Inspection on 16/01/08 for Southlands Nursing and Residential Home

This inspection was carried out on 16th January 2008.

CSCI found this care home to be providing an Good 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

Southlands Nursing and... 17/01/07

Southlands Nursing and... 24/01/06

Southlands Nursing and... 28/06/05

Southlands Nursing and... 17/01/05

Southlands Nursing and... 20/05/04

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

CARE HOMES FOR OLDER PEOPLE Southlands Nursing Home 9 Ripon Road Harrogate North Yorkshire HG1 2JA Lead Inspector Anne Prankitt Key Unannounced Inspection 09:30 16th January 2008 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 Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southlands Nursing Home Address 9 Ripon Road Harrogate North Yorkshire HG1 2JA 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) 01423 526203 01423 504015 www.bupa.co.uk BUPA Care Homes (GL) Ltd Mrs Susan Elizabeth Sowden Care Home 68 Category(ies) of Old age, not falling within any other category registration, with number (68) of places Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Aged 60 years upwards One identified service user currently resident within the home in the (PD) category may remain in the home until his needs cannot be met by the home or he reaches the category (OP). 18/01/07 Date of last inspection Brief Description of the Service: Southlands Nursing Home provides care with nursing for up to sixty eight people. The home is close to Harrogate town centre. The service is provided on three floors and provides good quality accommodation. There is car parking to the side of the building, and garden to the rear. There is a choice of two communal sitting areas, a large library and a coffee lounge within the home. On 16 January 2008, the registered manager confirmed that the weekly fees range from £600 to £1200. This does not include the Registered Nursing Care Contribution where applicable. Items not covered by the fee include hairdressing, chiropody, newspapers, aromatherapy, manicures and escorts. The registered manager said that people who are interested in living at the home are given a sample copy of the menu and activities programme, along with the terms and conditions of the home, and service users’ guide, or ‘brochure’ when they make an enquiry. The inspection report is displayed in the main foyer of the home for anyone who wishes to see it, and the registered manager will give people a copy of the report at their request. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Before the site visit the registered manager returned a self assessment called an ‘Annual Quality Assurance Assessment’. This provided information about Southlands. Surveys were sent to a selection of people who live at the home, their families and some visiting professionals who are involved in their care. A record has also been kept about what has been happening at the home since the last key inspection took place in January 2007. All of the information, including that which was gathered at the site visit, was used as part of this key inspection. Six hours preparation took place before the site visit, which lasted for approximately nine hours. The communal areas were looked at during the site visit, as were a sample of records, including a sample of care plans and staff records. Some staff and people living at the home were spoken with, and observations were made to see how staff interacted with the people they were caring for. All of the information was used to get an impression about what it is like to live at Southlands. Feedback was provided to the registered manager and her clinical manager at the end of the site visit. What the service does well: Everybody has a care plan which explains the care that they need. Staff are working hard to make sure that these plans explain people’s personal preferences. This will help staff to have a better understanding about each individual. One person commented: ‘I recommend the home. Susan (the registered manager) and her staff have been marvellous’. People can be assured that staff will look after their medication safely, and will make sure that it is given at the time it is prescribed. People have the choice to join in with a range of group activities. They can also have visitors whenever they wish. This helps to make their social life more interesting and fulfilled, and keeps them in touch with people who are important to them. One person commented positively ‘I can live life as I wish’. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 6 The staff know that they must report matters about people living at the home which could affect their welfare and safety. The registered manager will deal with all such matters quickly and efficiently. This helps to protect people. The registered manager takes complaints seriously. One person had ‘no complaints’. Another person said that they would be happy to complain if they had any problems, but that they were ‘quite content’. The environment is kept clean, tidy and well maintained. This means that it is pleasant and safe for people to live in. One person commented that they were pleased it was always ‘spick and span’. Staff get regular training to help them understand how to offer good person centred care in a safe way. People said that they get the ‘right care’, and that staff are ‘always respectful’. The registered manager is enthusiastic, and looks for positive ways to improve the service for people. A staff member said that she ‘listens to residents and staff, and spends good time with the residents’. What has improved since the last inspection? Good progress has been made in making sure that requirements and recommendations made at the last key inspection have been met. People’s care plans are more up to date. This means that they now give a better picture about people’s needs, and any changes that have had to be made to their care. This will help to make sure that people get the right care. The number of medication errors has reduced, and the way that staff look after people’s medication is now checked on a regular basis, to make sure that it is being safely managed. This should further reduce the potential for errors occurring. Information about people’s care is now passed onto staff privately, so that people’s right to privacy is upheld. And information about each individual is now kept separate from everyone else’s, so people’s records remain confidential. The registered manager has reminded staff that people can ask for drinks and snacks at any time of the day or night. She has introduced a special menu for overnight, and has checked with people that this is acceptable to them by completing a survey. This upholds people’s right to make choices in their own home. To encourage good food hygiene standards, staff no longer go into the kitchen unless they are wearing protective clothing, which is provided by the home. