Inspection on 14/08/07 for St Oswalds House Nursing Home

This inspection was carried out on 14th August 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

St Oswalds House Nursing Home 09/05/06

St Oswalds House Nursing Home 30/01/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE St Oswald`s House Nursing Home 12 Golborne Road Winwick Warrington Cheshire WA2 8SZ Lead Inspector Wendy Smith Unannounced Inspection 10 am 14 August 2007 th 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 Oswald`s House Nursing Home DS0000066209.V338910.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. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Oswald`s House Nursing Home Address 12 Golborne Road Winwick Warrington Cheshire WA2 8SZ 01925 656337 01925 573113 stoswalds@schealthcare.co.uk 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) Southern Cross Healthcare (Cheshire) Limited Louise Hughes Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 42 service users in the category of OP (Old age, not falling within any other category) 20th February 2007 Date of last inspection Brief Description of the Service: St Oswald’s House is a care home providing personal care and nursing care for up to 42 older people. The home was first registered in 1987 and consists of a two-storey building and a single storey extension. It is set in its own grounds in the Winwick area of Warrington. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 14th August 2007 and took five hours. The home had 40 residents. A tour of the building, including all communal areas and some bedrooms, was completed. A sample of records was looked at and time was spent in conversation with the home manager, the operations manager, residents and staff. Some of the information contained in this report is taken from the Annual Quality Assurance Assessment that was completed by the manager. Comments cards were provided for residents, visitors, social workers and GPs to give their views of the home. What the service does well: People who are interested in going to live at St Oswald’s have an assessment of their needs to determine whether their needs can be met in full at the home. In general the care plans had been completed to a good standard to show that residents’ needs had been identified and staff were aware of the care they require. Residents spoken with said that they usually find staff to be pleasant and polite. One resident said that the night staff are excellent. Another said ‘On the whole, I am perfectly satisfied’. The arrangements for handling residents’ prescribed medicines were looked at and found to be satisfactory. Storage facilities were tidy and well organised, and good records were kept. An activities organiser is employed for 30 hours a week and variety of different social activities for residents both inside home. Care plans record the time that residents like to go to and residents spoken with confirmed that they receive the need at a time that suits them. she facilitates a and outside the bed and get up, assistance they Records showed that any complaints received had been addressed by the manager and responded to without delay. Ten of the care staff have a national vocational qualification in care and four others have applied to do NVQ. One of the domestic staff also has a national St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 6 vocational qualification and another is working towards this. A significant amount of staff training has taken over recent months. All of the necessary checks are carried out to ensure that new staff are suitable and safe to work with vulnerable people. Quality assurance tools are used to monitor progress in all areas of the service. Staff, residents and relatives are given the opportunity to express their views to the home manager 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. St Oswald`s House Nursing Home DS0000066209.V338910.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 St Oswald`s House Nursing Home DS0000066209.V338910.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): Standard 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are interested in going to live at St Oswald’s have an assessment of their needs to determine whether their needs can be met in full at the home. EVIDENCE: A range of information about the home, and about Southern Cross Healthcare, is available for people interested in going to live at St Oswald’s. The home’s Statement of Purpose, Service User Guide, and a copy of the last Commission for Social Care Inspection report are all available in the entrance foyer. There is also a notice-board with pictures and names of the staff. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 9 The manager said that she goes out to assess all prospective residents. In her absence, another senior member of staff carries out the assessment. The care plans looked at all contained a copy of the Southern Cross pre-admission assessment that had been completed by the manager. The information was used to compile a plan of care for the person that could be used by the staff for the first few days following admission, while a more in-depth assessment was carried out. The care folders also contained a copy of the social worker’s assessment for that person. The Annual Quality Assurance Assessment, completed by the home manager, stated that all residents had been reviewed by their social worker in the last twelve months. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal care and healthcare needs of residents are met and their medicines are managed well. EVIDENCE: Each resident has a care plan that details their needs and gives instructions for staff about how their needs should be met. In general the care plans were completed to a good standard. All of the care plans looked at included risk assessments for pressure areas, falls, nutrition, continence, moving and handling, and bedrails where appropriate. There were also records of communication with relatives and visits by healthcare professionals. There is room for improvement in the daily notes made by staff. Many of the entries in the daily records were ‘safety maintained’ and ‘needs met’. These do not demonstrate that the person making the entry has found out what the resident has done that day or how they were feeling. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 11 On the day of the visit the manager said that no residents were terminally ill and all were able to spend at least part of the day out of bed. No residents had a pressure sore. Pressure relieving mattresses of various types were in use in a considerable number of bedrooms. The manager said that at present there were enough pressure relieving mattresses for all residents who need them, and she would be able to requisition more if needed. There are two hoists of different types and various bathing aids. The home does not have a ‘stand aid’ hoist to help residents who need this type of equipment. This was discussed with the manager who said that, at present, the home would not be able to accommodate anyone who required this equipment. Residents can choose to receive medical services from several GP surgeries, but most residents are with same practice which provides an excellent service for the home. The home also receives good support when needed from the tissue viability nurse specialist, speech and language therapist and dietician. At the time of the visit two people living at the home were receiving nutrition using a gastric feeding tube. In order to meet the needs of an increasing number of residents requiring nursing care, there are now two nurses on duty during the morning shift. Each resident has a sign on their bedroom door with their name and ‘Please Knock’. Residents spoken with said that they usually find staff to be pleasant and polite, in particular one resident said that the night staff are excellent. The arrangements for handling residents’ prescribed medicines were looked at and found to be satisfactory. There are separate medicine trolleys for residents who require nursing care and those who require personal care. Two senior care assistants are able to administer medicines to the residents who do not require nursing and they have completed appropriate training. Other than this, all medicines are handled by registered nurses. Storage facilities were tidy and well organised, and good records were kept. There was minimal use of controlled drugs. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11, 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social and recreational opportunities are provided for residents and the meals provided are of good quality. EVIDENCE: An activities organiser is employed for 30 hours a week and she facilitates a variety of different social activities for residents both inside and outside the home. The activities organiser said that she has been fundraising, including doing a sponsored swim, to raise more money for activities equipment and trips out. Funds have also been raised by asking visitors to bring in books to sell and this has been very popular. A notice-board in the entrance foyer provides information for residents and visitors about activities that have taken place this year. A recent tea dance had been very successful and there have been several trips out. A mobile library has started to visit the home each month. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 13 The activities organiser also spends time with some residents who do not wish to join in group events but who enjoy a social chat. The lounge on the first floor is used for some social events. A new hairdressing salon has been developed and on the day of the visit residents were enjoying having a hair-do and making a social event of it. Care plans record the time that residents like to go to bed and get up, and residents spoken with confirmed that they receive the assistance they need at a time that suits them. At present the home does not have any residents from a minority ethnic group, and no residents for whom English is not their first language. Visitors are welcomed at any reasonable time and a number of relatives visiting clearly had a good rapport with the home manager and were well-informed about the care of their relative. Residents are able to bring their own belongings to the home in order to personalise their bedrooms. New menus have been developed and the nutritional content of the meals is monitored. A choice is available at all mealtimes. Residents spoken with were very satisfied with the quality of the meals. The dining room has been improved and is lighter, brighter and generally more pleasant. One person who likes to take some meals in her own room said that the food is sometimes not hot when it is brought to her. Sometimes the plate is not covered, sometimes the main course and dessert are brought at same time including ice cream that had melted by the time she had eaten the main course. The manager has bought new water jugs and beakers for residents to have in their bedrooms. Staff need to be aware that if the jugs are filled up to the top they are too heavy for many residents to pick up. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaints and adult protection procedures. EVIDENCE: Southern Cross Healthcare’s policies and procedures are in place for responding to complaints. The complaints procedure is communicated to all new residents and their families in the written information that they are given on admission. It is also displayed in the home. Records showed that any complaints received had been addressed by the manager and responded to without delay. Since the last inspection, one complaint made to the home manager had also been copied to the Commission for Social Care Inspection. This complaint, which was of a serious nature, had been speedily and effectively addressed by the manager. Two residents spoken with both said that they would have no hesitation in making a complaint if necessary and would speak to a senior carer or the home manager. Southern Cross policies and procedures are in place for dealing with any allegations of abuse and have been communicated to staff through training sessions. The Annual Quality Assurance Assessment, that was completed by the manager, states that whistle-blowing policies and procedures have been included in recent staff supervisions and in the induction process for new staff. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 15 Incidents of inappropriate behaviour by a member of staff were reported to social services and dealt with following adult protection protocols to ensure that residents are protected from abuse. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, clean and safe environment. EVIDENCE: The original part of the building has been improved over recent months to make it lighter, brighter and more comfortable. All residents now have a single bedroom. Plans for further improvements include redecoration and carpeting of the small lounge, new armchairs and dining chairs, more profiling beds, and carpets for the bedrooms that currently have vinyl flooring. Residents spoken with considered that the home is always kept spotlessly clean and they found the domestic staff to be very obliging. Following a recent visit by an Environmental Health Officer, the home’s kitchen was awarded a four star rating. St Oswald`s House Nursing Home DS0000066209.V338910.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): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Enough qualified and experienced staff are provided to meet the needs of the residents. EVIDENCE: At the time of this visit the home accommodated 28 residents requiring nursing care, and 12 residents requiring personal care. In a morning there are two registered nurses, a senior carer and five care staff on duty; in the afternoon and evening, one nurse, one senior carer and five care assistants; at night one nurse and three care assistants. Agency nurses are sometime used to cover shortfalls due to sickness, holidays and maternity leave, but the manager has been recruiting bank nurses who will be able to provide additional cover. The home has 18 care staff, of whom ten have a national vocational qualification in care. Four others have applied to do NVQ. One of the domestic staff also has a national vocational qualification and another is working towards this. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 18 Personnel records for two recently recruited staff were looked at. The records showed that all of the necessary checks had been carried out to ensure that they are suitable and safe to work with vulnerable people. There were also records to show that induction training was underway. The training matrix showed that a significant amount of staff training had taken over recent months. Two staff employed at the home are qualified to provide moving and handling training. The manager prepares a three-monthly training plan. The audit carried out by the company training manager in June 2007 showed a significant increase in training completed since the last audit. The manager had arranged for training to be provided for staff by a dietician during August 2007. St Oswald`s House Nursing Home DS0000066209.V338910.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): Standards 31, 33, 35 and 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 to ensure that it is run in the best interests of residents. EVIDENCE: The manager, who is a registered nurse, has been in post since December 2006. She is registered with the Commission for Social Care Inspection as manager of this service and has started working towards the Registered Managers Award. A notice in the entrance area informs visitors that the manager holds a surgery every Thursday evening and is available to discuss any queries or issues. She keeps a record of the discussions with visitors. The manager has also sent out satisfaction survey questionnaires to try and get feedback from relatives who have not been to any meetings. St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 20 All staff have a regular one to one supervision meeting with the manager and good records are kept. There are also regular staff meetings and group supervisions. As a result of consultation with the staff, work allocations have been changed and the key worker system reviewed. The operations manager visits the home at least once a month and makes a report as required by Regulation 26 of the Care Homes Regulations. A monthly home audit is carried out alternately by the manager and the operations manager. The auditing of any accidents occurring in the home was very good. A two-weekly audit of medicines has been carried out over the last few months to try and rectify problems that were occurring. Compliance with medication policies and procedures is now recorded at 100 . The Commission for Social Care Inspection Annual Quality Assurance Assessment was completed very well by the manager. An administrator is employed to deal with day to day office work. The administrator has responsibility for looking after personal spending money in safekeeping for residents. Small amounts of money are kept in separate envelopes in the safe. Electronic records are kept and a statement can be printed out for the resident or their relatives. Receipts are kept for any purchases made on behalf of the resident. The home’s staff do not act as appointee for any residents. One resident has a solicitor to look after their financial affairs and five have appointeeship through social services. Information provided by manager showed that all plant and equipment in the home are serviced and maintained in good order. Fire records are maintained including details of regular fire drills and the names of staff attending. All of the required policies and procedures are provided by Southern Cross Healthcare. St Oswald`s House Nursing Home DS0000066209.V338910.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 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 3 X 3 X 3 X X 3 St Oswald`s House Nursing Home DS0000066209.V338910.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 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Oswald`s House Nursing Home DS0000066209.V338910.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 - 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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