Inspection on 04/02/09 for Silloth Nursing & Residential Care Home

This inspection was carried out on 4th February 2009.

CSCI found this care home to be providing an Excellent service.

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... 14/12/06

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Silloth Nursing & Residential Care Home Silloth Wigton Cumbria CA7 4JH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Margaret Drury     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Silloth Nursing & Residential Care Home Silloth Wigton Cumbria CA7 4JH 01697331493 01697331242 admin@sillothnursinghome.wanadoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cumberland and Westmorland Convalescent Institution Name of registered manager (if applicable) Mrs Elizabeth A Blair Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. Physical disability - Code PD (maximum places 5). The maximum number of service users who can be accommodated is 38 Date of last inspection Brief description of the care home 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. There is an 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 II listed building and has maintained many of it original features. Care Homes for Older People Page 4 of 26 0 5 Over 65 38 0 care home 38 Brief description of the care home Current fees for the home are 386.00 per week for residential care and 410.00 plus the Primary Care Trusts Registered Nursing Contribution for the appropriate banding. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The visit to this service, which forms part of a key inspection, took place on the 4th of February and we (The Commission for Social Care Inspection) were in the home for 5 hours. Information about the home was gathered in different way and this formed the basis of the inspection. We received an Annual Quality Assurance Assessment (AQAA) from the manager within the timescale allowed. This document provides information on the services strengths and weaknesses and any future plans to develp the home. It is a legal requirement that this is completed annually by all regulated services. The AQAA was extremely comprehensive and outlined the facilities and services available. We spoke to staff and residents and were able to speak to a family member on the telephone, at her request, Care Homes for Older People Page 6 of 26 after the visit. We received completed survey questionnaires from residents and staff that also helped us to assess this service. During the visit we spent time with residents, looked at care planning documentation and the completed assessments that ensured the care provided met the individual needs of those living in the home. We made a tour of the building to look at the environmental standards and looked at staff personnel and training records. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good system to introduce people to the home, with information provided and a needs assessment completed. This ensures all who are admitted know their needs can be met in an appropriate way. Evidence: This service has an up to date and relevant admissions procedure in place. All prospective residents are fully assessed prior to admission into the home. This covers all aspects of health and personal care and activities of daily living. This service provides care and support to people with or without nursing needs with the same indepth admission assessment being used for all. People who wish to use this service and their family members are invited and encouraged to visit the home to look at the accomodation and meet the staff and residents already living there. This visit helps to ensure that, if they do decide to move in, the process will be as smooth and easy as possible. Care Homes for Older People Page 11 of 26 Evidence: All residents have a written contract and terms and conditions of residency advising them of the facilities on offer and their personal rights. The fees charged are in line with those agreed by Social Services, with the only extras payable for hairdressing and newspapers. This service does not provide intermediate care but there is provision for people who wish to to stay for short periods of time. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at this home are involved with the development of their individual care plans so they receive the care and support they need in the way they prefer. End of life care is given a high priority. Evidence: Every resident has an individual care plan based on detailed initial assessments and risk assessments. The staff team have worked hard with people who use the service, developing the care plans that are unique to the individual so they receive the right amount of care and support to meet all the assessed needs. This ensures that, as far as possible, people living in this home make their own informed decisions and have the right to take managed risks in their own lives. The infomation provided also covered such areas as mobility, dietary needs and preferences, health needs and medical history, personal care, communication, social and religious preferences. There is appropriate equipment in the home to prevent pressure sores, to be used following appropriate assessment, and nutritional screening and weight monitoring is in place. Care Homes for Older People Page 13 of 26 Evidence: We examined the care plans for a number of people living in the home and found them to present clearly what is important to the individual, what are their emotional as well as their physical needs. We spoke to the nursing staff who had clearly put a lot of time and effort into the person centred care plan format and they agreed it gave a much clearer insight into the amount of care and support each individual needed. Healthcare needs are monitored and met through a good working realtionship with the local G.P. surgeries and there is a weekly clinic held with pre-arranged visits organised. We looked at the records for the receipt, administration and disposal of medication. These were well kept and showed that those living in the home received the appropriate treatment at the correct time. Medication is ordered by the nursing sister and received on a monthly basis in a monitored dosage system. High risk medication is recordered and stored correctly and medicines prescribed to be taken when required were also recorded in the right way. Care is taken that a