Inspection on 10/01/06 for St Edmund`s Nursing Home

This inspection was carried out on 10th January 2006.

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

St Edmund`s Nursing Home 17/09/08

St Edmund`s Nursing Home 12/12/06

St Edmund`s Nursing Home 06/07/05

St Edmund`s Nursing Home 30/11/04

St Edmund`s Nursing Home 11/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE St Edmund`s Nursing Home Worcester Road Off Barrowby Gate Grantham Lincs NG31 8SA Lead Inspector Roger Harrison Unannounced Inspection 10th January 2006 09:40 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 St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 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. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Edmund`s Nursing Home Address Worcester Road Off Barrowby Gate Grantham Lincs NG31 8SA 01476 576811 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) Lifeline Nursing Services Limited Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (4), Terminally ill (1) of places St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Care Home is registered to provide personal and nursing care for up to 46 service users whose primary needs fall within the following categories: 41 Old Age (OP) 3 Physical Disability (PD) 1 Terminally Ill (TI) 6th July 2005 Date of last inspection Brief Description of the Service: St Edmunds is situated in a residential area on the outskirts of Grantham and is approximately two miles from the town centre. Grantham is a market town, and contains a wide range of amenities. The home is close to a bus route; local shops and taxis are used to access the town centre. The home is a single story facility, arranged in four wings. Each wing has its own lounge and dining area, and there is a communal room at one end of the home, which is used for activities and entertainment. The home is built around a courtyard, which is fully enclosed, and laid to lawns, shrubs and patios with garden furniture. The home is registered for forty-six residents. Lifeline Nursing services ltd operates the home, and it is one of three homes operated by the company. There are adjoining warden - controlled bungalows operated by the same company. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a five-hour period, with the inspector using a method of inspection called “case tracking”. This involved selecting four residents who currently live at the home and tracking their experience of the care and support they have received during the time they have lived at the home. This was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. The aim of the inspection was to establish whether the care provided to a sample of residents is consistent with the care given to all residents who choose to live at St Edmunds What the service does well: 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. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 6 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 St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 7 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): Outcomes not looked at. The key standards were looked at during the last Inspection undertaken on 06/07/05. EVIDENCE: St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 8 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): 7,8,9,10 and 11. The staff team have a caring approach toward residents and their dignity and privacy is respected. Care and nursing plans are completed with residents, which are reviewed monthly. Care plan reviews and risk assessments are being further developed to reflect outcomes for residents more fully. EVIDENCE: All residents have a plan of care in their room. Each individual has a named key worker highlighted who is responsible for updating and reviewing the care plan. Individual choice and privacy needs are discussed as part of the care plan process. Two residents told the Inspector that they feel they are supported by the care team with their personal care needs, and one resident said, “I get everything I need here, my family visit me regularly and they are always made to feel welcome.” Care plans showed that needs are met and that each care episode is recorded. There was evidence available that showed care plan reviews/risk assessments are undertaken regularly but could be improved upon by providing more written detail regarding outcomes, which reflect the good practice observed. This was discussed with the Manager on the day of inspection who told the Inspector that she is updating the review system to ensure that records include more detail to evidence how changing needs are being met, and to reflect outcomes more fully on the care plan review. The Manager also told the St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 9 Inspector that further work is to be undertaken to update all care plans to provide residents with the option to undertake life story work, which will be added to plans with each individuals consent. During the inspection the Manager described the positive support that the home continues to provide to residents and their families during the bereavement process. With this in mind the manager is offering residents the opportunity to receive support to complete an “end of life plan” which will be used to help obtain more detail regarding residents wishes so that these can be supported fully wherever appropriate. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Staff take the rights and choices of each individual resident seriously. Residents are able to retain control over their own lives and needs. Food in the home is of good quality, which ensures a wholesome and nutritious diet. EVIDENCE: All rooms are numbered with residents own names on the doors. The home provides an entertainment/activity organiser for five mornings per week, who uses a “social assessment form” to ask residents about their individual needs and what they would like to do. There was evidence of a wide range of activities set out, which are provided both in the “Activity Lounge” and across the homes communal rooms. During the inspection the inspector observed a group of residents enjoying communal games in the activities room. The Inspector spoke with the activities organiser regarding the varied activities for this month. One of the activities undertaken is a keep fit group. The activities organiser confirmed that she is to review current arrangements for this activity and is to arrange a physiotherapy assessment and seek further professional advice for those residents who wish to take part in this so that any potential risks can be identified and minimised appropriately. The care team regard nutrition as an important part of the care provided and there was evidence of a varied nutritious menu, which also offers daily alternatives. Menus are sent out the day before so that residents can choose something different if needed. Relatives and friends are encouraged for lunch St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 11 and a charge is made for this facility. Meals can be taken in a dining area or in the resident’s own room. