Inspection on 06/05/08 for Summerville Nursing Centre

This inspection was carried out on 6th May 2008.

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

Summerville Nursing Centre 12/11/09

Summerville Nursing Centre 24/04/07

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Summerville Nursing Centre Hilltop Road Stockton Heath Warrington Cheshire WA4 2EF Lead Inspector Helena Dennett Key Unannounced Inspection 6 May 2008 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 Summerville Nursing Centre DS0000068757.V361785.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. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerville Nursing Centre Address Hilltop Road Stockton Heath Warrington Cheshire WA4 2EF 01925 265865 01925 212620 livingno@bupa.com www.bupa.com BUPA Care Homes (CFHCare) Ltd 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) Mrs Janette Margaret O’Hanlon Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45), Physical disability (6) of places Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 45). Physical disability: Code PD (maximum number of places: 6). The maximum number of people who can be accommodated is: 45. Date of last inspection 24 April 2007 Brief Description of the Service: Summerville Nursing Home has recently been taken over by BUPA. It is situated on the border between the Stockton Heath and Grappenhall areas of south Warrington. There is ample care parking space and a good public transport network around the home. It is within easy reach of Warrington town centre, the M6 and M56 motorways. The home is a large period house set in its own grounds by the Bridgewater canal. The original building has six large bedrooms, a bathroom, lounge, dining room, kitchen, laundry, staff facilities and office accommodation. A large purpose built extension houses thirty-seven bedrooms, two smaller lounges and bathrooms. All residents have access to the nurse call system. The charges range from £480 to per £620 week. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This key unannounced inspection visit took place over 6 hours. Before the visit the manager was asked to provide information about the home as part of this inspection process. We talked to six people living in the home and gained their views about the care and services that are provided. We spoke to four members of staff, the manager and the operations manager. Their views are incorporated into the findings of this report. Three sets of care records were looked at during the inspection visit to check on the care people who live in the home receive. Records of medication, care plans, and staff training records were also examined, as were policies and procedures. What the service does well: People who are thinking of moving into the home and those living there are given information about the services the home provides. Assessments are done before a person moves in so they can make an informed judgement on whether the home is suitable for them. People living at the home told us that they were happy with the standards of care provided at Summerville Care Centre. Medicines are managed well so ensuring that the health of the people living in the home is maintained. Staff are well trained and supervised so are equipped with knowledge and skills to ensure that people are looked after appropriately. There are good policies and procedures in place to make sure that the home is run in the best interests of the people who live there. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 6 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. Summerville Nursing Centre DS0000068757.V361785.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 Summerville Nursing Centre DS0000068757.V361785.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): 3&6 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People considering moving into Summerville are given information about the home have a full assessment before they move in to ensure that the home has the facilities and resources to meet their needs. EVIDENCE: People are provided with information about the home and the services it provides before they move into Summerville Nursing Home. A senior nurse from the home usually visits a person before they move in so that a full assessment of their needs can be carried out. This provides staff with information on the person’s needs so that they can be fully prepared when the person moves in. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9, & 10 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs so they receive care in the way they prefer. Medicines are managed well so ensuring that the health of the people living in the home is maintained. EVIDENCE: We looked at three peoples’ care files in detail during the visit to the home. These contained all the necessary information to ensure that staff are aware of the person’s needs. Clear, concise care plans are in place and provide information on the type of care to be provided. The care plans are reviewed regularly so that any changes can be identified and the care plan updated accordingly. This means the person receiving the care can be confident that their needs will be met. There was evidence in the care files that other health care professionals are asked to visit as necessary. Records of any visits from other professionals are kept so that all staff are aware of the visit and any action that may need to be Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 10 taken as a result of that visit. For example: the dietician had been contacted to give advice about one person’s weight. We spoke to six people living in the home. Most of them were very positive about the staff and the care that is provided. One person told us: ‘the staff are very good. I like to get up about 6am so the night staff help me to wash and I can then sit out for my breakfast. This suits me’. Another person told us: ‘the staff are great, they have helped me a lot. I came in here for a short stay and I chose to stay permanently. I have no complaints. The staff respond immediately if I ring the bell’ Two people told us that although they were very happy with the home and the care provided, they felt that the response to the bell is sometimes slow. One person said that some staff come in and turn the bell off saying they will come back in a minute but don’t return. We noticed that one person living in the home was not happy about being left on her own in an area of the home. When questioned the carer told us there was no room for this person to sit in the other lounge. We spoke to a qualified nurse who took immediate action to address the situation. Following the visit to the home, the manager told us she is in the process of investigating these issues and that action will be taken once the investigation is completed. Medicines are managed well. The medicines policy has been updated to ensure that it meets with current guidelines. A sample of medicine administration records (MAR) was looked at. The records were completed correctly and were up to date. Medicines were stored correctly. The privacy and dignity of people living in the home is generally maintained. Staff knocked on bedroom doors before entering and all bathroom and bedroom doors were kept shut when any care was carried out. The layout of the main lounge does not lend itself to privacy in that the nurses’ station is based there and the door of the lounge exits directly to the main reception area. However there are two smaller more private lounges in the home for people to use. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14 & 15 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There are enough recreational activities provided in the home to ensure that people who live there have stimulation and can pursue their interests. EVIDENCE: There is an annual budget to cover activities in the home. Staff also take part in fund raising activities so that people living in the home are not asked to contribute towards any of the activities provided by the home. An activity co-ordinator is employed to work 18 hours a week. In addition care staff help out with providing stimulation and activities for people living in the home. A ‘map of life’ is completed with the person moving into the home at the beginning of their stay. This provides staff with information on their past history and their hobbies. These interests can then be incorporated into the structured activities programme. The manager told us that the activity hours for the home has increased to 50 hours per week and she is in the process of recruiting people to fill that post. This means that a more varied programme of activities can be provided and Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 12 more time can be spent on an individual basis with people who do not wish to take part in group activities. Since the last inspection new wide screen televisions have been purchased. The television in the main lounge is wall mounted so everyone can see it. On the day of the inspection visit two people were seen enjoying the programme ‘Bargain Hunt’; subtitles were also displayed so those people unable to hear properly could still follow the programme. One person spoken with told us that the manager of the home had helped her set up a computer with Internet access in her room. This helped her keep in touch with her family and follow her own interests. In addition she had brought in a large flat screen television and enjoyed watching DVDs, some of which members of staff had brought in for her. Another person told us that she does not usually go into the lounge. She said the activity organiser was excellent and visited her regularly, keeping her in touch with any planned activities. She said she enjoyed reading the monthly newsletter. People living in the home are assisted to follow their own religious beliefs. Ministers and lay preachers visit regularly as well as members from the local churches. All of the people we spoke with were positive about the food. They told us they are given a choice of main meals. The appearance of the dining room has improved since the last inspection. New furniture has been purchased and several smaller tables are used so giving a more homely feel. BUPA use a computerised system to develop the menus so ensuring that they are nutritionally balanced. In addition a ‘nite bite’ system has been introduced so there is always food available for people living in the home should they get hungry in the evening. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People who live at Summerville are able to express their concerns and complaints so are confident that they will be listened to. The procedures in place make sure that they are protected from abuse. EVIDENCE: The complaints procedure is displayed in the main entrance. It is also in the service user guide. This sets out the action to take should someone be concerned about any aspect of the running of the home. People living in the home told us they would complain if they needed to. They said they would tell the manager of any concerns and felt confident the manager would deal with it appropriately. The manager keeps a record of complaints received and the action taken as a result. We received a complaint recently from an anonymous source. The company have investigated and as a result some changes have been made to make sure that the needs of the people living in the home are met. There is a procedure on protecting people from abuse in place. Most of the staff have had training on how to recognise and deal with abuse so people living in the home can be confident that they will be protected from abuse. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 14 Additional training has been arranged so that all carers will be trained in safeguarding procedures. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Summerville is maintained to a good standard so it provides people with clean and comfortable surroundings to live in. EVIDENCE: A major refurbishment of the home has taken place since the last inspection. All bedrooms, day spaces, corridors, bathrooms, toilets and reception areas have been redecorated and refurbished. New furniture, curtains and soft furnishings have been purchased. A new bath has also been purchased. Outside the home a raised flowerbed has been built and a summerhouse has been erected. Before the refurbishment we discussed the location of the nurses’ station with Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 16 the providers, as it invades the privacy of people using the main lounge area and is not conducive to staff conducting conversations on the telephone that may be of a confidential nature. The providers met with relatives and some of the people living in the home. They told us that it was the choice of relatives and people living in the home that the nurses’ station remains in the lounge area. As we toured the building we noted that several hoists were stored in the bathroom. Some were placed in front of the sink, which means that anyone using the toilet would have difficulty washing their hands. This needs to be addressed. The home was found to be clean and tidy in the main. One person’s bedside rails were marked and the bed frame required cleaning. The manager agreed to have this dealt with. People living in the home told us their rooms are kept clean and tidy. They were satisfied with the laundry and had no complaints. Summerville Nursing Centre DS0000068757.V361785.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): 27, 28, 29 & 30 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There are enough staff working in the home so the needs of people who live there are met. EVIDENCE: On the morning of the inspection visit three qualified nurses and seven carers were working in the home. The deputy manager, who is a qualified nurse, was working as part of the care team so that she could supervise the carers and monitor the standard of care that is provided. The manager told us that she intends to recruit an additional carer to work in the morning so that staff have more time to spend with the people who live in the home. People living in the home said that staff were good and attend to their needs. We looked at a sample of staff recruitment files. All the necessary checks had been carried out including getting two written references and a Criminal Record Bureau disclosure so ensuring the person is suitable to work in care. Staff told us they are supported in their training. Over 50 have achieved a National Vocational Qualification (NVQ) Level 2 or equivalent which means that staff have the skills and knowledge to carry out their role. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 18 The manager confirmed that all staff have attended fire safety training and moving and handling training. Staff supervision takes place. Summerville Nursing Centre DS0000068757.V361785.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): 31, 33, 35 & 38 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Summerville is well managed so it is run in the best interests of the people living there. EVIDENCE: The manager of the home is a qualified nurse and has worked at the home for approximately two years. She has had previous management experience within the care sector. Most staff told us they felt supported in their role and that they could approach the manager if they had any concerns. There was a relaxed and friendly atmosphere within the home. The company that runs the home has a quality assurance system that includes seeking the views of people who are living in the home; this is done annually. Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 20 Meetings are also held with the people living at the home and their relatives to discuss changes and provide them with information on the running of the home. Staff meetings are also held regularly. The operations manager visits the home unannounced at least once a month, talks to people living in the home and staff then produces a report following the visit. This means that senior management can monitor the quality of care and services provided and that people living in the home get the opportunity to discuss any areas of concern or ideas for improvement with a senior manager. Audits are carried out regularly so the manager of the home can ensure that standards of care are maintained. The company has appointed a Director of Quality and Compliance so that any issues identified in the homes can be addressed quickly and policies reviewed if necessary. There is a good system in place for the management of people’s money. Records are kept of all transactions. The manager confirmed that all essential equipment used in the home is maintained regularly. We looked at a sample of records. These were satisfactory. Regular health and safety meetings take place, ensuring that the health and safety of people living there and of staff are maintained at all times. Summerville Nursing Centre DS0000068757.V361785.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 2 9 3 10 3 11 N/A 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 2 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 Summerville Nursing Centre DS0000068757.V361785.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. 1 Refer to Standard OP8 Good Practice Recommendations The manager should review the response time to call bells to make sure that people are not waiting long periods of time for assistance. Consideration should be given to moving the nurses’ station from the lounge so that communal rooms are not used for staff purposes and people living at the home can have privacy. A review of the storage of hoists and trolleys in the home should be carried out to make sure that people living in the home can access communal toilets and hand wash basins at all times. 2 OP20 3 OP22 Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwest Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Tel: 01772 730 100 Fax : 01772 730 176 Email: enquiries.northwest@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 Summerville Nursing Centre DS0000068757.V361785.R01.S.doc Version 5.2 Page 24 - 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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