Inspection on 30/01/07 for Southwoods Nursing Home

This inspection was carried out on 30th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Southwoods Nursing Home 28 Thirsk Road Northallerton North Yorkshire DL6 1PH Lead Inspector John McGarva Key Unannounced Inspection 30th January 2007 10:00 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 Southwoods Nursing Home DS0000068036.V329003.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. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southwoods Nursing Home Address 28 Thirsk Road Northallerton North Yorkshire DL6 1PH 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) 01609 780362 01609 772533 Vorg Limited Mrs Theresa Mary Watkins Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006. Brief Description of the Service: Southwoods is a former dwelling house which has had a significant extension built to provide nursing care for up to 38 residents. It was first registered in February 1990 and is located a quarter of a mile south of the North Yorkshire county town of Northallerton on the west side of the main 168 Thirsk Road. It has two floors including the ground and there is a vertical lift providing level access to the first floor. Most of the garden area at the rear west facing side of the building is given over to car parking with flower / shrub beds round the rear and south side of the property. The fees charged at 15/11/06 are between £399 - £590 per week. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced inspection, which took place on Tuesday 30th January 2007 and Mrs Teresa Watkins the new manager was available to assist with the process. The inspection commenced at 10.00hrs and finished at 15.00hrs. Ownership of the home changed in August 2006 and several improvements in equipment and furnishings have taken place since this time. There were 38 residents in total, (full), all nursing cases, thirteen of which were on high banding for nursing. The inspection focused on the key standards and on issues raised at the last inspection. Discussions took place with the Manager as well as care staff and the residents. What the service does well: The manager was previously the training coordinator for the home and she is continuing to make training an important element in the management process. The home continues to provide a good standard of care, in a friendly and homely atmosphere and the resident’s testify to this. The staff, many of who have worked in the home for a long time, has a strong commitment to providing the best possible care despite some limiting aspects of the environment. Their rapport with the residents was observed to be professional and dignified. The quality of the food is a feature of positive comment by the staff and residents alike. There are good systems of care documentation in relation to care planning and the new manager is further developing these. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 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 Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s needs are sufficiently assessed thereby providing the foundation on which the care plans can be developed. EVIDENCE: Evidence from the case tracked residents records confirmed that there is good quality assessment documentation available upon which foundation the care plans are developed. The manager or senior nurse undertakes these either in hospital or the resident’s place of residence prior to admission. The rapid response placements, which can be made out of hours, are not always so assessed but an arrangement has been made to limit these admissions wherever possible. Intermediate Care (Standard 6) is not provided in this home. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good standard of care is being provided by staff that is well-motivated. EVIDENCE: The home was full, with thirty-eight residents, thirteen who were on the ‘high banding’ for nursing category. All, except one require assistance with washing/dressing and general hygiene’, twenty-one were doubly incontinent and all required wheelchairs to move about the home. Each resident has a ring folder into which the assessments and care plans are located. These are subdivided, with an index, into elements of care, along with the actions to be taken by the staff to meet those assessed needs. The plans are comprehensive, tailored to the individual and were clear and easy to follow. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 10 They also address social and emotional needs and there was evidence that they are regularly reviewed and updated. There is a separate sheet for the resident or representative to evidence that they have been consulted and informed about the construction of the care plan. The documentation is kept in secure conditions, in the manager’s office for the downstairs and in the clinical / medication room for the first floor residents. The ’daily accountability’ statements of all the residents are in two ring folders, separate from the care plans, one for each floor, to help improve accessibility for the care staff. Only the qualified nurses are involved in recording the care at the present time. The care staff, which makes most of the care interventions, should be making the appropriate records and this was discussed with the manager. Waterlow assessments are undertaken to determine risk from pressure sores and there are pressure-relieving mattresses as well as pressure-relieving cushions available. The Primary Care trust (PCT) provides power assisted mattresses at the present time but the home provide all other equipment including specialist cushions. The home is a pilot site for the ‘Gold standard’ for caring for people who are terminally ill. There is a key worker and named nurse system whereby identified care staff is allocated to devise and provide the care for a group of residents. Some of the residents spoken to knew who their ‘key worker’ and nurse is and there is an A4 sheet on the wall of each room which proclaims this information. In conversation, it was clear that the resident’s particular needs and wishes were respected in regard to when and how aspects of care took place. The residents spoken to were very pleased with the kind and careful care they received and were eager to talk to the inspector about this. Medications are stored and managed in accordance with recommended practice. The medication room is located on the first floor and the system is the traditional chemist supply rather than a blister pack system, and seems to be working satisfactorily. Due to the space constraints in the medication room, the drug trolley is kept in the manager’s office on the ground floor. A new medication trolley has been provided Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily routines enable the residents to have control over their own lives and a a new activities organiser is now available to assist in the social care . EVIDENCE: The residents spoken to say that they decide their own daily routines. The home now has an activities organiser who works 8 hrs per week, two afternoons and a work experience girl visits on Sunday afternoons. Activities, including ‘group activities, reminiscence, flower arranging, dominoes, exercise and singing are regularly organised. Trips out are also arranged, deploying the ‘Bedale bus’ and visit to the seaside and pantomime have also taken place. For those who are imobile, music and massage and Pets as Therapy is provided`to promote tactile stimulation. Residents can bring in their own items of furniture and other personal possessions into their rooms and this is evidenced in some rooms where significant items of furniture have been brought in. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 12 Visiting arrangements are flexible so that the residents are able to see relatives and friends whenever they wish. The residents made favourable comment on the quality of the meals provided and the meal served on the day of inspection included fresh vegetables and meat and was very well presented. There is a choice of the main meal of the day with alternatives available when indicated. Many of the residents require assistance or supervision with their feeding. