Inspection on 17/07/07 for St Oswalds Nursing & Residential Home

This inspection was carried out on 17th July 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 Nursing & Residential... 23/04/09

St Oswalds Nursing & Residential... 18/08/08

St Oswalds Nursing & Residential... 19/12/07

St Oswalds Nursing & Residential... 29/06/06

St Oswalds Nursing & Residential... 02/02/06

St Oswalds Nursing & Residential... 02/09/05

St Oswalds Nursing & Residential... 04/01/05

St Oswalds Nursing & Residential... 27/05/04

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

CARE HOMES FOR OLDER PEOPLE St Oswalds Nursing & Residential Home 2 Crowhall Lane Felling Gateshead Tyne & Wear NE10 9PX Lead Inspector Mr Tom Moody Key Unannounced Inspection 10:00 17 July and 1st August 2007 th 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 Oswalds Nursing & Residential Home DS0000018178.V338467.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 Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Oswalds Nursing & Residential Home Address 2 Crowhall Lane Felling Gateshead Tyne & Wear NE10 9PX 0191 495 0585 0191 438 1722 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) None Four Seasons Healthcare (England) Limited (Wholly owned subsidiary of Four Seasons Health Care Ltd) Ms Valerie Kelly Care Home 70 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (64), of places Physical disability over 65 years of age (52), Sensory Impairment over 65 years of age (9) St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One person under the age of 65 who also has a physical disability. The Manager will be supernumerary to the staffing complement Date of last inspection 29th June 2006 Brief Description of the Service: The home is in an urban setting close to local facilities. The home extends to four stories. It is contains 70 registered beds. Social care is provided on the ground floor and social care for service users with dementia is provided on the top floor. The middle two floors provide nursing care. The home is of traditional appearance with a tiled roof. It has one passenger lift and because it is built on rising ground there is access to the outside from the two lower floors. For the same reason views from some of the lower floor windows are restricted. There is a lounge and dining room on each floor with additional lounge space close to the first floor entrance. The home has a patio area and a large car park. The grounds are landscaped. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over two days in July. One inspector was present at both of the site visits. The manager and staff were spoken to as well as service users and relatives. Care plans and other documentation were examined and a tour of the premises took place. Verbal feedback was given to the manager on the main findings of the first site visit. A further visit was made some days later to confirm improvement work was underway. The home is reasonably well equipped with appropriate aids and adaptations in bathrooms and toilets. The decor is being gradually improved in a style that is suited to the client group’s age and lifestyle preferences. The home has plenty of space in all areas. It is popular with service users and their families. What the service does well: The morale in the home is good and staff feel motivated and enthusiastic. They confirm the Manager is approachable and they have confidence in her. The kitchen staff are well motivated and provide a flexible service tailored to service user’s needs. The ground floor of the home has a very homely feel and service users show a sense of ownership. There is a an ongoing and active social programme in the home. Staff on the top floor have had training in dementia care and these ideas are being put into practice with good effect. The manager ensures that regular staff meetings are being held. There is a good relationship between service user’s relatives and many of the staff. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 6 One relative said, “I’ve got no worries over how she is looked after”, “They are well looked after in here, she’s been in other homes but this is the best one.” Another said, ”They are very well looked after.” 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 Oswalds Nursing & Residential Home DS0000018178.V338467.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 Oswalds Nursing & Residential Home DS0000018178.V338467.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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. All service users entering the home have their needs accurately assessed by social care and health service staff. The home makes it’s own assessment in addition to this. This ensures that their needs are met by the home. Most service users and their family have the opportunity to visit the home before they come to stay, unless there are exceptional circumstances. This allows them to make an informed choice about staying in the home. EVIDENCE: The provider’s self-assessment indicates they provide a satisfactory Service Users Guide which includes terms and conditions and Statement of Purpose. They also state that the latest CSCI report is available and that service users can make visits and have trial periods before deciding to come into the home. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 9 The manager states that relatives and service users can visit as often as they wish before deciding if they want to be placed in the home. Service user’s confirmed this. One said, “I was greeted at the door, I had a meal and I felt most welcome.” The Service Users Guide has improved. This is comprehensive and contains all relevant information. The care plans examined were completed well and the assessment of service users needs was good. St Oswalds Nursing & Residential Home DS0000018178.V338467.