town centre. Care is provided for the physically and mentally disabled who require both nursing and personal care. Single and double rooms are available on the ground and first floor. The first floor is accessed via a passenger lift. The home has a secure rear garden, which residents can access, via a conservatory. The weekly fees for this service range between £458.00 - £618.00, depending on the size of the chosen room and the assessed needs of the resident. Chiropody, hairdressing and newspapers are additional to the fee. Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector carried out this unannounced key inspection on the 21st June 2007 and was in the home for a period of 7 hours. On the day of the inspection the home was accommodating 26 residents. During this time the registered manager, 3 staff members, 5 residents and 4 relatives were spoken with. The registered manager Mr Peake was available throughout the inspection and the inspector would like to extend her thanks for his help and assistance throughout the inspection. The inspection focused on the improvements from the last inspection, and an inspection of the key standards. The inspection focused on the outcome of care for the residents using case tracking. Other methods used to monitor the homes compliance against the key standards included the management of medication, staff records and a tour of the environment. The manager also completed the Annual Quality Assurance Assessment (AQAA), and information provided in this assisted with the inspection process. The residents spoken to confirmed that they were pleased with the home. They felt that their wishes were respected and they found the staff to be most helpful. What the service does well: What has improved since the last inspection? Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 6 The home has improved their recruitment procedure, which further protects the residents. Policies and procedures have been reviewed and updated since the last inspection. Some improvement with the decoration has been completed which has further enhanced the homes appearance. Care plans have further improved since the last inspection. The home has achieved their gold standard in Palliative care. 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. The summary of this inspection report can be made available in other formats on request. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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 Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 and 4 (6 is not applicable to this service.) Quality in this outcome area is good. Prospective residents and their representatives have the information needed to assist them with their choice of home. All residents have their needs assessed prior to being admitted to ensure that the home can meet their assessed needs fully. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home has updated their Statement of Purpose and Service User’s Guide. Copies of the documents were available at the inspection and the manager confirmed that copies are provided to potential residents to assist them with their choice. Residents who had recently been admitted to the home confirmed that they had been provided with a copy of the Service User’s Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 9 Guide. They also confirmed that they were pleased with their choice of home and liked their rooms. The pre-admission assessments for three recently admitted residents were reviewed during the inspection. These showed that the home was completing a full needs assessment of the residents which forms the basis of the residents care plan. Residents being case tracked confirmed that the manager had assessed them prior to them going into the home. The residents also felt that their care needs were being fully met. The manager advised the inspector that all the residents’ contracts have been reviewed and updated since the last inspection. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. Care plans are reflective of the residents assessed care needs, with risk assessments being completed and regularly updated. The home has the facilities and expertise to meet the needs of the residents. Medication procedures are well organised. Staff ensure the dignity of the residents and respect their need for privacy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were examined during the inspection and these generally reflected the residents care needs providing guidance for carers on how to meet those needs. Risk assessments had been completed and were being regularly reviewed and updated each month. Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 11 A new resident’s care plan failed to include a pain assessment, which had been highlighted in their pre-admission assessment. It also failed to provide sufficient detail about the residents wound care. The manager confirmed that monthly audits are now being completed. He acknowledged this helps to monitor how the nurses’ are completing the care records and these shortfalls would have picked up as part of the audit. In the homes AQAA it was recorded that residents and relatives are invited to six monthly reviews about their care. Relatives confirmed this to the inspector during the inspection. Residents have access to health care services and a record of this is maintained within the residents care plan. Residents have access to dentists, opticians and other community services as required. Residents and staff were complimentary about the care provided at the home comments included: “perfectly satisfied with the home” “Carers are good with residents, and look after them well”. “Care is very good”. All staff were observed interacting well with the residents during the inspection and a pleasant atmosphere was evident. The home has also been awarded their gold standard in palliative care. Some staff have received specialist training to further assist them in meeting the needs of the residents requiring palliative care. The manager and all staff spoken with provided a good knowledge and understanding of the residents care needs. The homes medication system was reviewed for the residents who were being case tracked. The system was found to be well-organised and appropriate records were being maintained. The manager also completes a monthly audit of the medication system. