Inspection on 14/12/06 for Silloth Nursing & Residential Care Home

This inspection was carried out on 14th December 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.

Other inspections for this house

Silloth Nursing & Residential... 04/02/09

Silloth Nursing & Residential... 28/02/06

Silloth Nursing & Residential... 01/08/05

Silloth Nursing & Residential... 24/01/05

Silloth Nursing & Residential... 22/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Silloth Nursing & Residential Care Home Silloth Wigton Cumbria CA7 4JH Lead Inspector Jacqueline Southern-Leigh Unannounced Inspection 14th December 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 Silloth Nursing & Residential Care Home DS0000010106.V317451.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. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Silloth Nursing & Residential Care Home Address Silloth Wigton Cumbria CA7 4JH 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) 016973 31493 016973 31242 Cumberland and Westmorland Convalescent Institution Mrs Elizabeth A Blair Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38), Physical disability (5) of places Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 38 service users to include: up 38 service users in the category of OP (Old age, not falling within any other category) up to 5 service users in the category of PD (Physical disability under 65 years of age) The number of places for Nursing not to exceed 28 Date of last inspection 28th February 2006 Brief Description of the Service: Silloth Nursing home is close to the Golf course with sand dunes and views across the sea to Scotland on one side and a protected conservation area on the other. The home is on one level providing spacious accommodation and ample communal areas. The interior courtyard with raised flowerbeds for residents to enjoy and plant out. The car park has a smooth surface giving safer and easier access to the home. It is a Grade I listed building and has maintained many of it original features. Current fees for the home are £363 per week for residential care and £385 plus the Primary Care Trusts Registered Nursing Contribution for the appropriate banding. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Key Inspection starting at 10.30am and finishing at 3.45pm. The inspection included a tour of the premises, meeting with residents and staff and looking at the homes policies and procedures. Information was also gathered prior to the inspection in the form of a PreInspection Questionnaire that was completed by the home and questionnaires that were completed by residents and their relatives. What the service does well: What has improved since the last inspection? What they could do better: The home should continue to increase the range of activities available to the residents to ensure that the residents have a good choice of interesting and stimulating activities to take part in if they wish. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 6 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. Silloth Nursing & Residential Care Home DS0000010106.V317451.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 Silloth Nursing & Residential Care Home DS0000010106.V317451.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): 1,2,3,4,5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that it can meet the needs of prospective residents and provides them with relevant information regarding the home. EVIDENCE: The home provides potential new residents with a Service Users guide and a Statement of Purpose, copy’s of both of these along with the last Commission for Social Care Inspection Report, are kept on the notice board which is available to all residents and relatives. All residents have written contracts, the fee’s charged by the home are inline with the current Social Services payment agreement, no top-up fees are charged, also included in the homes fees are three monthly chiropody treatments and toiletries for all residents. All potential new resident are assessed in their home or hospital environment by either the Registered Manager or a Staff Nurse with the Registered Managers qualification prior to admission to ensure the home can meet their needs and the environment is suitable for them. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 9 The home has an open door policy for prospective residents, they are welcome, along with their relatives, to look around the home at any time during the day, and no appointment is required. One resident told me that his overall opinion of the home was ‘very good indeed’. The home does not offer intermediate care. Silloth Nursing & Residential Care Home DS0000010106.V317451.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): 7,8,9,10 & 11 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 good assessment procedure that meets the needs of the service users and ensures that health, personal and social care is well maintained. EVIDENCE: The care plans of a proportion of the residents were examined during the inspection, they were found to contain a lot of relevant information however, for residents with more complex care needs the sheer volume of information recorded made the care plans difficult to follow. It was suggested during the inspection that an overview of the care plan with numbers, headings and a brief summary for each area may be helpful for the staff. The residents plans not only contained medical and health information but also a good selection of information regarding lifestyle choices and end of life wishes, this will support the staff in giving a good level of personalised care for the residents. The home works with the local Tissue Viability Nurse to ensure all wounds and skin care is up-to-date, helping to protect the more vulnerable residents. The home has a policy for self-administration of medication, the majority of the residents have their medication administered by the nursing staff, Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 11 residents that wish to self-medicate are assessed as competent and their wishes recorded in the plan of care. The home has a set of policies and procedures in place for the safe storage, administration and disposal of medication. The medication and administration process for a selection of residents were checked and found to be correct, this also included controlled drugs, which were stored and administered safely. Staff were observed interacting with residents, this was always in a calm and relaxed manner, it was observed that a mixture of first names and surnames were used depending on the residents preference. Staff were seen to knock on residents bedroom doors before entering. I was able to talk to several residents in some detail all on an individual basis; all were very happy with their care and felt they were treated with dignity and respect. The home records the end of life wishes of the residents in their files, however the manager is undertaking a new assessment that looks at all aspects in more detail such as funeral arrangements etc, the manager told me one gentleman had told her that he was very relieved that she had given him the opportunity to discuss his funeral arrangements, he knew exactly what he wanted but every time he tried to broach it with his daughter she got upset so he dropped the subject. Silloth Nursing & Residential Care Home DS0000010106.V317451.