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 7 To reduce the risk to people who might enter the sluice rooms, staff now make sure that they are kept locked when not in use. 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. The summary of this inspection report can be made available in other formats on request. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 8 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 Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use the service experience good quality outcomes in this area. People’s needs are assessed to check that they can be met before they are admitted. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Because of circumstances beyond their control, the registered manager and her staff had not been able to visit the two recently admitted people whose pre admission assessments were looked at. However, the staff had consulted with other professionals who had been involved in providing care and support, and with their family, to get an idea about the care that the person would need. The registered manager explained that these were extraordinary circumstances, and has given assurance that normally every effort is made to meet people to carry out an assessment of their needs before they have to make a decision about whether they want to live at the home. This gives Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 10 people the opportunity to meet with staff who may be involved in their care in the future. In support of this, three out of the five people who returned their surveys said that they received sufficient information before they moved into the home. One person spoken with said that they had not been able to meet with staff before they were admitted. But their family had made enquiries on their behalf, and they were entirely satisfied with the service that they had received following their admission. They commented ‘I recommend the home. Susan (the registered manager) and her staff have been marvellous’. A member of the care staff also explained that they are told about the care people need before they arrive, so that the right care can be offered straight away. The home does not provide intermediate care. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. People’s care is generally well catered for, and provided within timescales acceptable to them. We have made this judgement using a range of evidence including a visit to the service. EVIDENCE: The staff have now transferred information about people’s needs onto new care plan documentation provided by the company. The plans are based on people’s physical, social and emotional care, and their personal needs and wishes. They are well set out, and focus more on people as individuals. Risk to people’s health and welfare is assessed and reviewed regularly along with the care plans, when staff look at how people’s independence can be maintained and supported. For instance, they check regularly that people who want to look after their own medication are safe and happy to do so. One risk assessment identified that the person needed extra equipment because their skin was vulnerable to the risk from pressure sores. This action Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 12 had been overlooked, and the equipment assessed as needed had not been provided. But preventative equipment was put into place for this person as soon as this was brought to staff’s attention. There was evidence in the plans to show that people have access to other health professionals outside the home, who assist in supporting staff to give the right care to the person concerned. This included support from the psychiatric services, physiotherapy, and various out patient clinics. One person said that staff had helped them to attend their out patient appointments, and this was appreciated by them. There is a free physiotherapy service available at the home for people who are assessed as needing it. The registered manager agreed that staff now need to look at how they can make entries about people’s day to day care more personal. In support of this, staff are receiving additional training on person centred care. ‘Personal Best’ committees have also been set up on each floor, which will look at how care can be provided to people in a more personal way. This will help staff to complete more sensitive areas of the care plan, such as people’s wishes upon death and dying, which in some cases has not yet been discussed with them. People are accommodated on three floors, and there is a separate medication system for each floor. The number of medication errors has reduced from five reported incidents in the previous year to one since the last key inspection, which took place in January 2007. The registered manager believes that this has been achieved through constant audit of the system, and rigorous staff supervision. A nurse commented that care staff were now very clear that nurses must not be distracted whilst giving out medication. This was observed to be the case on the day of this site visit. This will help to reduce the risk from any further errors occurring. The records seen were well kept and up to date. Systems are in place for checking that creams, sometimes administered by care staff, have been applied, so that these can also be recorded on the charts. Discussion took place about one medication, whose dose varied, and how it could be more clearly explained on the records. The registered manager agreed to look at this, and to revise the way that instructions for staff are recorded. Although there were no reported errors, this will help to make sure that the person concerned always receives the correct dose. People who returned their surveys said that they always or usually get the care and support that they need, and out of the four people who chose to comment, all thought that staff listened to and acted upon what they said. Staff knocked on doors before they entered people’s rooms. One was seen hand delivering people’s post. They spoke courteously to people. A number of people are cared for in bed due to their frailty. Staff were seen entering their rooms to make sure that they were warm and comfortable. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 13 People spoken with on the day of the site visit agreed that they were treated well by staff. They said that staff were kind and supportive, and that they understood what care they needed. They commented that they get the ‘right care’, and that staff are ‘always respectful’. Staff get an update before they start their shift, so that they know whether any change in care is needed, and this information is now passed on in a private place. This maintains people’s confidentiality. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. Plans to further develop individual activities for people will help to make their lives more interesting, and their care more person centred. We have made this judgement using a range of evidence including a visit to this EVIDENCE: There is a busy activities programme, which a full time activities person organises. People get a list of forthcoming events, which allows them to plan their time. They said that they are able to do this without having to fit in with the routine of the home. The activities person was not on duty on the day of the site visit, so there were no activities taking place. But people said that they enjoyed the choice of activities that were normally on offer. Three of the five people who returned their surveys said that there were always activities for them to join. However, people were pleased that they did not have to attend if they did not want to. The registered manager said that she has become more involved in the activities programme. Over Christmas, she has worked flexibly and at weekends so that she could join in and meet informally with people and their relatives during the festive celebrations. Photographs were displayed which showed people joining in with a Christmas party and carol singing. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 15 The registered manager is now looking further at individual activities for people who do not wish to, or who are unable to join in the group activities. She is thinking of innovative ways in which these can be provided as staff begin to build up a better picture about people’s interests. She has already held staff meetings to gather ideas. However, care is taken to identify individual needs. For instance, a representative of the Blind Society visits to give support to people with limited sight. And one person explained how a particular staff member helps them when they want to look at their reading matter in their room. Attention to individual needs and wishes helps to make people’s lives more interesting. Representatives from the Church of England denomination conduct a church service at the home each month. The Roman Catholic priest also visits, and one person is supported in going to church. These arrangements help to meet people’s spiritual needs. People said that staff place no undue restrictions upon their choices about how they want to spend their time. Staff worked flexibly around people. For example, breakfast is available over a three hour period to allow people time to get up when they wish, and people’s medication was taken to them only when they were ready to receive it. This helps to uphold people’s right to make choices. One person commented positively ‘I can live life as I wish’. There are no restrictions placed on visiting. This means that people can maintain important links with their family and friends. One person was delighted that a family member could have lunch with them each day. This was very important to them. The registered manager explained that the four week menu has been checked to make sure that it is nutritionally balanced. People are provided with a variety of choices at each mealtime, and there is a ‘night bite’ menu available from 6.30pm to 6am. The chef said that this facility is not often requested, but sandwiches and snacks are delivered to each floor for those people who become hungry overnight. People who returned their survey said that they either usually or sometimes like the food, but those on the day said that the food was good. One said it was ‘wonderful’. The mealtimes are flexible. In between, people can have hot drinks at their request. For example, staff were observed placing orders for cappuccinos to be delivered to a person’s room, and providing a cup of tea to someone at their request. As part of their routine, they also made arrangements for everyone in their rooms to have clean water jugs and glasses. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 16 The chef audits the kitchen services. This process is monitored by the registered manager. The chef said that he sees every person admitted to the home within twenty four hours of arrival to establish their likes, dislikes and special requests. But he said that should a person have particular dietary needs, staff would inform him of these as soon as the person was admitted. He organises regular fresh meat, fish, vegetable and fruit deliveries, and was satisfied that the budget is sufficient for the provision of a good nutritious menu. He attends ‘resident meetings’ to get collective feedback on the meals service. This will help to make sure that people get a good diet based on their individual nutritional needs, and which is satisfactory to them. People can eat in the very attractive ground floor dining room, or in their own room if they wish to. Staff are organised so that people who remain in their room, and need help, can be assisted appropriately. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. They are protected by a registered manager who will act quickly upon any matters of concern that are brought to her attention. We have made this judgement using a range of evidence including a visit to the service. EVIDENCE: There have been five complaints and numerous commendations made directly to the home in the last year. The records showed that an appropriate person investigated the complaints. Two were upheld. These included concerns about staff induction and conditions for new starters, and a miscalculation of finances. A response had been given to the complainant in each instance, with no further feedback received. Everyone who returned their survey knew how to complain, although they were not always sure who they should complain to. However, people spoken with were confident that their concerns would be dealt with, whoever they passed them on to. One person had ‘no complaints’. They said they do not see the registered manager that often, but knew if they wanted her they could ‘just ask to see her’. Another person said that they would be happy to complain if they had any problems, but that they were ‘quite content’. Staff spoken with knew that they must pass any complaint on to someone more senior, so that it could be dealt with quickly. One trained staff member Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 18 explained that they would always attempt to resolve any complaint brought to their attention. But the registered manager is on call if her support is needed. Staff have been provided with training about how to recognise and report abuse. They knew that in order to protect people from harm, they must pass on any concerns to the registered manager if they believed, or were told, that a person was not being properly treated. The registered manager has dealt with one such allegation since the last key inspection, and took quick action to make sure that the matter was reported to the local authority so that it could be fully investigated by them. This is now resolved. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. People live in a clean, comfortable and well maintained environment. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home is situated on the main road close to Harrogate town centre. The accommodation is provided on three floors. Bedrooms are individualised, and people are welcome to bring in their own personal belongings. There is parking and a garden area at the back of the building. There are no communal sitting areas on the first and second floor of the home, which provide bedroom, bathroom and toilet, and satellite kitchen facilities. However, a lift is available to assist people to the ground floor, where there are two communal sitting areas, a large library with seating, and a coffee lounge. Group activities are also provided on the ground floor. On this site visit, the Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 20 communal areas were well used by people from each floor who wanted to spend time with others. Everyone agreed that the home is kept fresh and clean. One person commended the staff, commenting that it is always ‘spick and span’. This was very important to them. A maintenance person is employed to keep in-house maintenance up to date. Outside contractors service equipment that the maintenance person is not able to attend to. This helps to keep the home well maintained. The registered manager said that both the fire officer and Environmental Health Officer have carried out a routine visit since the last key inspection, and that they raised no issues of concern about the premises. There are dedicated cleaning and laundry staff who work separate to the care staff. The laundry is located in the basement, away from any food preparation areas. The laundry assistant said that soiled laundry is delivered separately for laundering. She is provided with protective clothing to reduce risk to herself, and to people living at the home, from the risk of cross contamination. People’s clothing looked well cared for. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. Well trained staff give people good care. People may benefit further when the permanent staff force is replenished and effectively deployed. We have made this judgement using a range of evidence including a visit to this service EVIDENCE: One out of the five people who returned their survey thought that staff were always available when needed. The remaining four people though staff were usually or sometimes available. One person spoken with said that, although it did not presently cause them any undue problem, they normally have to wait for around ten minutes before staff respond to their call bell. A visitor said that sometimes staff seemed to be under a lot of pressure, although they believed that their relative’s care needs were generally well met. These comments apart, people spoken with on the day of the site visit were generally satisfied that there were enough staff. Staff did not appear rushed on the day of the site visit. They went about their work quietly and unobtrusively. It did appear however that when they were not busy, they sometimes chose to chat together rather than spend quality time with people in their rooms. And the registered manager agreed that on the afternoon of the site visit there were long periods when there were no staff seen in the communal areas. She did explain though that the activities person would normally be available for people. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 22 However, she believes that the home is well staffed, and has already identified that the way that staff are currently deployed may cause people to believe that there are not enough of them. She has organised ‘Leadership Skills’ training for trained staff to help them become more assertive and effective when managing the staff team for which they are responsible. This will be to the benefit of people living at the home. Staff themselves identified that the recent use of agency staff due to sickness had made it more difficult to provide a consistent service for people. But they believed that generally there were sufficient of them to provide care and choice, although one commented that they ‘could do with an extra pair of hands’. The registered manager is currently employing new staff members, and it is her aim to provide an ‘excellent staff team’ through effective training and support. There is an active National Vocational Qualification (NVQ) programme for staff. The registered manager was pleased that 50 of care staff have achieved NVQ Level 2 or above in Care. Staff also undergo mandatory training in fire safety and moving and handling. Infection control and Food hygiene training is also provided where applicable, and the registered manager keeps a training matrix updated so that she can organise training for staff when it becomes due. This will help to make sure that care is provided in a safe way. Staff are offered additional training to help them in their work. For instance, training has been provided in abuse awareness. Staff will soon receive information about the Mental Capacity Act, and the effect that this law will have on people’s rights to make decisions for themselves. ‘Personal Best’ training, which focuses on making sure that staff give people a personal service of the highest quality, is also provided to all staff