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is adequate. Activities are limited for some of the residents given the home is currently without an activities organiser. The dietary needs of the residents are well catered for with a balanced diet and varied selection of food to meet the tastes and choices of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the activities organiser has been on long term sick, leaving the carers to arrange some activities for some of the residents who wish to participate. The home provides mobility plus every week, and has a regular sing –a –long. Pet therapy visits fortnightly and the manager confirmed that this is therapeutic for some residents. The home also has Karaoke system in place for the residents. The home has also purchased a large wall mounted television and a system to allow residents to view more channels. The manager Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 13 recognises the shortfall with their activities at this time and appreciates that activities are not suitable for all the residents. The home has an open visiting arrangement and welcomes visitors at any time. Four relatives were spoken to during the inspection and all expressed their satisfaction with the home and the quality of care provided. Residents, relatives and staff stated that the food in the home is good. All confirmed that they were given a choice. The cook confirmed that the menus would be reviewed and changed when the second cook commences. The cook was spoken to and confirmed that there was little waste from the food. All the residents are offered five portions of fruit and vegetables daily. Residents can have anything for breakfast including a cooked breakfast. Two choices are offered for lunch and again if the resident does not like the choice the cook will do an alternative. Teas are limited to sandwiches and a pudding at the moment due to only being one cook. Generally all the comments about the food were positive, one relative felt that the vegetables on occasions were a little hard. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The home has a clear complaints policy in place and residents, relatives and staff are aware of this. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following the last inspection the home has introduced a complaints book, and records all complaints no matter how small. The complaints book showed the date of the complaint, details of the complaint and the investigation undertaken to resolve the issue. Residents and relatives spoken to were aware of the complaints policy. All staff have been provided with training in the protection of vulnerable adults. Staff spoken to confirmed that they would be confident to report any concerns that they might have. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. The homes appearance would be further improved by more decoration and provision of new furniture and furnishings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is situated in Kidderminster near to the town centre, providing easy access for visitors using public transport. The home stands in spacious grounds providing parking for several cars. From the last inspection the home has changed their outside sign which reflects the home in a positive manner and provides e-mail and website details. Externally the home is well maintained, standing in large well kept gardens. Further improvements to the homes Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 16 decoration have been completed since the last inspection, which improves the appearance of these areas and a new carpet in the lounge has been fitted. Some carpets in corridors and some bedrooms appear well worn. The chairs and some furniture were also tired looking and the homes appearance would be further enhanced if these were replaced. It is recommended that the home replace these on a rolling program. The home appeared generally clean and tidy in all areas the management of odours is commended. Residents and relatives confirmed that they were pleased with the cleanliness of the home and found their rooms to be comfortable. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. There are sufficient staff on duty at all times to ensure that the care needs of the residents are met. The home follows a rigorous recruitment policy to further protect the residents. The home is committed to training to ensure that they understand the care needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty records were examined during the inspection. These showed that the home was providing staffing levels within the minimal recommendations for the 26 residents being cared for. Residents and staff advised the inspector that they felt that there were enough staff on duty to meet their needs. The files for three recently employed staff were reviewed during the inspection these showed that the home had completed the appropriate checks prior to Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 18 their commencement. It was recommended that the home request that applicants provide details of all their employment history. In the last twelve months the home has improved their training for staff, including the induction training for new staff. Recent training has included dementia care; fire Marshall training for the nurses in charge. Palliative care training. The manager recorded in the AQAA that this has provided staff with more clarity about their role and what is expected of them. The home has met the standard of having 50 of carers with NVQ level 2 or above. All staff spoken to confirmed that they are committed to their work and felt it was a pleasant atmosphere to work in. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. The home is managed by a first level registered nurse who has many years experience. All equipment is serviced and maintained to ensure that the health and safety of residents and staff is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 20 Following the last inspection the manager has worked hard to implement and review all policies and procedures in the home. This information has been provided for all staff to assist them in meeting the resident’s needs. Copies of all the policies were available for the inspector to reference during the inspection. The manager has also introduced monthly monitoring audits to ensure that the staff are following policies and procedures. The audits include medication administration; care planning, bedrails, bed mattresses, environment audits and infection control. Given the amount of work and time taken to complete the above the manager had to put his Registered Manager’s qualification on hold. The homes quality assurance is developing and a questionnaire is provided for all new admissions. The home did a recent survey for the visiting professionals out of the 15, 6 responded and the outcome was good. The homes AQAA confirmed that they would forward their annual development plan for quality assurance for 2007/2008. All fire and maintenance records were available and up to date at the time of the inspection. The manager has also updated the homes Fire risk assessment. The home has developed a contingency plan in place in case of any emergency situation. Residents’ finances are not managed by the home; they are usually managed by their relatives or an advocate on their behalf. Shrubbery Nursing Home, The DS0000004143.V337671.R01.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 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 X X 3 Shrubbery Nursing Home, The DS0000004143.V337671.R01.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP31 OP19 Good Practice Recommendations It is recommended that the manager complete the registered manager’s qualification. It is recommended that the home reviews carpets, furnishings and furniture and develop a replacement program to further enhance the homes appearance. Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Shrubbery Nursing Home, The DS0000004143.V337671.R01.S.doc Version 5.2 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. 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