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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users health care needs are met. Service users have access to all healthcare services that they need. The home has appropriate policies and procedures to ensure service users receive their medication in a safe way. EVIDENCE: The provider’s self-assessment indicates that they provide good documentation and individualised holistic care practice. It also states service user and relatives participate in meetings and that care plans are audited. The home has suitable policies and procedures covering these areas of service. The Manager has good awareness of service users social, recreational and clinical needs. Visiting professionals did visit the home and at the time of the site visit a diaetician was providing training. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 11 Medication is stored safely. A monitored dosage system is in use and recording is good. Controlled drugs are safely stored and stock balances are correctly kept. Care plans are comprehensive and well written. Service user’s care plans contain much useful clinical information and doctors and other professional visits are recorded. Some of the life histories were well recorded and detailed. When asked about their relatives care experience, visitors said, “I’ve got no worries over how she is looked after”, “They are well looked after in here, she’s been in other homes but this is the best one” and ”They are very well looked after.” One qualified staf member did not have much awareness of deaf issues and did not know the principle behind induction loop systems and how they were supposed to help hearing aid users. The homes loop system was not working well and the manager was advised to contact the local authority officer, with responsibilities in this area, for advice. The home has appropriate equipment and suitable adaptions to meet service user,s needs. The atmosphere on the Mental Health unit was very calm although service users are active and engaged in activities. St Oswalds Nursing & Residential Home DS0000018178.V338467.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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home endeavours to provide a lifestyle that matches service users needs and preferences. Meals are of good quality and the timing and choices are varied to meet service users needs. EVIDENCE: The Providers self-assessment indicates that relatives and service users have regular meetings. Also there are plans for a sensory room and there is a minibus available for outings. Staff deal with relatives, in person, and in telephone enquiries, appropriately. The chef makes regular contact with service users to monitor satisfaction with the meals. Menus are satisfactory. The meal seen by the inspector was of good quality and well presented. “Home cooked” dishes, such as bread and butter pudding were available. Service users are aware of alternative choices. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 13 The kitchen is clean and well organised. It is well equiped. The décor has improved in the dining areas, making them more pleasant. The kitchenettes still need refurbishment and some of the equipment in these areas is looking old and worn. The quality and presentation of food was good.Service users spoke of, “enjoying their meal” and relatives confirmed that, “They get well fed.” Service users were supported by staff,during their meal, in a suitable manner. Staff addressed service users appropriately. Visiting is unrestricted and visitors were seen coming and going throughout the day. Activities are available, one service user spoke of “baking scones” and said she was going to, “the hairdresser.” Service users were watching T.V. and appropriate music was available. The manager said that the home can use an adapted bus for transport to facilities such as shops and entertainment. A service user said that, “We get the minibus out, we’re going to Whitby.” The home has several patio type areas and these were being used by service users and staff. St Oswalds Nursing & Residential Home DS0000018178.V338467.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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The homes policy on adult protection reflects the multi-agency approach to adult protection, and local procedures and staff know how to use it. This should ensure the protection of service users. Service users and relatives are confident that the process and the staff will act in the service user’s best interests. EVIDENCE: The provider’s self-assessment indicates the home has appropriate policies and procedures, including whistle blowing, and they make the statutary notices required under the regulations. The home has participated in adult protection issues and experience shows the homes management deal with the issues appropriately. Service users said that they would be happy to raise issues with the staff and said, “I’ve no problems but the staff would sort me out if I had”, and “the staff look after me really well.” The Manager stated she had an open door policy and she is aware of service user’s legal rights. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 15 All of the relatives that were spoken to confirmed that they found the staff helpful and felt that the Manager was approachable Complaints are recorded appropriately and staff training includes adult protection issues. St Oswalds Nursing & Residential Home DS0000018178.V338467.