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Inspection on 08/11/05 for Southwold Nursing Home

Also see our care home review for Southwold Nursing Home for more information

This inspection was carried out on 8th November 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

Southwold has a good staff team who understand conditions likely to be suffered by residents and the care required to meet the needs. Residents and visitors were positive about the staff team commenting, "the care was excellent". The home is of a good design to enable the home to meet residents needs and is well maintained and very clean. The home offers a good range of activities organised by a dedicated team. Residents spoke highly of the range of activities on offer and how they were encouraged and enabled to attend if they wanted to.

What has improved since the last inspection?

The home has been completely redecorated outside, and three of the kitchens on the wings have been completely renewed. A number of carpets in bedrooms and on corridors have been replaced.Work on the garden which is funded by residents fundraising activities continues to develop with the addition of a water feature and a summer house.

What the care home could do better:

Ensure that residents care plans are formally reviewed in writing on a regular basis, as well as the informal reviews that take place daily, which would demonstrate that the care given was what was currently needed by the resident. Ensure that appropriate locks are fitted to all bedroom doors with keys available to residents if appropriate so that residents are able to feel secure with some independence if they wish.

CARE HOMES FOR OLDER PEOPLE Southwold Nursing Home Southmoor Road Wythenshawe Manchester M23 9NR Lead Inspector Leslie Hardy Unannounced Inspection 8th November 2005 07:15 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 Southwold Nursing Home DS0000021658.V266154.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. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Southwold Nursing Home Address Southmoor Road Wythenshawe Manchester M23 9NR 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) 0161 945 6367 0161 945 9002 brdget.elmokhtari@anchor.org.uk Anchor Trust Ms Bridget El Mokhtari Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (3) of places Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users aged over the age of 60 requiring nursing care shall be 37. 3 named service users are currently accommodated who are below 60 years of age and require general nursing care. 27th February 2005 Date of last inspection Brief Description of the Service: Southwold is a home with 40 beds providing personal care with nursing. The Home was purpose built for the specific resident group in the early 1990’s, initially to provide a better care setting for people on long stay wards within the NHS. It is built on two floors and has a passenger lift. The home is on the edge of the Wythenshawe Hospital site. It is close to a major motorway network and public transport provides very frequent services to Manchester, Stockport and Altrincham. These services are situated very close to the entrance to the home. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced was carried out on Tuesday 8th November 2005, starting at 7.15 am and lasted for 6 hours. During the inspection, 14 residents, 6 visitors and 10 staff were spoken with. The majority of the recommendations from the previous report had been implemented. The home is an appropriate building to deliver the care that residents needed and it is kept well maintained, clean and tidy. Residents and visitors spoke highly of the care given by well motivated staff in the home, but a small number expressed concerns over the fact that the home had been without a manager for some months as they felt that the home needed the stability and leadership a manager gives. During this inspection only a selection of key National Minimum Standards were assessed therefore to gain the full picture of how the home meets the needs of residents, this report should be read in conjunction with previous reports. What the service does well: What has improved since the last inspection? The home has been completely redecorated outside, and three of the kitchens on the wings have been completely renewed. A number of carpets in bedrooms and on corridors have been replaced. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 6 Work on the garden which is funded by residents fundraising activities continues to develop with the addition of a water feature and a summer house. 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. Southwold Nursing Home DS0000021658.V266154.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 Southwold Nursing Home DS0000021658.V266154.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 Good assessments undertaken prior to admission ensure that the home is able to meet the needs of residents appropriately. EVIDENCE: Before new residents were admitted to the home they were assessed by the referring agency and for nursing care by a funded nursing care or continuing care assessor from a NHS Primary Care Trust. A senior member of staff from the home also undertook an assessment that was fully recorded. These assessments were not only used to ensure that the home was able to meet the needs of residents following admission but also to identify equipment and facilities that needed to be available if the resident was admitted. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 and 10 Residents were treated as individuals who had their privacy respected. Good care planning and risk assessment take place. All care plans should be subject to the same level of review throughout the home. Medication was handled well. EVIDENCE: All residents had care plans based on the preadmission assessments and a full range of risk assessments that were undertaken following admission. Some care plans were found to be over 2 years old; others for the same resident were very recent in response to a newly identified need. Care plans and risk assessments had not been reviewed on a regular basis. Some reviews were just a date and signature, others had a comment which gave a basis for the review. All reviews should be monthly with a comment made on how the care plan still meets the resident’s needs and why the re assessment has not changed. The home had no residents with pressure ulcers. The home had a wide range of appropriate equipment for the treatment and prevention of