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Inspection on 15/11/05 for St Joseph`s Nursing Home

Also see our care home review for St Joseph`s Nursing Home for more information

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

What has improved since the last inspection?

Both requirements made at the last inspection in relation to the care planning process had been met. Three bedrooms and been re-carpeted and 1 bedroom had been re-decorated.

What the care home could do better:

As required at the last inspection the manager must make sure that staff have signed for everything that is given to residents on the medication sheets so that a full audit trail is available. Food that has been opened and stored in the fridge in the dining kitchens on the units must be labelled with a date of opening. The newly appointed manager, who took up post in September 2005, must apply to the Commission for Social Care Inspection (CSCI) for registration.

CARE HOMES FOR OLDER PEOPLE St Joseph`s Nursing Home 52 Plymouth Grove West Longsight Manchester M13 OAR Lead Inspector Geraldine Blow Unannounced Inspection 15th November 2005 09.30 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 Joseph`s Nursing Home DS0000021581.V266137.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. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Joseph`s Nursing Home Address 52 Plymouth Grove West Longsight Manchester M13 OAR 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 273 4147 0161 273 2162 Little Sisters of the poor Kathleen Maria Kiernan Care Home 53 Category(ies) of Old age, not falling within any other category registration, with number (53) of places St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users requiring nursing care will be 13. These service users are accommodated on the ground floor. Three named service users requiring nursing care are currently accommodated on the first floor. When these service users no longer require this accommodation the first floor will revert to accommodating service users requiring personal care only. The maximum number of service users requiring personal care only will be 40. These service users are accommodated on the ground and first floors. Minimum nursing staffing levels specified in the Notice dated 15th December 2004 and served in accordance with Section 13 of the Care Standards Act 2000 must be maintained. All service users are 60 years or over. The service should,at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th June 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: St Josephs Nursing Home is registered to accommodate 13 residents assessed as requiring nursing care and a maximum of 40 residents assessed as requiring personal care only. The home is owned and run by The Little Sisters of the Poor. The home is located in Longsight just south of Manchester City Centre. Local facilities and bus routes are within easy walking distance. The home provides ample secure parking facilities at the front of the building. The home is a three storey purpose-built building set in large, secure, wellmaintained grounds. The home is divided into 3 units and a wide variety of communal areas are available for residents. Bedroom and communal accommodation for the residents is provided on the ground floor and the first floor. All rooms are single and provide en-suite facilities. The second floor provides living accommodation for the Sisters. A daily mass is held in the chapel and for those residents who are unable to attend the chapel morning mass can be accessed via a special TV channel direct to their bedroom if they wish. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, conducted by 2 inspectors, and took place on the 15th November 2005. During the inspection time was spent talking briefly to the manager as she was in the process of conducting interviews for a new chef, residents and some staff to find out their views of the home. Also time was spent watching how staff worked with the residents. In addition a tour of the building was conducted and time was spent examining residents files. The CSCI have not received any complaints regarding the home since the last inspection. During this inspection only a selection of the key National Minimum Standards were assessed. Therefore in order to gain a full picture of how the home meets the needs of residents, this report should be read with the previous and any future reports. What the service does well: As identified at the last inspection, the homes décor, furniture and the facilities throughout the home are of a high standard. A variety of communal areas are available for residents including a chapel, a large concert hall, a library, an activities room, a small shop, a treatment room for physiotherapy and chiropody, a hairdressers and a laundrette on each floor. A very pleasant tea bar was available for the residents and their visitors to use on the ground floor. The home is divided into 3 units. Between the 3 units the home provides 1 smoking room, 2 small kitchen/dining rooms and one large dining room. There are 9 lounge areas between the 2 floors and several seating areas throughout the home. The standard of cleanliness throughout the home was high and there were no offensive odours. The residents spoken to all commented on how nice their rooms were and how clean and comfortable the home was. The atmosphere in the home felt warm, welcoming and tranquil. Staff were seen to have good interactions with residents and were observed to be kind and patient when dealing with residents individual needs. All of the residents spoken to were positive with regard to the staff. One resident said, “the home is really good and the staff really care” another resident said, “the staff are always helpful”. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 6 From the observations of the inspectors and the comments from residents, staff appear to maintain the respect and dignity of the residents. When bathrooms and toilets were in use a “do not disturb” signs were clearly displayed. On the day of inspection the manager was conducting interviews for a new chef. The residents spoken to said that there was always a choice of meals and there was always plenty of food and the quality of the food was good. A daily menu was on display and residents had a choice of dining rooms. Evidence was seen that the home provided a variety of activities and residents said that birthdays and special occasions are celebrated. Visitors, staff and their families are made to feel welcome to join in the celebrations. At the time of inspection the home was in the process of organising a range of Christmas activities that included a meal out, a race night, a pantomime visit and a singer. The home was also in the process of organising a fund raising autumn fair. Residents and their families are encouraged to be involved in the fair by manning various stalls. The plans of care inspected were found to be detailed and had evidence of resident and/or relative involvement. A large supply of equipment, necessary for the prevention or treatment of pressure sores, was viewed during the inspection. The GP visited the home every Monday and Thursday and had her own consulting room where residents could be seen. Residents could also be seen in the privacy of their own room if they prefer. The home also has a separate chiropody consulting room. What has improved since the last inspection? What they could do better: As required at the last inspection the manager must make sure that staff have signed for everything that is given to residents on the medication sheets so that a full audit trail is available. Food that has been opened and stored in the fridge in the dining kitchens on the units must be labelled with a date of opening. The newly appointed manager, who took up post in September 2005, must apply to the Commission for Social Care Inspection (CSCI) for registration. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 7 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 Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 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 St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were inspected at the previous inspection. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 10 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 The health and personal care needs of the residents were being met at the home. The system for recording all prescribed medicines needed some improvement to provide an accurate audit trail of medication. EVIDENCE: The plans of care inspected were found to be detailed, informative and clearly set out the action that needed to be taken by staff to ensure that all aspects of physical, social, emotional, cultural and religious needs of the residents were met. The requirement, from the previous inspection, regarding the need to risk assess the use of bed rails had been met. Evidence was seen that the care plans had been reviewed. However they had not been reviewed on a monthly basis as Standard 7.4 of the National Minimum Standards details. The inspectors were informed that these residents had been at the home for a long time and their care needs had not changed. It is recommended that the plans of care are reviewed monthly. Evidence was seen that the resident or their representative had been involved in the development of the care plans. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 11 The standard of recording in the daily progress sheets was variable and did not always refer to the residents’ assessed needs or evidence of the actual care delivered. The home had a pressure sore risk assessment and there was evidence that the tissue viability nurse had visited the home to provide advice regarding the most appropriate treatment. The requirement from the last inspection that a detailed review of pressure sores/sounds must be undertaken each time the dressing is renewed had been met. The plan of care documented which pressure-relieving mattress was in use for individual residents. The requirement from the last inspection that all prescribed medication must be signed for by the person administrating them had not been met and has been reiterated in this report. From observations made during the inspection and discussions with residents it appeared that the nurses and care staff treated the residents with respect and dignity. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 12 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, 14 & 15 The home provided a good environment for the residents who live with a wide range of activities. Residents were able to exercise choice and control over their lives A choice of meals is offered to residents. EVIDENCE: The resident files contained a detailed personal history, which included significant life events, hobbies and interests, pets, religious and spiritual observance. Although the home does not employ the services of an activity organiser evidence was seen that the home offered a wide variety of activities. Residents spoken to confirmed this. The notice board outside the main dining room displayed information regarding forth-coming activities. From speaking to a number of residents it was evident that they are encouraged to exercise choice and control over their day-to day lives. A choice of alternative meals was available. Staff consulted residents on a daily basis for their preferred meals. The daily menu was on display St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 13 throughout the home. Positive comments were made by the residents in relation to the quality, quantity and choice of meals served. It was noted that some food had been opened, covered and stored in one of the fridges in the dining kitchen on one of the units. However it did not contain an identified date of opening. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 14 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): EVIDENCE: These standards were inspected at the previous inspection. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 15 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, 24 & 26 The premises are safe and the home’s environment, including the standard of hygiene, was well maintained both internally and externally. EVIDENCE: At the time of inspection the home was found to be clean, tidy and free from odour. The home was tastefully decorated and furnished to a high standard. Bedrooms were decorated and furnished to a high standard. Many bedrooms had been personalised with resident’s own photographs and ornaments. One resident spoken to had only been living at the home for 2 weeks and told the inspector that she would like a bedroom with a garden view. The Sisters confirmed that arrangements were in place for the lady to be moved to such a bedroom. The home’s laundry was situated on the ground floor corridor and contained appropriate washing and drying facilities. Dirty linen was transferred to the St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 16 laundry in coded bins, soiled linen was transferred separately. The laundry had a dirty and clean entry and exit system. Laundry staff were employed. The inspectors were told that Personal Protective Equipment (PPE) was available in resident’s bedrooms where personal care was delivered and available in toilets and bathrooms to facilitate the management of personal care. It has been recommended, in accordance with Infection Control guidance that: 1. The home should ensure equipment such as the hoist is cleaned in between each use either by the use of equipment wipes or soap and water. 2. To prevent the risk of cross infection an individual sling should be provided for each resident requiring the use of the hoist. 4. The home should consider purchasing individual hand held alcohol gel for staff or wall mounting alcohol gel. 5. The home should develop and implement a policy to include the above. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 Appropriate NVQ training is being provided EVIDENCE: It appears that appropriate measures are in place to ensure that a minimum ratio of 50 of care staff will be trained at NVQ level 2. The inspectors were informed that the home employs 33 care staff. Eleven carers had achieved NVQ level 2 and 2 further carers were currently undertaking level 2. Eight carers were due to commence NVQ level 2 in January 2006. In addition the home had 4 members of staff who were NVQ assessors. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 18 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 The manager must apply for registration with the Commission for Social Care Inspection EVIDENCE: The manager, Sister Josephine, took up post at St Joseph’s in early September 2005. The application forms for registration were requested on the day of inspection. Sister Josephine has previous experience of home management. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 19 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 X X X X 3 X 3 STAFFING Standard No Score 27 X 28 3 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X x X X X X x St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 20 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 2 3 Standard OP7 OP15 OP9 Regulation 17 Schedule 3 13 13 Requirement The daily progress report must include an accurate record of all nursing care provided. All opened food stored in the fridge must be dated. The person administrating must sign for all prescribed medication. The previous timescale of 31/8/05 had not been met. The homes manager must apply to the Commission for Social Care Commission for registration. Timescale for action 22/11/05 15/11/05 22/11/05 4 OP31 9 20/12/05 St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 21 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 OP7 OP26 Good Practice Recommendations In accordance with Standard 7.4 of the National Minimum Standards it is recommended that the residents plans of care are reviewed at least once a month. It is recommended, in accordance with Infection Control Guidelines that: 1. The home should ensure equipment such as the hoist is cleaned in between each use either by the use of equipment wipes or soap and water. 2. To prevent the risk of cross infection an individual sling should be provided for each resident requiring the use of the hoist. 4. The home should consider purchasing individual hand held alcohol gel for staff or wall mounting alcohol gel. 5. The home should develop and implement a policy to include the above. St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 22 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 St Joseph`s Nursing Home DS0000021581.V266137.R01.S.doc Version 5.0 Page 23 - 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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