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): Quality in this outcome area is good. This judgment has been made using available evidence including visits to this service. The environment is well maintained and safe. The home has most of the equipment it needs to meet service users needs. Rooms are comfortable, furnished to service users tastes, and the home is kept clean. EVIDENCE: The provider’s self-assessment indicates that there is a refurbishment and decorative programme underway. It lists all of the certification for maintenance including waste disposal. Areas on the ground floor of the home have been redecorated. Wood effect flooring has been installed in the dining areas and these areas have been redecorated. The small kitchens off the dining rooms still need refurbishment and some equipment, such as stained and worn jugs, should be replaced. One relative remarked that “the new paper looked better.” St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 17 The second floor is out of use due to ongoing refurbishment. New furnishings and equipment were available in this area awaiting installating. This included a number of new adjustable beds. The top floor was clean, bright and airy and provided a pleasant environment for service users. All areas were at an appropriate temperature. Some areas were too dark at the time of the first site visit,but at a second site visit work was underway to improve this on the ground floor and new lights had been installed on the second floor. The were no unpleasant smells in most of the home but one toilet was odourous. The extract fan in this area had failed but this defect was addressed almost immediately. The induction loop system to help deaf service users as not working well and was only picking up ambient noise. This is not how this equipment should work and it was recommended that the home seek independent advice from an access officer or RNID. The patio areas outside the home provide a good facility but drifts of leaves and moss should be removed to ensure safe access. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager ensures that the home operates safely with sufficient numbers of staff, who are appropriately trained, are available to meet service users needs. EVIDENCE: The provider’s self- assessment claims that the home has flexible, friendly staff and that they use no agency workers. Duty rotas indicated an appropriate level of staff. The self-assessment indicates 62 of staff have attained NVQ level 2 or above. The home has appropriate policies in training, employment and recruitment Staff confirmed that a good level of induction take place and they feel supported. Training records indicated this was the case. The call system was answered promptly during the inspection. One relative indicate that more staff would be welcome especially at busy periods such as meal times. However, staff were seen to support service users quite well at these times. Service users spoke well of the care they received from staff. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 19 The staff were well motivated and happy when carrying out their duties. The are comfortable in their role and speak appropriately to service users and visitors. At the time of the site visit the local health trust’s dietician was in the home providing training. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager is diigent in her approach and has a positive vision of how the home should operate. She is supported by the senior management of the company to ensure the home runs in service user’s best interests. EVIDENCE: The provider’s self-assessment indicates the manager is approachable and has an open door policy. It also indicates there is an annual customer survey and that there are regular quality audits carried out. The management of the home has always displayed a co-operative attitude towards CSCI and has generally been open and transparent in their dealings with the regulatory authority. St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 21 The registered manager is an experienced nurse and has recently completed the registered managers award. The manager has introduced some positive changes in the home including training. There has been a gradual change of personnel in the home. Discussions with staff indicate the morale in the home is good and staff feel motivated and enthusiastic. They confirm the Manager is approachable and they have confidence in her. Service users and relatives also say that the manager is approachable. The manager is aware of her statutory responsibilities, including health and safety, and record keeping is good. She stated that supervision takes place and staff confirm they have regular supervision sessions. The manager said that that they operate the Four seasons quality audit system and that customer satisfaction surveys are carried out. The results are fed back to each home. The Manager confirmed she felt well supported in her role by the senior management St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 X 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 2 3 2 3 3 3 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 3 3 X X 3 3 3 St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 23 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 OP22 Regulation 23(2n) Requirement The home must have suitable aids and adaptations including equipment for those with sensory loss. Timescale for action 29/08/07 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 OP19 Good Practice Recommendations Patio areas should be kept free of leaves and moss to ensure unimpeded access St Oswalds Nursing & Residential Home DS0000018178.V338467.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 St Oswalds Nursing & Residential Home DS0000018178.V338467.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. 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