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home supports the residents to maintain a balanced lifestyle with options for choice. EVIDENCE: The home undertakes regular quality control audits looking at different aspects of the running of the home, the most recent questionnaire involved the residents directly, as a result the home is now increasing the level of activities on offer for the residents as the residents felt there were not enough available. The home has also introduced a monthly newsletter to keep the residents and visitors informed about up-coming events and also other social information. The home has an activities schedule for residents that is kept outside the dining room, the schedule demonstrates that the home does offer residents different activities, around the Christmas period some residents have been out to see performances of plays and groups have been into the home carol singing, residents told me they enjoyed these very much. Different Religious services are available at the home for those that wish to attend. The home has an open door policy for visitors, relatives and friends were seen coming in and out of the home during the inspection, visitors are offered Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 13 refreshments by the home and are able to use the staff room kitchen to make themselves drinks. Residents are now consulted on many aspects of the running of the home; recent examples are with the menu choices and colours schemes for decorating the home. The home has a four-week rolling menu, which is changed seasonally; a copy of the menu was displayed by the dining room. The residents are offered a choice everyday and if they do not like the choices they are offered an alternative, the lunch on the day of inspection was nicely presented and looked appetising. Comments from residents show that they are very happy with the meals; ‘the food can’t be faulted’ and also ‘the food is good, I have no reason to complain, in fact it’s just like being at home, I can have what ever I want’. Silloth Nursing & Residential Care Home DS0000010106.V317451.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 & 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 robust complaints process that protects the rights of the residents. EVIDENCE: The home has a good complaints procedure; they have not received any written complaints since the last inspection. Verbal complaints or concerns raised by residents with the manager are dealt with quickly and directly. One resident explained that if he had any concerns he would report them to matron, he said they were always dealt with immediately, that they were investigated and then Matron made a decision. He was aware that he could ‘go higher to the committee’ if he was not happy with matrons decision, but said he had never needed to and could not envisage ever needing to. Staff have received training on Protection of Vulnerable adults and all staff and new volunteers have appropriate criminal record checks. Silloth Nursing & Residential Care Home DS0000010106.V317451.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): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment of the home is clean, warm and safe; it meets the needs of its residents. EVIDENCE: The home is a Grade I listed building and therefore has many of its original features, there are beautiful stained glass windows and the outward appearance of the home is very impressive. All the accommodation is on the ground floor, the majority of the rooms are en-suite, some also have their own shower, there are only two rooms that are not en-suite and they are directly opposite a toilet. The bedrooms and en-suites are all of varying sizes and shapes, but are all of a very good standard, residents can chose the colour of their bedroom. The home provides nice furniture for the residents, some of which has been upgraded, however residents are encouraged to personalise their rooms and may bring in some furniture if they wish. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 16 All the residents have televisions in their rooms; if the resident does not have a television the home will provide one for them. All residents are able to have telephones in their rooms if they choose. The en-suite bathrooms all have disposable gloves, aprons, hand-towels and liquid soap in discrete dispensers on the walls; this is an example of best practice in terms of infection control and safety. There are three bathrooms for the use of the residents, which are in good condition, warm, and suitable for use, there are hoists and slings available for the residents use. There are adequate sluice facilities within the home, which were clean and tidy with no unpleasant smells. There are three separate lounges; one of the lounges had been recently refurbished to a high standard. There is a dining room, which is due to be refurbished in January 2007. The home has a staff room with a small kitchen area that visitors are able to access to make drinks during the day. The main kitchen is opposite the dining room; this is a good-sized room with a separate dry goods store. The home has its own laundry and specialised staff, the laundry was very clean and well organised, most of the residents bedding is changed on a daily basis, and the resident’s clothes are very well cared for. The home itself was clean, tidy and very homely there were no unpleasant odours. The home has extensive grounds, which are available to all the residents; it is very private and has lovely aspects on some sides. Silloth Nursing & Residential Care Home DS0000010106.V317451.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A staff team that has been recruited, inducted and trained adequately to give a good standard of care meets the residents needs. EVIDENCE: The staffing levels at the home are good and provide the residents with a high level of support and care. The majority of the Care Assistants have undertaken or are currently undertaking National Vocational Qualifications in care at level II or III. Staff training is given a high priority at the home as the manager feels this will provide the residents with the best care possible, a list of the planned training was supplied, this look appropriate and comprehensive. The Manager informed me that staff are up-to-date with protection of vulnerable adult training, this is essential to ensure the safety of the residents. Staff files were checked, recruitment policies and processes are in place and these were seen to be followed in the files. All new staff have a one-week induction period, the induction process is being reviewed at present, the home are aiming to make it more dynamic. One resident told me that ‘the staff could not be better’, this opinion was also shared by other residents that I spoke to on the day of inspection. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home safeguards the rights and best interests of the residents. EVIDENCE: The Registered Manager is Anne Blair; Ms Blair has been in post for 18 years. The manager works closely with and is part of the management committee that monitors all aspects of the running of the home, recent examples of changes that have been introduced by the management committee are purchasing new electrically operated beds, redecorating the lounge and the new plans for redecorating and up-grading the dining room. Both residents and staff at the home feel that the manager is approachable, and that they would always go to her if they had any concerns. The home has policies in place for safe guarding and protecting the residents in terms of financial issues. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 19 The home has a comprehensive set of Health and Safety policies and procedures, which are up-to-date. The home paid for an independent Fire Assessment in May 2006 to ensure they were up-to-date with the latest legislation. The home undertakes its own quality assurance; they have annual questionnaires that are given to residents, relatives and other relevant people who have regular contact with the home such as General Practitioner’s, District Nurses and Social Workers. The committee and management team use the questionnaires to look at current practice and make improvements for the benefit of the residents, the last one was undertaken in October 2006 and several new practices have already been put into operation as a result. Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 4 4 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Silloth Nursing & Residential Care Home DS0000010106.V317451.R01.S.doc Version 5.2 Page 23 - 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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