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Inspection on 28/09/05 for South Quay Nursing Home

Also see our care home review for South Quay Nursing Home for more information

This inspection was carried out on 28th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents were positive about the care being delivered and were complementary about the staff and the way they are supported. An example of residents comments are that the staff are "lovely" and "the girls are really nice". The care being nursing care being delivered is to a good standard and there is evidence of the use of evidence based practice. The food being served during the visit was well received by the residents of whom seven said that they enjoyed it for example "Food is lovely". The home is clean and generally well decorated and was tidy on the day of the visit although the inspection was not planned. The garden area to the rear of the home has been greatly improved and offers a pleasant and accessible outside area for the residents to enjoy.

What has improved since the last inspection?

At the last inspection there were three requirements made only one of which remains unmet. The company has re-introduced the updated statement of terms and conditions and they have now been issued to all of the residents. The introduction of the mechanism for the provision of separate accounts for each residents whose personal allowance has accrued to more than is practical to be kept in the home has now been agreed.

What the care home could do better:

Two requirements have been identified regarding the need for the home to undertake the redecoration of the communal and bedroom areas as planned and to replace the furniture which is now becoming tired and worn.

CARE HOMES FOR OLDER PEOPLE South Quay Nursing Home Cowpen Road Bltyh Northumberland NE24 5TT Lead Inspector Suzanne McKean Unannounced 28 September 2005 9:30 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. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service South Quay Nursing Home Address Cowpen Road Blyth Northumberland NE24 5TT 01670 351831 01670 540253 south.quay@fshc.co.uk Ringdane Ltd 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) Pamela Towers CRH 79 Category(ies) of OP - Old Age (79) registration, with number of places South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is able to provide two places to named residents under the age of 65. Should either of these residents leave the home, the Commission for Social Care Inspection must be notified. Date of last inspection 14.01.05 Brief Description of the Service: South Quay is a purpose built two-storey building of traditional brick built and tiled roof construction. It is situated on a large corner site on the outskirts of the town of Blyth. The home is within walking distance of the main shopping area of the town and the local amenities situated in that area. It is on the main bus route. The surrounding area is predominantly domestic housing with a small number of commercial properties. The home is registered to provide places for 79 service users all of which can be accommodated in single rooms. The home is registered as a care home, which is able to, provided nursing care and as such the Manager is a Registered Nurse. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over seven hours on two days by the inspector, who has visited the home on a number of previous occasions. The manager was on duty during the second visit and assisted the inspector with the inspection. Twelve residents were spoken to during the visit and four relatives, the inspector also spoke to six of the staff in process of the inspection visits. Records examined included, five care plans, training records and the records for complaints as well as the health and safety, accident and some of the maintenance records. There were two requirements and three recommendations identified during this inspection. What the service does well: What has improved since the last inspection? At the last inspection there were three requirements made only one of which remains unmet. The company has re-introduced the updated statement of terms and conditions and they have now been issued to all of the residents. The introduction of the mechanism for the provision of separate accounts for each residents whose personal allowance has accrued to more than is practical to be kept in the home has now been agreed. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 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. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 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 South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 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, 6 There is a comprehensive assessment undertaken by the staff prior to admission, which forms the basis for the development of the care plan. The home does not offer intermediate care. EVIDENCE: Five care plans were examined and each has comprehensive pre-admission assessments, which were undertaken by the Manager or the senior staff in the home. The residents also have a care management assessment, which is provided, to the home on admission and from these documents an individual care plan is produced. The home is not registered for, and therefore does not provide, intermediate care. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 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 Individual care planning is undertaken and the care is being delivered in line with these plans. The residents are having their needs met. Residents are confident that the staff treat them with respect and maintain their privacy so far as possible when delivering care and throughout their daily life. EVIDENCE: Each resident has an individual care plan, based on the admission assessment and then added to during the placement. Five care plans were examined which were completed to a good standard. Assessments are in place for nutrition, wound care, moving and assisting, and continence promotion as well as a dependency score. There were risk assessments in place for specific areas for example use of bed rails. The plans show regularly reviewing and updating and that reviews are regularly held with residents and their representatives. The care plans show residents have access to all NHS services and facilities. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. The recording of nursing action for wound care was satisfactory with evaluations dated and signed. There was evidence that South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 10 the home seek expert advice from external professionals, including the McMillan Nurse and General Practitioners. The staff spoken to are aware of the need to maintain residents privacy and are doing so as part of their delivery of care. The residents interviewed were complementary about the care they received and said that the staff treat them well. An example of the comments made were that the staff were “lovely” and “the girls are really nice”. The staff were observed throughout the day to address the residents by their preferred name and there was a good relationship noted between the residents and the staff. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 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) 15 The food being served is being prepared safely by knowledgeable staff and offers choice to the residents. The home offers the resident a balanced diet and there is sufficient quantity of both food and fluids to meet their needs. EVIDENCE: The residents are offered three meals a day with choices for the main meals and residents on the day were seen eating heartily one asked said that the “food is nice”. The meal being served was ample portion size, hot and well presented. Residents were offered assistance in a discreet manner. Second helpings and alternatives to the main and dessert course were available. A variety of cold drinks were available throughout the meal and hot, cold drinks, biscuits were offered at intervals in the day when drinks trolleys were circulated. Three residents expressed some dissatisfaction with the teatime meal and felt that there was only sandwiches being offered, the menus and the choices list were examined and discussed with the cook. Alternatives are available and staff ask all residents on an daily basis for their choice of both main lunch time and tea time meal. However, it was agreed that the staff were not emphasising the second choice when speaking to the residents about the menu. There was an ample supply of frozen, tinned, dried and fresh food available all of which was appropriately stored. The kitchen staff were aware of residents specialist needs including how to fortify foods for those who have poor South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 12 appetites or those who have lost weight although they rely on care staff to request for specific residents. The kitchen was clean and well organised. The kitchen records are being kept appropriately and were examined these include recording the temperature of the food being served, the fridge and freezer temperatures and the cleaning schedule. It was a recommendation at the last inspection that the cook and the deputy cook be offered additional catering training, this has not yet been undertaken. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 13 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 The home ensures that the residents and relatives are aware of the complaints policy and that it is available in a variety of places. There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The residents are protected by ensuring that the staff are given information regarding Protection of Vulnerable Adults and whistle-blowing. EVIDENCE: The complaints procedure is available in the service users guide and a copy is displayed in the home. The records of the complaints made to the home were examined, there has been two complaints recorded since the last inspection and these were recorded in detail with the outcome and action taken as a result identified. Two of the residents who were interviewed during the visit understood how to make a complaint, and could identify the way this would be dealt with. Three relatives who was visiting the home was aware of the complaints procedure but felt that their concerns were being dealt with before the need for formal complaint. Written guidance is included in the company policies and procedures regarding the protection of vulnerable adults. Staff confirmed that they knew about the guidance and could identify the action they would take if they were made aware of or had any concerns regarding this issue. Staff are being given this information during induction and via supervision and training on protection of vulnerable adults has been developed and is being delivered as planned. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 14 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, 22, 24, 26 The home is generally decorated and maintained to a good standard however some redecoration and replacement of furniture in both bedrooms and communal areas is required to maintain the homes generally good standard. The home is clean, tidy and there was no unpleasant odour during the visit. The necessary specialist equipment for the control of infection is provided in the home and the staff were aware of their responsibilities in this respect. EVIDENCE: The majority of the service user bedrooms observed during the inspection visits were pleasantly furnished and were personalised to the taste of the occupant, and in line with the National Minimum Standards. However, there remain some areas of redecoration, which must be completed at planned. There are a number of bedroom carpets in need of replacement as well as redecoration