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the staff has received abuse awareness training. EVIDENCE: The home has a complaints policy with time-scales for the resolution of these and this is included in the Statement of Purpose. There have been no complaints received about the home in the past year. There are Adult Protection and Whistle Blowing procedures available to protect the residents. All care staff receive training in Adult abuse issues on a regular basis. All policies and procedures are dated, indexed and the signatures of the staff to evidence that they have seen and understood them. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Issues in relation to the heating system and bathing facilities need to be addressed. EVIDENCE: The home meets the standards for homes registered before April 2002. The layout and general provision in relation to the environment is not ideal. There is a shortage of storage space, as evidenced with hoists and empty wheelchairs seen in corridors and lounges. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 15 Some individual rooms are rather small with two being less than 10 sq metres in size. There are twenty-two single rooms and eight shared rooms, which means that, when full, sixteen of the residents (42 ) are sharing. Only two single and three shared rooms have en-suite toilet facilities and in consequence commodes are used extensively. Since the new owner took over in August 2006 there have been some improvements to the environment and include: Four fully profiling beds for the high dependency nursing cases. Two new power assisted hoists and slings. New commodes and wheelchairs. A power assisted ‘Stand-aid’ would help the staff in the transfer of the residents between surfaces without resorting to hoists and slings. Lockable space is provided in each resident’s room for them to store valuables, money or their medications. There are problems with the temperature of the home in winter months as the heating system for the extension, much of the home, is by electric storage heaters, which are on a white meter. This is a fundamentally flawed system as the greatest heat is delivered at night with reducing temperatures during the day. Some resident’s rooms were less than ideal in temperature with one being only 64 degrees Fahrenheit. It is not possible with this system to control the temperature in the individual rooms and inconsequence Standard 25 is not fully met. Heating for the bathrooms is by wall mounted electric blower heaters. There are only two bathrooms and one assisted shower room available for use. One bathroom with a new electric hoist is located downstairs and the other with built in electric chair is upstairs. The assisted separate shower is located on the first floor. A bathroom with a domestic bath and no hoist is also located on the first floor and in consequence not used. The conversion of this room to an assisted shower would be possible and ensure that this room makes a contribution to the usable bathing facilities of the home. Liquid soap and disposable towel dispensers are provided in all the residents rooms, bathrooms, toilets, sluice rooms and medication room to help reduce risk of cross infection. There are two sluice rooms; one on each floor and each has benefit of a sluice disinfector which helps reduce incidence of malodours in the home. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 16 The lighting in the bathrooms is inadequate and some of the resident’s rooms need to have larger wattage light bulbs fitted. Suitably qualified people including a qualified occupational therapist have not assessed the premises and such an assessment would be of benefit. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 7 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient staff to provide personal care to the residents and satisfactory recruitment practices are followed. EVIDENCE: At the last inspection the home had a training coordinator working 35 yrs per week and had made a significant impact on the volume and quality of the in house training. This included NVQ courses as well as induction and foundation training for all the care staff. The training coordinator is now the manager and the home and she is continuing to make training an important element in the management process. Thirteen of the care staff has achieved NVQ Level 2 training standard and an additional three are in training. Three of the care staff had embarked upon NVQ Level 3 training. The percentage of the care staff trained to NVQ Level 2 or above is now 56 , an increase of 6 since January 2006. Each of the care staff has their own personal development file in accordance with good recommended practice and CSCI standards. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 18 Care staff spoken to confirm that there is now funding and time for continuing training and that all the care staff had received training in First aid at Work (FAW) and also aggression training. A member of the care staff stated that she had completed NVQ Level 2 and also Key Skills and Palliative care. Routine mandatory training takes place in Fire Safety, Moving & Handling, Health & Safety and Adult abuse. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 19 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): 31,32,33,35,36,37 &38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a manager who enjoys the support and confidence of the staff. EVIDENCE: The new manager is a first level nurse with many years experience in caring for elderly people. She was previously the training coordinator for the home and she has commenced the Management Award training, as has the deputy manager. She answered all questions without hesitancy or reluctance and the staff spoken to appreciated her more open approach. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 20 There are now regular meetings held with the staff and together with the new owner, there appears to be a more open consultative approach to the management of the home. One of the care staff had never seen an inspection report despite her working several years in the home. This was a matter that was alluded to in the report of September 2005. The personal files of a member of staff was inspected and found to contain all the relevant documentation including references and the requisite Criminal Record Bureau (CRB) checks. There are readily accessible service records relating to servicing of the hoists, gas appliances, lifts etc. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 21 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 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 2 2 2 1 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 3 3 Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 23 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 Refer to Standard OP8 OP21 Good Practice Recommendations All care staff should record their care interventions in the documentation The lighting in the bathrooms and residents rooms should be improved where indicated. The bathroom on the first floor, which does not have any hoist, should be made usable. 3 OP22 A power assisted ‘stand-aid should be provided. Suitably qualified people including a qualified occupational therapist should assess the premises 4 5 OP25 OP24 Additional profiling beds should be provided. The problems in maintaining adequate ambient temperatures in resident’s rooms should be addressed. Each resident should be able to adjust the temperature of his or her rooms. 6 OP33 The manager should discuss the inspection reports with the staff and they should be encouraged to read them. Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI Southwoods Nursing Home DS0000068036.V329003.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!