groups. This will help to make sure that people have good experiences when they are offered care. At this site visit, the recruitment records, which have recently been updated, did not provide sufficient detail to evidence when the police check for each new employee had been obtained, and when the staff member had started working at the home. The registered manager has previously demonstrated that people living at the home are protected from unsuitable workers through very robust recruitment procedures, and was disappointed that the information had not been transferred over to the new files correctly. She intends to address this administration error, and will provide details separate to this report to confirm that the people concerned had all necessary checks in place before beginning to provide care to people. In support of this, a recently employed member of staff confirmed that all checks were obtained by the registered manager before she was allowed to provide care. She also confirmed that she had received a good and full induction to ease her into the way that the home operates. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. The registered manager is enthusiastic and determined, and aims to run the home for the benefit of people who live there. We have made this judgement using a range of evidence including a visit to this service EVIDENCE: Since the last key inspection, the manager has been successfully registered with the Commission for Social Care Inspection. She is not a qualified nurse, but she holds a management qualification, has good knowledge and experience of home management, and has been awarded by the company for her dedication to her work, and her commitment to the home. She no longer oversees the management of any other services as was previously the case. This means that she can concentrate her efforts on the management of Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 24 Southlands. A clinical nurse manager supports her, who has been allocated some supernumerary hours so she can oversee the care that people get. This will help to make sure that any problems are picked up at an early point. The company asks people for their views about how the home is running. They send people, their families and professionals involved in their care annual surveys, so that they are able to pass on their comments about what the home does well, and where it could improve. However, the registered manager has developed other effective ways of keeping in touch with people. For instance, she writes a seasonal newsletter, and holds occasional coffee mornings, where she mixes informally with people and their relatives. She also holds formal meetings for people who live at the home and their relatives. Heads of departments also attend, so people can be provided with up to date information about what is going on in their home. A company representative also visits the home on a regular basis to check that standards and the quality of the service for people are being maintained. One person said that the registered manager and staff had been ‘marvellous’ since they had been admitted. Staff said they appreciated the registered manager’s open door policy, and approachable attitude. One said that she ‘looks after the staff’, and that she ‘listens to residents and staff, and spends good time with the residents’. Another concluded ‘This is the best home I’ve ever worked in’. They said that the registered manager is ‘the best boss’ they had ever had. They said ‘I think she’s absolutely brilliant’. People have locked facilities in which they can keep their valuables. Some people choose to give their personal monies to the home for safe keeping. This is kept separately for each person in a central account, which accrues interest. A careful check is kept on how much each person has, and they are apportioned a fair share of the interest. They have access to money at any time, because there is a cash float kept locked safely away at the home. The information provided before the inspection identified that the home is kept well maintained. The kitchen records seen were kept up to date, and staff confirmed that there were no issues arising from the most recent routine visit from the Environmental Health Officer, which took place in the last year. However, the fire door into the kitchen stores was held open in such a way that it would not close if fire broke out. This was closed immediately, and must be kept shut to reduce the risk to people from the spread of fire. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 25 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP8 Regulation 16 Requirement Timescale for action 16/01/08 2 OP29 19 Schedule 2 3 OP38 13 When an assessment identifies the need for special equipment to reduce the risk from pressure sores, then this must be provided promptly so that the risk to the individual is minimised. For all future recruitment, clear 16/01/08 information must be kept to evidence that staff at the home have been deployed only after all the necessary checks have been completed to confirm that they do not pose a risk to the people living there. To protect people from the 16/01/08 spread of fire, fire doors must be kept shut unless agreed otherwise by the fire officer. Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 27 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 OP7 Good Practice Recommendations To make the daily records more individual to the person concerned, they should include reference to their social and emotional needs, and how they have been met. People’s wishes upon dying and death should be sought where possible, and written down in the care plan, so that they can be assured that staff will understand these wishes, and carry them out. The way that the variable dose medication discussed is recorded should be made clearer, so there is less chance of the person being given the wrong dose. Individual activities offered to people who do not wish to, or who are unable to leave their room, should be reviewed regularly, as information about their personal needs and wishes are looked at in more depth. Care staffing availability, and the way that they are deployed, should be kept under regular review to reflect changes in people’s needs so that the care that they get remains consistent and person centred. 2 3 OP9 OP12 4 OP27 Southlands Nursing Home DS0000027979.V353414.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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