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 12 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 manager and care team take complaints seriously and wherever possible involve residents and carers in resolving issues as soon as they are evident. The Care team know how to act in order to protect residents from abuse. EVIDENCE: It is company policy that all concerns, including verbal complaints are recorded. The complaints procedure and subsequent complaints were looked at and discussed in detail with the manager. There had been two complaints made since the last inspection, which appear to have been appropriately dealt with. Where complaints require further investigation and response by the home, the manager has keeps written details of correspondence, and how each matter has been, or is being resolved. During the inspection residents told the Inspector that they felt they could raise concerns and one resident said, “I have nothing to complain about but if I did I would always know to tell someone”. The home has a copy of the Lincolnshire Adult Protection Committee Procedures. The organisation supports training for all staff about the need to protect residents from all forms of abuse, Evidence of this training was available on staff files. Since the last inspection the Manager has taken action appropriately to commence the Adult Protection procedure in order to protect residents from abuse and has fully involved other external professionals in the process using good communication. This action has enabled residents to be protected from abuse in the right way. During the inspection a discussion with three members of staff helped to confirm that the team are aware of necessary protocols to invoke the procedure. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Residents live in a home, which is safe, well maintained, clean and Hygienic. EVIDENCE: The home is very well maintained, decorated to a high standard and clean throughout. The area outside the home is also well maintained and safe. Residents are encouraged to bring possessions into their rooms and to make them homely. Each room is individually furnished, and residents told the Inspector that they were fully supported to use their rooms safely and in the way they wished. During the Inspection the Inspector talked to domestic staff who demonstrated a commitment to the important role each undertakes to ensure hygiene standards are maintained in all areas of the home. There are enough bathrooms and toilets to meet the needs of the residents and appropriately serviced equipment is in place to support resident’s physical needs as appropriate. During this Inspection the Inspector talked to three care team members about fire safety. This group confirmed they regard the needs and safety of residents as central to their role. The group also confirmed that fire alarms are tested weekly, and were able to describe the appropriate action they would take in order to maintain residents and staff safety in the event of a fire. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 14 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): 27,28,29 and 30. The manager ensures that staff are recruited safely. Residents feel that competent, considerate and trained staff are meeting their needs. EVIDENCE: On the day of inspection the care team were observed providing a range of personal and social care support sensitively. A trained nurse is always on duty in home on a 24-hour basis and the Manager confirmed through staff rotas available that there is an adequate mix of skills across the staff team on each shift. Residents told the inspector that they receive care in the way they wanted it to be but that they would like there to be more staff available to spend more time with them when they needed it. This issue was also raised by staff members and was discussed in detail with the manager who confirmed that the home maintained an ongoing recruitment drive with the aim to establish and maintain a more consistent staff team. The manager confirmed that she would further review the current staffing arrangements and consider holding a full team meeting to seek and discuss ideas regarding how concerns raised might be resolved or improved upon. Staff are recruited appropriately and are provided with induction training. This was confirmed by staff records and through a discussion held between the Inspector and a group of staff members. Training courses are organised for staff to meet needs identified thorough supervision, which is undertaken by the Manager and deputy manager. Opportunities are made available by the organisation for care staff to develop skills and to enrol on National Vocational Courses, and at present nine team members are undertaking a range of NVQ qualification courses, including assessor training. A request for funding for four more NVQ 2 places and two St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 15 assessors has been submitted which confirms a commitment to continue developing the current staff team in the right way. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 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): 33,35,36 and 38. The home has a competent and committed acting manager who understands the needs of residents. The manager is open to developing current systems further to enable residents to remain at the centre of the care giving process. EVIDENCE: The acting manager is in the process of submitting an application to the CSCI to be the registered manager. The managers office has been well organised, and provides a base for maintaining all records. During the Inspection the Inspector looked at staff supervision records, which confirmed supervision does take place, but that this needed to be more consistent for all staff with records of each session maintained appropriately. The manager told the inspector that she understands her responsibilities and demonstrated an open approach to positive change and toward individual development to become the homes registered manager in order to continue making a positive difference to the residents lives, and in supporting the staff team to develop practice in the right way. The Manager confirmed that all residents are enabled to manage their own finances with external family/professional support as they wished. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 2 X 3 St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 18 NO. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP36 Regulation 18(2) Requirement The registered person must implement a formal supervision structure to enable supervision to be carried out at least six times a year. Timescale for action 26/05/06 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 OP38 Good Practice Recommendations That the Manager seeks physiotherapy/Occupational therapy advice and guidance regarding physical exercise classes undertaken with residents as part of the activities plan at the home in order to at take appropriate action to identify and minimise any potential risks to residents safety. St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 St Edmund`s Nursing Home DS0000002598.V274842.R01.S.doc Version 5.1 Page 20 - 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. 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