Inspection on 17/05/05 for Singleton Nursing & Residential Home

This inspection was carried out on 17th May 2005.

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

Singleton Nursing & Residential... 25/06/07

Singleton Nursing & Residential... 21/02/06

Singleton Nursing & Residential... 14/12/04

Singleton Nursing & Residential... 29/04/04

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

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

CARE HOMES FOR OLDER PEOPLE Singleton Nursing & Residential Home Hoxton Close Singleton Ashford, Kent TN23 5LB Lead Inspector Lisbeth Scoones Unannounced 17 May 2005 12.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Singleton Nursing & Residential Home Address Hoxton Close, Singleton, Ashford, Kent, TN23 5LB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01233 666768 Singleton Nursing & Residential Home Limited Mrs Elizabeth Anne Obousy Care Home with Nursing 36 Category(ies) of Older People x 36 registration, with number of places Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14.12.04 Brief Description of the Service: Singleton Nursing and Residential Home is a 36-bedded purpose built detached building providing accommodation on two floors for Service Users requiring both nursing and personal care. It was first registered in May 1997. The Home is located next to a GP surgery and near a shopping centre. The local village hall and primary school are situated next to the Home, allowing residents to see the children during the day and also to participate in any of the activities that may be held in the local hall. The Home is served by a regular bus service with a bus stop nearby. Singleton is about 4 miles from the centre of Ashford. There is ample car parking provided by the main entrance with overflow facilities near the entrance of the Home. Some seating arrangements have been provided but the garden space is limited. Singleton Lake and park are nearby. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours and comprised discussions with the manager, deputy manager, newly recruited carer and other staff, 6 residents and 2 visitors. A partial tour of the building was undertaken and records examined. On the day of the inspection, the home had full occupancy. What the service does well: What has improved since the last inspection? What they could do better: At this inspection it was ascertained hat three bedrooms are without a hand basin. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 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. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4, 5 The manager or her deputy assess the residents’ needs prior to admission thereby assuring residents that their needs will be met. Residents and their families are provided with opportunities to visit the home and assess the quality of the service and suitability of the home. EVIDENCE: Residents spoken to and records examined confirm that comprehensive assessments are made prior to admission. The manager and her deputy demonstrate a good awareness of the home’s registration criteria and if there were any queries in this respect, they would contact the CSCI for discussion. The changing needs of one resident were discussed and a specialist referral had been made. See also standard 7 in respect of care planning. Residents are aware of CSCI inspections and inspection reports but not many residents showed an interest in reading these. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 Care plans are comprehensive and regularly reviewed and whenever possible, residents and their relatives are involved in care plan reviews. Residents’ health care needs are fully met and staff are trained to treat residents with respect for their dignity and privacy. EVIDENCE: Care plans contain risk assessments, observation charts, care plans detailing health, personal and social care and daily records. These are well maintained and for the majority of the residents include a “Life History” page. Some of the residents spoken to said they are aware of their care plan and that they are consulted for care plan review. Risks in respect of tissue viability are assessed and acted upon. The home assesses residents for their continence needs and promotes continence. There is evidence of nutritional screening. See also standard 15. All residents are registered with a GP and have access to chiropody, physiotherapy (after assessment), vision and hearing tests. Residents’ oral health care needs are assessed and the deputy manager has recently devised a system for dental referrals. This is evidence of good innovative practice. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 10 As already recorded, a prompt psychiatric referral was made for a resident whose needs have changed since admission. The care plan includes mental health needs and refers to observation checks to be maintained and recorded. Staff interacted with the residents in a calm, respectful and kind manner. At this inspection it was noted that three residents have no washbasin in their rooms. In respect of promoting independence and infection control practices, it is recommended that the installing of these be included in the home’s development plan. See also standards 24 and 26. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 14,15 Residents maintain contact with family and friends and are enabled to exercise choice and control over their lives. Residents are enabled to pursue their social, recreational and religious interests. Residents are provided with a choice of wholesome and nutritious meals. EVIDENCE: Residents and visitors confirmed that they are made welcome and kept informed of meetings and organised activities. Relatives and friends visit residents either in their own room or in communal and private sitting areas. The home employs an activities organiser. A resident said she enjoys the activities provided and is looking forward to a forthcoming “Crafts and cakes” event. The resident also said that many of the residents are too frail to take part in any big events. One to one social contact is provided to those residents. The wish not to take part is respected. Resident said they like the food. The chef is aware of the nutritional and dietary needs of older people as well as their preferences. Some residents choose to eat in the dining room; others prefer to have their meals served in their room. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Residents and their relatives and friends are confident that their complaints will be listened to and that prompt action will be taken. Staff are knowledgeable of adult protection issues which makes residents feel safe and protected from abuse. EVIDENCE: The home has a complaint procedure and residents said they know who to speak to if they have any concerns or complaints. The manager keeps a complaint log, which contained few entries. The manager and her deputy speak to the residents every day thereby providing the residents with an opportunity to air their views. Staff have attended adult protection training and know what to do if abuse is ever witnessed or suspected. Staff are first introduced to the subject at induction. This is further covered at NVQ and in-house training. The home’s practices are supported by a written policy and the Kent and Medway multiagency adult protection procedures. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 26 The standard of the environment within the home is good providing residents with a safe, attractive and homely place to live. Residents have sufficient and suitable lavatories and bathing facilities and specialist equipment is provided to maximize their independence. Residents live in safe comfortable bedrooms maintained to a good standard but three residents rooms have no washbasin. The home provided a clean, pleasant, odour free and hygienic environment but the standard of hygiene in one of the sluice rooms was poor. EVIDENCE: The home has a budget for internal and external redecoration. The home looked well maintained and there is a rolling decorating programme. The entrance area to the home looked attractive and colourful with plants and flowers. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 14 Residents’ bedrooms visited are homely, clean and furnished with residents’ own belongings. Residents said they are happy with their environment and the standard of cleanliness. As referred to in standard 10, three residents’ rooms are without a washbasin and it was recommended that, for the purpose of hygiene and the promotion of independence, the installation of these is considered. The poor standard of cleanliness in one of the sluices was discussed with the manager and it was said this would be addressed. The need for replacement of sluice equipment has been identified in a recent Regulation 26 report. See also standard 33. The home has a new washing machine. Staff are trained in infection control principles and practices and clinical waste disposal management. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 Residents are cared for by a good match of well-trained registered nurses and care staff. Recruitment policies are good and appropriate checks undertaken to safeguard the residents. The arrangements for induction, NVQ and on-going training are good with staff demonstrating competence in their job and a clear understanding of their roles. EVIDENCE: The home has a stable workforce with few staff changes. A recently appointed care worker spoke with enthusiasm about her induction and further training prospects. Duty rotas seen demonstrate that staffing levels are adequate for the needs of the residents. NVQ training is encouraged and there was evidence of on-going training. A newly appointed care worker demonstrated that her recruitment process had included a CRB and POVA check, the completion of an application form followed by an interview and the obtaining of two written references. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36, 38 The manager, supported by a deputy, administrator and other senior staff provides clear leadership throughout the home. The manager operates an open leadership style and residents benefit from a well run home. Staff are appropriately supervised. Quality assurance systems are in place to ensure that the services are regularly reviewed and residents’ views sought and acted upon. Residents’ and staff’s health, safety and welfare are promoted and protected EVIDENCE: Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 17 Mrs Obousy is the manager and has nearly completed her NVQ 4 in management. In addition to her managerial role, she and her deputy regularly work hands-on. Residents praised her leadership and said that she and all the staff are approachable, kind and caring. Staff said that they receive formal supervision but no records were requested at this inspection. The manager and staff speak to the residents on a daily basis and one of the directors produces a monthly report in accordance with Regulation 26. The report includes conversations with residents and staff as well as details of health and safety issues and quality and improvement. All staff attend statutory training in respect of fire safety awareness, moving and handling, first aid, food hygiene and infection control. Risk assessments are undertaken. Accidents are appropriately recorded. The manager informs the CSCI of any event reportable in accordance with Regulation 37. Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 2 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 Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 x 3 Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. Refer to Standard 24.2 Good Practice Recommendations That every residents room be provided with a wash-hand basin Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Singleton Nursing & Residential Home H56-H05 S26114 Singleton N & R H V222978 030505 Stage 4.doc Version 1.30 Page 21 - 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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