stock of such medication does not build up as the manager considers this to be a waste of resources. We observed the way in which staff interacted with residents and found this to be in a calm and relaxed manner. Residents we spoke to remarked how considerate and polite the staff were when speaking to them and also how kind when delivering personal care. The home has an excellent end of life care policy in place with details of the individual wishes recorded on the care plans. The home has been invited to complete the Gold Standards Framework in Care Homes, which is new award for palliative care. This home is the first in the aea to be invited to take part in this initiative and two of the qualified members of staff are invloved. The manager has recently been complimented on the end of life care already provided by her and the staff and she hopes this award will give the staff a further insight into the importance of this level of care. Ministers of religion are available for spiritual care and support at this time if required. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed and provide daily variation and interest for people living in this home. Evidence: Since the last inspection the manager and staff have worked hard to improve the activities available to those living in the home. There is a copy of the programme on display in the hall so that residents and visitors can see at a glance what is available. The home has employed an activities organiser whose hours of work are dependent upon the activities that are organised. Lifestyle choices, that form part of the social assessment, are recorded on each care plan so staff know what interests are most important to the individual. There is a monthly meeting held for the residents, during which the activites programme and meals and menus are among the topics discussed. There is a weekly coffee morning organised by members of the league of friends that is open to residents and visitors. We were able to speak briefly to some of those attending and all agreed that it was always a very pleasant occasion. Discussions with the residents during our visit also confirmed this. It helps with social interaction between those living in the home and visitors from the community. Comments such as I really enjoy the coffee morning and It is lovely to talk to those who come into the Care Homes for Older People Page 15 of 26 Evidence: home were made. One of the residents has organised a weekly sewing class that is attended by residents, staff and their children and is proving a great success. At the request of the residents more outings have been organised with transport arranged through the community bus. Shopping trips, visits to garden centres and the theatre have been enjoyed. The manager is now looking at how best to arrange activities for those residents who are cared for in bed. There is a church service held every two weeks and Communion is organised for those of the Catholic faith. Local ministers are also on hand to provide spiritual support to residents and families during the end of life care process. Families and friends are encouraged to visit the home and are always made welcome and offered refreshment A choice of meals is offered each day from a four weekly menu and there is always a further choice available. We looked at the menus and judged that they were varied and nutritious. Changes in the menu are discussed during residents meetings. Comments such as I really enjoy my meals, we always have a choice and if I dont like what is on I can choose something else were made. The manager has ensured that there is a protected meal time for residents that may need assistance. We observed this time and found the staff who were supporting these residents to be respectful and gentle. Meals can be taken in residents rooms if they wish. Special diets are catered for. The kitchen area was clean and well organised. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good safeguarding procedures help to ensure that people remain safe in this home. The complaints procedure is clear and accessible, meaning that people using this service know any concerns will be listened to and acted upon. Evidence: There are suitable policies and procedures in place for dealing with complaints and concerns. The complaints procedure forms part of the introduction pack that is provided to all prospective residents. The manager is always available to speak to residents and visitors if they have a concern but there have been no complaints to record and we, The Commission for Social Care Inspection, have not received any. The residents we spoke to during the visit were aware of the procedure and what they would do should they need to use it and comments on the returned surveys confirmed this. There are clear procedures in place for safeguarding vulnerable adults and training in this subject is updated each year. Staff records show that all staff have enhanced Criminal Record Bureau checks before they start work in order to protect the people they care for. All volunteers visiting the home also have enhanced checks in place. Tihere s a copy of Cumbrias policy in the home for staff to refer to if they wish and this subject is also discussed during staff supervision. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Silloth Nursing and Residential Care Home provides a safe and comfortable home that is well maintained and decorated and furnished to a good standard. Evidence: Silloth Nursing and Residential Care Home is a grade II listed building overlooking the Solway Firth with views to the Scottish coast. The exterior of the building has retained its original features, which gives a very impressive appearance. The building is single storey with acomodation acessible to all. There are 32 single rooms and 2 registered as doubles for people wishing to share accomodation. All but 2 have en-suite toilet facilities with some having showers. The home is well maintained with the House Committee making monthly visits to look at the environmental standards. There is an annual maintenance programme, which ensures the building is kept to a high standard. As this is an old building all the bedrooms are different shapes and sizes, a fact that makes them interesing. They are all personal to the individual and, whilst the home does provide furniture, residents are encouraged to bring in items from their own