pressure ulcers. The home also had a good range of aids and adaptations to assist residents in moving, the use of which for each resident was documented. The home had Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 10 recently purchased a number of hospital standard profile beds to effectively meet the needs of bed fast residents. All residents had access to dentists and opticians and spoke about accessing these services. A number of residents also accessed specialist NHS services for continence, wound care and swallowing difficulties. The home was part of a South Manchester Primary Care Trust Pilot project where residents are reviewed regularly by an active case management team headed by a Consultant Physician. This was found to have positive benefits for the health care of residents. The home had appropriate systems in place for the ordering, receipt, storage administration and disposal of medications that provided a safe system for residents. Residents said that they were treated with respect by staff who were seen to knock on bedroom doors before entering, and this was confirmed by residents. Residents requiring care or treatment received this in the privacy of their own room and the need for privacy was respected when bathing or using the toilet. Those who shared rooms had a curtain that was used to ensure privacy. Residents wore their own clothes. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 and 15 Residents had control over how they spent their day with a good range of activities on offer. Good quality food was available but their was no choice of meal offered on the day of the inspection. EVIDENCE: Residents said they were able to go to bed and get up or remain or return to bed as they wished. The home had a lot of activities available provided by an activities service from the local hospital NHS trust. There were activities available throughout the day. This was available to residents as they wished and they spoke about attending activity sessions when they wanted to. There were also a limited number of trips out. A number of visitors were seen in the home, all of who praised the home, the staff and the care the person they were visiting received. Bedrooms contained a lot of personal processions brought in by residents, and this ranged from photographs and pictures to pieces of furniture. Residents generally spoke positively about the food. The was only one choice of main course and sweet course available on the day of the inspection but residents’ said that they only had to ask for other choices to be made Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 12 available. One resident felt that the portions over faced them although the staff said they could leave what they did not want, but as the resident said, “my generation do not do that”. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home takes complaints seriously with a robust policy in place. EVIDENCE: The home had a complaints procedure that was available to residents and visitors. One complaint had been received by the home since the last inspection and was found to have been appropriately investigated and responded to. The home used the Anchor adult abuse policy and that of the local authority. Anchor also had a national confidential telephone reporting line for concerns. Staff were found to be aware of what constituted adult abuse and how to report it. Carers stated that trained staff frequently reminded them of how to recognise abuse and how to deal with any allegations. Details of an advocacy service were available in the home for residents who required this. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 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 the following standard(s): 24 The home need to ensure that bedrooms have locks fitted to ensure that residents who are able to can have privacy when they wish. EVIDENCE: The home has 32 single rooms and 4 doubles, which were well furnished and all had access to an on suite toilet. The administrator stated that locks were due to be fitted to all bedroom doors this financial year to ensure that residents were able to gain privacy and security if they wished. In advance of this all residents had had a key management assessment undertaken which would enable keys to be issued to residents once locks had been fitted. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): None of these standards was assessed at this inspection. EVIDENCE: Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 31,33,38 The lack of permanent manager was causing some instability. Regular servicing and maintenance of equipment ensures residents safety. EVIDENCE: The previous manager who had been at the home over 13 years had been promoted earlier this year to an area managers position within Anchor care homes. However, due to difficulties in recruiting a new manager has continued to provided some managerial cover. A project manager within Anchor started at the home to provide more stable cover for three days a week. Some residents and visitors commented on the instability they felt that the lack of permanent manager was causing and perceived lack of leadership. The home undertake an Anchor organisation quality audit known as “SAM” which gives over the year a picture of how the home is meeting its objectives of providing good care. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 17 Regular servicing and maintenance of equipment and installations was undertaken to provide a safe environment. The homes handyman was responsible for regular checks of the fire alarm and fire doors to ensure they would activate appropriately in an emergency. Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 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 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 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 X X x x X 2 X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement All care plans must be reviewed monthly and risk assessments at regular intervals. Locks suited to service users capabilities and accessible to staff in an emergency must be fitted to all bedroom doors. Timescale for action 30/01/06 2 OP24 23 31/03/06 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 When care plans are reviewed it should be stated why the plan is either continued or stopped Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Southwold Nursing Home DS0000021658.V266154.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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