Inspection on 03/11/05 for Sonesta Nursing Home

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sonesta Nursing Home 24/11/08

Sonesta Nursing Home 16/05/06

Sonesta Nursing Home 19/05/05

Sonesta Nursing Home 02/12/04

Sonesta Nursing Home 27/05/04

Sonesta Nursing Home 10/03/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Sonesta Nursing Home 797 Finchley Road Golders Green London NW11 8DP Lead Inspector Mr David Hastings Unannounced Inspection 3rd November 2005 09:30 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 Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 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. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sonesta Nursing Home Address 797 Finchley Road Golders Green London NW11 8DP 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) 020 8458 3459 020 8905 5235 Sonesta Nursing Home Limited Mr Ejaz Chowdhry Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Specific service user One specific service user who currently resides in the home and is under 65 years of age can reside in this home. This condition will need to be reviewed when s/he vacates the home. 19th May 2005 Date of last inspection Brief Description of the Service: Sonesta is a privately owned registered care home with nursing for up to thirty-two older people. It is situated on the Finchley Road in Golders Green, close to local shops and public transport. Accommodation in the home is provided in eighteen single and seven double rooms. The home has a large ground floor lounge and dining area, and central kitchen, and a smaller first floor lounge. There is a large garden to the rear of the home. The stated aims of the home are to provide a comfortable and safe environment, and the specialist care that service users in the home need. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday 3rd November 2005 and lasted 5 hours. Six staff and eight residents were spoken to. A partial tour of the premises took place and care records were inspected. The inspector was assisted by the registered provider and the nurse in charge who were both open and helpful throughout the inspection. An additional visit took place on 22nd June 05 as a result of an anonymous complaint received by the CSCI concerning service users going to bed too early in the evening. This complaint was investigated by the CSCI and as a result three requirements were issued that service users be consulted on what time they wish to get up and go to bed, the regular trimming and cleaning of service users’ nails and the provision of drinks so service users can properly wash down their medication. All three of these requirements have been complied with. What the service does well: What has improved since the last inspection? The staff are more aware of the social and recreational needs of residents and these needs are now clearly recorded. The residents with dementia at the home have been assessed and the home has applied for a variation to admit service users with dementia. Potential residents are assessed to ensure their needs can be met by the home before they move in. Staff have undertaken dementia training. Likes and dislikes are now recorded in care plans and the cook is aware of the dietary needs of residents. Resident’s privacy is better maintained at the home. The registered provider has complied with eleven requirements made at the last inspection relating to the above issues. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 6 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. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 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 Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 The registered provider makes sure that all potential service users have a comprehensive assessment of their needs carried out before they move into the home on a trial basis. Training has been organised for staff so they can better meet the needs of people with dementia at the home. EVIDENCE: The inspector examined four assessments and care plans of service users who had recently been admitted to the home. A requirement was issued at the last inspection that no service user could be admitted to the home without a comprehensive assessment and written confirmation that the home can meet all their assessed needs. The assessments were detailed and covered all elements of standard 3 of the National Minimum Standards for Older People. The inspector also saw written confirmation to the service user that the home would be able to meet their assessed needs. Both these requirements have been complied with. A requirement was also made at the last inspection that the home must apply for a variation of conditions for either the existing service users with dementia or for a condition to allow the home to admit people with a diagnosis of dementia. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 9 The registered provider informed the inspector that she has applied for an additional admission category for people with dementia and that no one with dementia will been admitted to the home until this category has been obtained. A requirement regarding dementia training for staff has been complied with as the registered provider has organised dementia training for all the staff at the home. Staff interviewed said the training had been very helpful. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Care plans give detailed information on how staff are to meet the needs of service users. The home is good at meeting service users’ physical health care needs. The service users are protected by the home’s medicines policies and procedures. The adherence by staff to these procedures is satisfactory. Service users’ privacy is respected. EVIDENCE: The inspector examined seven care plans. These plans gave detailed information on how staff are to meet the health, personal and social care needs of service users. The plans described individual service user’s social and recreational needs and how these needs should be met and monitored by staff. This was a requirement from the last inspection that has now been complied with. The registered provider informed the inspector that following a requirement from the last inspection all service users at the home with a diagnosis of dementia have been assessed by the doctor and, where needed, the psycho-geriatrician. The provider also confirmed that medication had been reviewed and that relatives had been involved in the assessments. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 11 Service users that the inspector spoke with said the staff were very good. Staff interviewed had a good understanding of the needs of service users. Following an anonymous complaint made in June 2005, a requirement was issued that all service user’s nails are trimmed and cleaned on a regular basis. This requirement has now been complied with. Another requirement was issued as a result of the complaint that staff must record the times that service users wish to get up and go to bed. This is now being recorded in care plans, and service users confirmed that they are asked when they wish to go to bed. The inspector saw examples of staff respecting and maintaining service users’ privacy. Service users confirmed that the staff knocked on their bedroom door before entering and staff interviewed were able to describe how they maintained people’s privacy at the home. This was a requirement from the last inspection that has now been complied with. The CSCI pharmacist inspector visited the home on Monday 7th November 2005 and below is a summary of her findings. The medicines policy is complete. No service users are taking responsibility for their own medication and no medication is being disguised. One service user’s medication is being added to a PEG feed in accordance with instructions from the dietician and the pharmacist. All the documentation was in place. The records for the receipt, administration and disposal of medication were satisfactory. The new system for the disposal of unwanted medication has not yet been introduced. The inspector explained that two members of staff would have to sign for medication disposed of into the waste bins to ensure no mishandling. A medication history/audit trail was difficult to established quickly. The medication is stored in a medication room in two trolleys and a metal cupboard. The Controlled Drugs are stored in another metal cupboard with an inner compartment, which complies with the Misuse of Drugs [Safe Custody Regulations]. The Temazepam was not, however, stored in the inner metal cupboard with the other Controlled Drugs. The Controlled Drugs were checked and found to be correct. The entries in the Controlled Drug register were also satisfactory. The room temperature was maintained at 25oC or below and the medication refrigerator between 2-8oC. The rest of standard nine was being met. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Staff are aware of the social and recreational needs of service users and service users can choose from a range of activities. Visitors to the home are welcomed and can visit at any reasonable time. Service users are helped to exercise choice and control over their lives. The home provides a wholesome, appealing and balanced diet. EVIDENCE: A requirement was restated at the last inspection that staff must record progress on goals identified in the care plans regarding the social and emotional needs of service users. Records examined indicated that much more emphasis is now being given to meeting the social and emotional needs of service users. The activities coordinator was able to describe how she and the rest of the staff team keep service users occupied. This included not only group activities but also one to one time with service users. Service users confirmed that they took part in a range of activities. The visitors’ book indicated that many service users were visited by friends and family at any reasonable time and service users confirmed that visitors were made welcome. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 13 Records indicated that some service users manage their own finances. Service users informed the inspector that they are able to exercise choice in relation to meal times and food, clothes, care provision and relationships. Service users’ likes and dislikes in relation to meals are now being recorded And the cook is aware of the dietary needs of all service users including those with dementia. These were requirements from the last inspection that have now been complied with. Lunch was relaxed and enjoyable. Staff were sitting with service users providing discreet assistance as needed. Service users were generally positive regarding the quality of food and confirmed that a choice of menu was available. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints are taken seriously and acted upon by the management of the home. Service users are protected from abuse by clear procedures and staff awareness. EVIDENCE: Satisfactory records of complaints were seen and the homes complaints policy meets the requirements of Standard 16 of the National Minimum Standards for Older People. Service users that the inspector spoke with were aware of how to make a complaint at the home. The home has a satisfactory Adult Protection Procedure. The nurse in charge was aware of this procedure and how to respond to an allegation of abuse at the home. Staff at the home have undertaken training in adult abuse awareness and those interviewed had a clear understanding of what they must do if they suspected abuse was occurring at the home. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Sonesta Nursing Home has a warm, friendly and comfortable atmosphere. There are some minor repair issues but the home is generally accessible, safe and maintained to a satisfactory standard. EVIDENCE: Three requirements were issued at the last inspection relating to the flooring in the laundry and food store and fitting safety guards to a number of radiators in service users’ rooms. The registered provider explained to the inspector that the company she had booked to carry out the replacement of the flooring had ceased trading and she has now approached another company. The requirements have been restated and the timescale set for compliance has been extended. The radiators have still not been fitted with safety guards and this requirement has also been restated. The premises were found to be clean, tidy and free of offensive odours. The laundry facilities were seen, and the equipment appeared to be satisfactory with the appropriate sluice specification. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 16 The standard of decoration at the home is good and service users said they were happy with their rooms. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Staff are provided with appropriate training so they are competent to carry out their work at the home. EVIDENCE: Records examined indicated that staff had completed the required mandatory training and the registered provider confirmed that mandatory training such as moving and handling was taught during induction. The home uses a training agency as well as in house training. Staff interviewed confirmed that training was available to them. Staff also confirmed that they had attended the recent dementia training course. One staff member commented that, “there is a lot of learning here”. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 38 The issue of who is to be the registered manager must be addressed in order to comply with standard 31 of the National Minimum Standards for Older People. Service users’ financial interests are safeguarded. There are good systems in place to monitor health and safety compliance and protect the safety and welfare of service users and staff. EVIDENCE: A requirement was restated at the last inspection that the acting manager must apply to be registered with the CSCI and undertake the relevant training. The registered provider, the acting manager and the nurse in charge are all attending the registered managers award. The registered provider, in reality, takes charge of the day to day running of the home and the acting manager is responsible for the clinical management of the home. The registered provider would like to be the registered manager of Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 19 the home. The inspector suggested she apply for registration with the CSCI on the understanding that there would be clearly defined roles and responsibilities and a named clinical manager for the home. The requirement relating to this issue has been amended and restated. Records in relation to service users’ finances were examined. The registered provider informed the inspector that the home does not hold any money on behalf on service users. Service users or their representatives are invoiced monthly for small items including hairdressing, newspapers, chiropody and toiletries. Receipts are maintained at the home and copies sent to representatives when required. The inspector saw individual receipts for items purchased by the home. Satisfactory records were seen in relation to valuables held on behalf of service users. The registered provider is appointee for one service user at the home. She informed the inspector that she is still in the process of attempting to transfer this responsibility to the local authority. Examination of records within the home indicated that the health, safety and welfare of service users and staff were being safeguarded. The accident book indicated that falls by service users were being recorded with appropriate action taken and service users risk assessments updated where necessary. Fire records were found to be up to date including weekly alarm tests and fire drills for day and night staff. The registered provider has written to the local fire officer who wrote back informing her that a fire officer will visit in 2006. The nurse in charge was able to describe how the staff would respond to a fire including the evacuation of service users. However the fire evacuation procedure needs to be revised and include a floor plan of the building in order to assist evacuation. A requirement relating to this has been made in the relevant section of this report. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 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 x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x 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 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x 3 x x 2 Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 21 Yes 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 OP19 Regulation 23(2)(b) Requirement The registered provider must ensure that the flooring in the laundry is replaced. (Timescale of 01/10/05 not met) This requirement has been restated. The registered provider must ensure that the flooring in the food storage area is either repaired or replaced. (Timescale of 01/10/05 not met) This requirement has been restated. The registered provider must ensure that any radiators in service users en suite bathrooms are fitted with a guard. (Timescale of 01/09/05 not met) This requirement has been restated. The registered provider must ensure that the home has a registered manager. (Timescale of 01/09/05 not met) This requirement has been amended and restated. Timescale for action 01/01/06 2. OP19 23(2)(b) 01/01/06 3. OP19 13(4)(a) 01/01/06 4. OP31 8(1) 01/02/06 Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 22 5. OP9 13(2) The registered manager must ensure that there is a clear medication history available for each service user in addition to a list of their current medication. This could be done by adding the changes to a service user’s medication to the doctor’s visit chart in the service user’s care notes. The registered manager must ensure that a list of medication returned to a service user on leaving the home is available and that the list has been signed by the service user or his or her representative to ensure no miss handling. The registered provider must ensure that the fire emergency plan is reviewed and includes a floor plan of the home. 01/12/05 6. OP9 13(2) 01/12/05 7. OP38 23(4) 01/12/05 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 OP9 Good Practice Recommendations The registered manager should ensure that Temazepam tablets and liquid are stored in the inner compartment of the metal cupboard, which is the Controlled Drug section of the cupboard. Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Sonesta Nursing Home DS0000010547.V259169.R01.S.doc Version 5.0 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. 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!