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Inspection on 02/08/05 for Strathmore Nursing Home

Also see our care home review for Strathmore Nursing Home for more information

This inspection was carried out on 2nd August 2005.

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.

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

The home was well-managed and provided residents with a clean and comfortable environment in which to live. Residents were supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. Residents were particularly complimentary of how kind the staff were and spoke very positively about how `homely` and `friendly` life at the home was. The home also provides a particularly varied social activities programme. Residents, their relatives and staff made it very clear to the inspector that the home was managed in a way that made them feel comfortable about expressing any concerns or ideas regarding the home.

What has improved since the last inspection?

The ongoing programme of refurbishment and redecoration within the home continues to improve the environment of the home for residents. Training opportunities for staff have been increased and staff are of the view this training is appropriate to their work and the way they care for residents.

CARE HOMES FOR OLDER PEOPLE STRATHMORE NURSING HOME 51 Seymour Road Astley Bridge Bolton BL1 8PT Lead Inspector Mike Murphy Unannounced 2 August 2005 nd 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 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. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Strathmore Nursing Home Address 51 Seymour Road Astley Bridge Bolton BL1 8PT 01204 309795 01204 309796 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Holt and Mrs Kay Holt Mrs Karen Prescott CRH N Care Home with Nursing 32 Category(ies) of OP Older People - 32 registration, with number PD Physical Disabilities - 3 of places TI Terminal Illness - 3 STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 32 service users, to include: up to 32 service users in the category of OP (Older People). up to 3 service users in the category of PD ( Physical Disabilities under 65 years of age) up to 3 service users in the category of TI (Terminal Illness under 65 years of age) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 15th March 2005 Brief Description of the Service: Strathmore Nursing Home is a care home providing nursing and personal (‘residential’) care for older people. It is a large, purpose built home on three floors (with a passenger lift). The main entrance and car park is to the rear of the home. There is a garden with lawns and mature borders to the front, and a roof terrace (accessed via the first floor), to the rear.The home has 32 places. There are eighteen single bedrooms and seven double bedrooms. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the home’s first of two annual inspections for the inspection year 2005 to 2006. The inspection took place over three hours. The inspection included discussion with residents and their supporters, a tour of the premises, inspection of care and other records maintained at the home, and discussion with staff. What the service does well: What has improved since the last inspection? What they could do better: The servicing of the fire alarm system within the home was in need of up dating. Clearly this is in need of being addressed and is considered in the requirements section of this report. Please contact the provider for advice of actions taken in response to this STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3. Standard 6 does not apply to this service. Prospective residents were being appropriately assessed prior to admission. This is essential to ensure that the home is able to meet the needs of such prospective residents and assist them in choosing if the home is suitable for them. EVIDENCE: Inspection of 5 residents care records revealed that a pre admission assessment had been conducted on all 5. These assessments included consideration of prospective residents physical, psychological and social needs. The assessments had been done by the home manager who is a registered nurse. These assessments were supplemented by others conducted by various health and social care professionals such as doctors, nurses and social workers. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 9 STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10, 11. The health and personal care needs of residents at the home were being assessed and addressed appropriately. The arrangements for the management of resident’s medicines were appropriate and staff interacted and assisted residents sensitively and appropriately during the inspection. Clearly these are important factors in ensuring residents receive appropriate care and treatment. EVIDENCE: The health care records of 5 residents who live at the home were inspected on this occasion. These were found to contain care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health, personal and social care needs of residents and were formally evaluated at least monthly. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity, mobility, and nutrition (including weight monitoring) and other relevant areas and were also evaluated at least monthly. The arrangements for resident’s medicines were secure and appropriately documented. Discussion with residents indicated that staff at the home treat them with respect and STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 11 seek to maintain resident’s dignity and privacy particularly when personal care is being provided. Examples of such comments are ‘ the staff are pleasant and kind’, ‘they care for me well here’, ‘ I can go to the lounge or stay in my room as I choose’, ‘ my family are able to visit at any time’. Residents also indicated in their comments, and this was supported in discussion with staff and inspection of care records, that they are able to access health care services appropriately, this included access to opticians, dentists, and chiropodists. Clearly this assists residents in maximising their health and well being. All residents were registered with a local GP. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 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 standard(s) 15. Meals provided a balanced and varied diet. This is an important area for residents as the meals provided are a central component of how they describe their satisfaction or otherwise with a home. EVIDENCE: Residents spoke very positively in respect of the food provided at the home, flexibility of meal times, choice of meals and dining areas provided. Comments made included ‘ the food is excellent here’, ‘I can have something else to eat if I wish’. Menus were varied, balanced and provided extensive choice. Inspection of the kitchen revealed that it was clean, adequately equipped and managed. Staff served and assisted residents appropriately and sensitively with their lunch on the day of inspection. This was a hot, substantial and well presented meal. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18. Appropriate measures have been taken to provide an environment where residents and their supporters feel comfortable with making a complaint if necessary, and to prevent residents becoming victims of abuse. These are important areas that are crucial to the protection of resident’s in a care home, many of whom are extremely vulnerable. EVIDENCE: Discussion with residents and their relatives indicated that there was a general awareness and information provided that enabled people to make a complaint if they desired. A detailed and accessible complaints procedure was in place and prominently displayed in the home, which included details of how complainants could contact the CSCI if desired. Resident’s spoken to felt comfortable and confident enough to raise a complaint if they felt it necessary to do so. Inspection of policies and procedures operated at the home, discussion with staff and inspection of staff training records indicated that staff were aware of the importance of protecting resident’s from potential abuse and how to communicate any concerns they may have in this area. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26. The home appeared to be structurally well maintained and to provide an appropriate environment for residents to receive personal and nursing care and accommodation. EVIDENCE: An ongoing programme of refurbishment and redecoration was in operation at the time of this inspection. All areas of the home designated for resident’s use were accessible to them. Adequate and suitable WC and bathing provision was accessible to service users. 12 resident’s bedrooms were inspected on this occasion – these were clean, appropriately/adequately furnished and very personalised. Communal lounges and dining areas were clean, warm and appropriately furnished. Appropriate aids and adaptations were in place throughout the home that STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 15 assist residents to maintain their safety and meet their physical needs. Individual aids and adaptations are provided following referral to the appropriate health care professional. The home was clean and free of odour at the time of this inspection. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30. Staffing arrangements at the home appeared to be appropriately managed and suitable to meet the assessed needs of residents at the home. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with senior staff on duty at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s. Inspection of 2 recently employed staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction training. Inspection of training records demonstrated that staff at the home were provided with appropriate training in care and related issues – including NVQ training. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 38. The home continues to be appropriately managed at the time of this inspection. This is important as residents need to have confidence in and access to competent managers. EVIDENCE: The registered home manager is a very experienced registered nurse manager and is completing an NVQ4 in management. Discussions with service users within the home, their relatives, and staff employed at the home indicated that the registered manager has developed a management style that is open, supportive, positive and inclusive. The following certificates of inspection/service records were found to be satisfactory on this occasion; electrical systems/equipment, fire fighting STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 18 equipment, passenger lift/lifting equipment, gas safety, accident records/monitoring, monitoring of hot water temperatures, general and specific health and safety risk assessments, and control of clinical waste disposal. However a recent record of the servicing of the fire alarm system was not available for inspection. STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 2 STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 20 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 38 Regulation 23 Requirement That a copy the most recent record of service in respect of the fire alarm is supplied to the CSCI Timescale for action 30th of September 2005 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 Good Practice Recommendations STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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 STRATHMORE NURSING HOME F56 F06 S5702 Strathmore V230623 020805 Stage 4.doc Version 1.40 Page 22 - 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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