homes. The rooms are well decorated with residents given the opportunity to choose their own colours. All rooms have telvision sets with the home providing one for residents who may not have their own. There is ample communal space with three lounges and a newly upgraded dining room. The manager has recently refurbished a small room into a quiet lounge for Care Homes for Older People Page 18 of 26 Evidence: residents and their families to use. This facility is much appreciated by families who are visiting residents who are very ill. There are three bathrooms all suitable for people who may have a physical disability and communal toilets for residents to use. Since the last inspection a new, more suitable bath hoist has been installed. The kitchen facilities are good with a seperate dry goods store. On the day of our visit we noted that the kitchen area was clean and well organised. There are laundry facilities with designated laundry staff who look after all the laundry and personal clothes. Bedding is changed on a daily basis. The home has policies and procedures in place covering infection control and there is an ample supply of gloves and aprons for the staff to use. There are sluicing and disinfecting facilities to reduce the risk of cross infection. The home was extremely clean and sweet-smelling on the day of our visit. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in this home are supported by well trained, effective staff who have been correctly recruited. This means that peoples needs are met and they are safe from possible harm or poor practice. Evidence: Staffing levels are, overall, satisfactory for the number and dependency level of those presently living in the home. We looked at the staff rotas and observation during our visit indicated that the home has sufficient staff on duty with a range of qualifications, skills and experience to provide a consistent level of individual care for the number of residents. At the time of our visit there were some vacancies and the manager is careful to monitor occupancy and re-assess the staffing levels if necessary. There are two qualified nurses plus five care staff on duty during the day with an extra carer working between five oclock and nine oclock in the evening for extra support during this busy time. Through the night there is one member of qualified staff and two carers. The manager confirmed that extra staff are always available for night duty should this be necessary. The care staff do not undertake domestic duties as there are domestic, laundry and catering staff also employed. The manager is over and above the staff on the duty rota and there are administrative staff employed to cover office duties. There are also maintenance staff who work Monday to Friday ensuring the building is well maintained. Care Homes for Older People Page 20 of 26 Evidence: The numbers and skill mix of all the staff ensure that the residents are cared for, supported and, wherever possible, kept safe at all times. Staff files were examined and confirmed the home has robust and effective recruitment procedures and follows good practice guidelines with regard to the recruitment and retention of staff. The manager confirmed that there is a very low staff turnover with many working at the home for a number of years. All staff have enhanced Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) in place before they start work.Staff files were clear and up to date with records of all documentation and references taken up before an offer of emplyment is made. The home has a very high number (95 ) of staff with NVQ in care at levels 2 or above, with others working towards the award. We looked at the staff training records and noted training had been completed in manual handling, continence awareness, infection control, palliative care and adult protection. Courses have been organised for The Mental Capacity Act, dementia care and Parkinsons Disease. Emergency first aid training has been arranged for April of this year. Residents living in the home spoke well of the staff with comments such as, the girls are lovely, the staff spoil me and I am looked after so very well. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective management and quality monitoring help safeguard people using this service and procedures are in place to safeguard their interests and promote their health and safety. Evidence: This service has a well qualified and experienced registered manager, Anne Blair, who has worked at the home for over 18 years. She maintains her professional development through relevant training. She is a qualified nurse and has gained her Registered Manager Award. She works closely with the staff and management committee to ensure the home is run well and in the best interests of those living there. The atmosphere in the home was warm and friendly and it was obvious from our observations that she knew all the residents well and understood their needs. Comments from the residents included, I see matron every day, Anne is always around to talk to and Matron is very helpful. Staff also agreed that the manager was approachable and fair and they could go to her Care Homes for Older People Page 22 of 26 Evidence: with any issue regarding the running of the home. Staff and residents meetings are held on a regular basis, which allow all parties to contribute ideas to the running of the home. Nursing staff felt they were supported well in their work and they had regular clinical supervision. Annual qulity assurance audits are completed and these, together with the residents meetings, ensure those living in the home and their relatives are able to express their opinion about the care and support provided. The results of the audit are used to look at current practice and to ensure the service provides a high standard of care and support. There is a procedure in place for the handling of residents finances although there is only a small amount of cash held on behalf of some of those living in the home. There is a full set of policies and procedures that are audited and updated annually to ensure they remain in line with current legislation. Records and servicing contracts indicate that the home arranges for all equipment to be serviced under annual contracts and all the necessary certificates were up to date and available for inspection. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!