of some bedrooms. Some of the communal areas need redecoration and there is damage to the dining room ceiling which needs repair. There are a number of windows in bedrooms in which the doubleglazing has become faulty and as a result there is water vapour inside of the South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 15 gap, this reduces the ability of residents to see clearly outside for that portion of the window. Mrs Towers, the home staff and some relatives have worked very hard to improve the garden area at the rear of the premises to give the residents a very pleasant accessible area to enjoy when the weather permits, this can be viewed from inside the home and a number of resident expressed their enjoyment of it. On examination of the individual care plans it was confirmed that where they required any specialist equipment, beds or hoists, they were provided. There are an appropriate number of communal toilet facilities in the areas close to the lounges and dining area. There was no evidence of malodour during the visit to the home and there is sufficient equipment available including gloves and aprons to be used in strategies for the prevention of cross infection. The on suites are not equipped with disposable paper towels, liquid soap, and waste bins which would assist in control of infection and the Manager agreed that this would be beneficial. The laundry area was in order despite it being a very busy time of the day and it was small but well organised with wheeled racks and individual baskets for clean clothing. The sluices were tidy, clean and odour free and the disinfectors operational. Staff followed infection control policies throughout the day. The light and emergency call cords were all clean and all emergency cords reached skirting level. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 16 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, 29 The home is staffed with appropriate numbers of staff and there are qualified nurses on duty in sufficient numbers to meet the needs of the residents. The staff are recruited and selected according to the company policies which ensure that residents are cared for by staff who have the skills and personal characteristics to deliver good care. EVIDENCE: On the day of the visit there was a qualified nurse on each of the units, and a senior carer on the Residential unit and there were six carers on duty as one had rung in sick on the day leaving a shortfall which could not be covered at short notice. The manager was on annual leave for the first visit although she was present during the second. The Deputy Manager, was not on duty during the first visit but was visiting the home and was able to participate for a period of the day. There was also one domestic, two kitchen staff, one of which was the cook and one laundry assistant on the day of the visit. Staffing rotas showed that the Manager is ensuring that enough staff are on duty to meet the staffing levels agreed recently with the CSCI. It was noted that when sickness and staff holidays occur these occasions are being covered by the home staff. However, when this is not possible, late reporting does occasionally result in fewer staff being on duty for short periods. It is expected that this will be reviewed as the numbers of residents and the dependency levels change to ensure staffing levels remain appropriate. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 17 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, 38 The Registered Manager, Mrs Towers, ensures that she has systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. She is continuing to ensure safe working practices in the home in line with the company policies and procedures. EVIDENCE: There are clear lines of accountability both in the home and within the company. The accident, health and safety, moving and handling, control of infection and risk assessment records were examined, they were satisfactory. The Manager confirmed that she ensures safe working practices are understood by staff through training, regular staff meetings and giving regular information updates, evidence of this was available. This is supported by the company policies and procedures. South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 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 x x 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 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 x 2 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 3 South Quay Nursing Home B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 19 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 19 Regulation 23 (2) (b) (d) Requirement The home must undertake the redecoration of the communal areas as planed and the windows in which the double glazing has become faulty must be replaced or repaired as necessary. The plan of redecoration and replacement of furniture must be undertaken as planned. This must include the bedroom carpets identified during the tour of the premises. Outstanding Timescale for action 01.03.05 2. 24 23 (2) (d) 01.03.05 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. 2. 3. Refer to Standard 15 15 26 Good Practice Recommendations It is recommended a strategy to ensure the hot, non sandwiches choice is promoted be put into place giving the residents the opportunity to select the alternatives. It is recommended that training of the cook and deputy be reviewed to ensure that they remain confident and competent to undertake the role as planned. It is recommended that liquid soap is provided in the on suite areas of the residents bedroom. B53-BO3 S644 SOUTH QUAY NURSING HOME V237653 030805 STAGE 4.doc Version 1.40 Page 20 South Quay Nursing Home Commission for Social Care Inspection Norhtumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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. 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