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Inspection on 15/03/06 for Swallownest Care Home

Also see our care home review for Swallownest Care Home for more information

This inspection was carried out on 15th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Prospective residents and their families are given sufficient information to make an informed choice. The staff help relatives and the service users when they visit the home. The staff at the home involve the health and social care professionals when necessary. The staff have good knowledge of the service users` conditions and capabilities. The staff interact with the service users and their relatives; they behave respectfully and in a friendly manner. The service users have the opportunity to exercise their choice. There is provision for leisure and social activities. The residents are able to maintain contact with family, friends and members of the local community. Meals served at the home are of a good quality and the residents are offered a choice. The residents are able to have snacks and drinks in between meals if they so wish. The home is kept clean and tidy without any offensive odour. The grounds are kept tidy and safe. The acting manager and staff work towards delivering the best care possible.

What has improved since the last inspection?

Very little improvement has been made since the last inspection. This can be verified by the requirements made on this inspection.

What the care home could do better:

The staff must receive training and be competent to safeguard and care for the service users. The monthly visits by the responsible individual must focus on staff training, supervision and quality assurance. The acting manager must be visible and there must be service user, relatives meeting held to inform them of changes. All requirements made on this inspection must be complied within the set timescale.

CARE HOMES FOR OLDER PEOPLE Swallownest Nursing Home Chesterfield Road Swallownest Sheffield South Yorkshire S26 4TL Lead Inspector Marina Warwicker Unannounced Inspection 15th March 2006 11:00 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 Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Swallownest Nursing Home Address Chesterfield Road Swallownest Sheffield South Yorkshire S26 4TL 0114 2540608 0114 254 8846 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 Care Homes No 2 Limited Helen Firth Care Home 65 Category(ies) of Old age, not falling within any other category registration, with number (65) of places Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: Swallownest is a care home providing nursing and residential care for 65 older people. It is located in the village of Swallownest, which is on the Sheffield/Rotherham border and near the M1 motorway. The home is within easy reach of local shops and other community services. The home was purpose built and was developed in three phases and the design of the unit is in three wings, each with its own lounge and dining area. All bedrooms are single occupancy and seventeen of the bedrooms have ensuite facilities.The garden area is fitted with seating and raised flowerbeds; they also have a rear patio with access to the garden from the sun lounge and dining areas. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of Swallownest Care centre was carried on 15th March 2006 between 11am and 4.30pm. The inspector spoke with the service users, visiting relatives and the staff on duty. A tour of the home took place and the records held at the home in relation to the service users and the management were checked. The inspector would like to thank the staff, the administrator and the acting manager for their co-operation and contribution. What the service does well: Prospective residents and their families are given sufficient information to make an informed choice. The staff help relatives and the service users when they visit the home. The staff at the home involve the health and social care professionals when necessary. The staff have good knowledge of the service users’ conditions and capabilities. The staff interact with the service users and their relatives; they behave respectfully and in a friendly manner. The service users have the opportunity to exercise their choice. There is provision for leisure and social activities. The residents are able to maintain contact with family, friends and members of the local community. Meals served at the home are of a good quality and the residents are offered a choice. The residents are able to have snacks and drinks in between meals if they so wish. The home is kept clean and tidy without any offensive odour. The grounds are kept tidy and safe. The acting manager and staff work towards delivering the best care possible. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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 Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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 the following standard(s): 1,2,3,4&5 Prospective residents and their families have sufficient information to make an informed choice. The service users take part in a professional needs assessment by the placing authorities before moving into the home. The staff at the home assure them that the identified needs will be met. Opportunities are given to prospective service users to visit the home before moving in. Each resident is provided with a statement of terms and conditions once they have decided to take up permanent residency at the home. EVIDENCE: The staff and the service users said that copies of the service user guides were available for them. However, two relatives said that what is written in the service user guide does not always happen and when they had approached the registered manager about this, she was defensive and did not help with their Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 9 queries. Two relatives said that the staff were very helpful when they visited the home before their relative was transferred to the home. They also said that the acting manager visited the hospital and reassured them that their relative would be well looked after. Two service users and their relatives said that they had received copies of contracts. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8,9,10&11 All residents have care plans. The staff ensure that the health and social care professionals from the hospitals and from the community are involved when necessary. The qualified nurses and the trained senior health care workers manage the medication according to the pharmacy guidance. The residents are treated with respect by the staff at the home. Most staff have not had training on looking after people who are dying. EVIDENCE: The home is divided into three units. Ellis and Stewart are the personal care units and Kendall is the nursing care unit. Three care plan were checked, one from each unit. The Inspector, with the help of the nurse and the senior care assistant, checked the care plans. The service user files consisted of a full needs assessment, risk assessments for the identified care needs and the plan of action to be taken by the care staff to support the service user. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 11 Comprehensive daily records were kept of each service user. The staff had good knowledge of the service users’ conditions and capabilities. The inspector observed the staff interacting with the service users and their relatives; they behaved respectfully and in a friendly manner. Two staff said that they had not dealt with death and dying of service users, one said that she had received training in her previous place of work and none of the staff spoken to had received training at the home on bereavement counselling or palliative care. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14&15 The service users have the opportunity to exercise their choice. There is provision for leisure and social activities. The residents are able to maintain contact with family, friends and members of the local community. Meals served at the home are of a good quality and the residents are offered a choice. The residents are able to have snacks and drinks in between meals if they so wish. EVIDENCE: Three service users and seven visitors/relatives were consulted. They said that there was choice in relation to activities, daily routine and meals. However one set of relatives said that due to staff shortage at night-times different agency staff came on duty and this was causing some disturbance of their night routine. The acting manager was made aware of this. The inspector witnessed relatives freely visiting the home. The service users said that the meals served were good and that they are offered snacks with drinks in between meals. The staff were seen helping and encouraging the service users at meal times in a sensitive and discreet manner. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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 the following standard(s): 16,17&18 The home has a complaints procedure, which is accessible to service users, visitors and staff. There were procedures to protect the rights of service users. The homes policies demonstrated how the service users are protected from abuse, inhuman or degrading treatment from staff and other visitors, however the care staff were not familiar with the procedures. EVIDENCE: The staff said that they had seen the complaints policy but were not familiar with the stages. The care staff said that they would report any incidents or accidents to the senior carer or the nurse. The service users and their relatives said the staff made arrangements for electoral voting and introduced advocates if needed. During discussions with staff it was evident that not all care staff had attended training on protection of vulnerable adults from abuse and the procedures the home is expected to follow. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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 the following standard(s): 19,22,&25 The location and the layout of the home are suitable for its stated purpose. Environmental adaptations had been made to meet the needs of the service users. The management need to review the number of hoists and stand aids used at the home in relation to the dependency of the present service users. The lighting, water supply and ventilation of service users’ accommodation were satisfactory. However, there is an ongoing problem with the heating at the home. EVIDENCE: The home was clean and tidy without any offensive odour. The grounds were kept tidy and safe. Relatives commented that there wasn’t sufficient staff call buzzers for the service users to use when they are in the communal areas. They said although staff are expected to be around, due to pressures of work sometimes they are elsewhere attending to jobs. The service users said that their rooms were comfortable and kept clean by staff. They also mentioned that there had been problems with the heating systems, which often left them Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 15 cold and requiring extra blankets and fan heaters in their bedrooms. The responsible individual was made aware of this. The staff said that due to the dependency levels they would benefit by an extra stand aid hoist. Three relatives commented due to staff having to share hoists on some occasions the service users were having to wait some time until the hoist became available. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The staffing numbers and skill mix does not reflect the dependency levels of the service users at the home. The staff training need to be improved and increased in frequency to ensure the service users are in capable and safe hands. The staff files did not contain the information required by the Care Standards Regulation 2002. The home had processes for staff induction. EVIDENCE: The service users, the visitors and the staff voiced their concern about the lack of staff on duty on some shifts, especially in the mornings and at the weekends. It was ascertained that to cover staff holidays the management were reluctant to use bank or agency staff. Four staff personal files were checked. It was difficult to obtain the information. Apart from fire safety training the staff have not had mandatory training. Some care staff said that they were to enrol themselves to work towards NVQ level2 in care. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 17 The care staff said that the registered manager carried out the induction training and made arrangement for the new staff to shadow experienced staff. However, very little formal training had taken place. During discussions with the staff it was evident that the staff were expected to stay behind and handover to the staff coming on duty. This was performed by the staff and was unpaid. The inspector notified the Responsible Individual of the importance of making arrangements for overlap and formal handover time for staff. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36,37&38 The registered manager moved on within the company in November 2005 and an acting manager has been appointed. There has also been a change in the administrator at the home. The present management and staff are working towards delivering the best care possible. There has not been any effective quality monitoring since the last inspection. Staff supervision has not been carried out regularly. The acting manager is unable to ensure that the service users and the staff health and wellbeing are taken care of since the staff have not received the appropriate mandatory training. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 19 EVIDENCE: The acting manager and the senior care staff were familiar with the conditions and treatment of the service users. The visitors and some of the service users said that the registered manager was not visible, only saw her when there had been complaints and some did not know who she was. However, they were aware of one of the nurses taking up the acting manager’s post and commented that they would welcome a manager who comes around when she is on duty and see and speak to them. They said that the relative and residents meetings were not useful because often when concerns were raised the manager became defensive and nothing got done. Since the staff working at the home had not received training on moving and handling, health & safety and COSHH, an immediate requirement notice was served and the Responsible Individual was informed. The inspector instructed the acting manager that she should ensure that at least two staff on each shift must be proficient of the mandatory topics until all staff had received training. The staff said that they had received supervision but apart from one staff whose supervision record was dated August 2005, the others did not have any documentary evidence. In different parts of this report comments have been made about the inadequate record keeping. However, all records were kept securely according to the Data Protection act 1998. Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 20 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 2 3 3 3 2 3 3 2 X STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 1 X X 2 3 2 Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 4,5 Requirement The service user guide must reflect the aims, objectives and facilities at the home. Any deviation from the information provided must be explained and the service user guide must be regularly up dated. The staff must receive training on offering comfort to those who are dying and their families and how to support them. Previous requirement. Time scale set 21/11/05. To maintain continuity of care, staff must be recruited to the vacant posts. When using temporary staff, every effort must be taken to request the same staff. All staff must be familiar with the homes’ complaints procedure. Previous requirement. Time scale set 21/11/05. All staff must receive training on protection of vulnerable adults and formal procedures as to who needs to be involved. Previous requirement. Time scale set 21/11/05. DS0000003089.V277377.R01.S.doc Timescale for action 15/05/06 2 OP11 12 15/05/06 3 OP14 18 15/05/06 4 OP16 22 15/05/06 5 OP18 12 15/05/06 Swallownest Nursing Home Version 5.1 Page 22 6 OP22 16 7 OP25 23 8 OP27 18 9 OP27 18,24 10 11 OP29 OP30 7,17 12,18 12 OP31 9 13 OP33 24,15,12 In the absence of the registered manager the Responsible Individual must ensure there is adequate moving and handling equipment at the home. There must be call buzzers in the communal areas so that the service users are able to request for help. The service users’ rooms must be centrally heated and the service users must be able to control the temperature in their rooms. Immediate 15/03/06. The staff on duty must reflect the size and layout of the building and the dependencies of the service users. Previous requirement. Time scale set 31/05/05,21/11/05. Immediate 15/03/05. Handover time must be formally provided for staff at the end of each shift. The management must not rely on the good will of staff to stay on after shifts and complete the handover. Immediate 15/03/05. The staff recruitment records must be available for inspection. The staff training and development programme must meet the needs of staff employed. Previous requirement. Time scale set 21/11/05. The organisation must employ an appropriately qualified, experienced individual to manage the home. The responsible individual with the help of the management must carry out effective quality assurance and monitoring of activities at the home. The staff must be given regular feedback on their performance. DS0000003089.V277377.R01.S.doc 15/05/06 15/03/06 15/03/06 15/03/06 15/05/06 15/05/06 15/05/06 15/05/06 Swallownest Nursing Home Version 5.1 Page 23 14 OP36 18 15 OP38 13,16,23 All staff must receive formal supervision at least six times a year and there must be documentary evidence to support this. Previous requirement. Time scale set 31/05/05, 21/11/05. All staff must receive training on moving and handling, health & safety and COSHH. Previous requirement. Time scale set 21/11/05. Immediate action to commence on 15/03/05 and training of staff to be achieved by the stated timescale. 15/05/06 30/04/06 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 Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 Swallownest Nursing Home DS0000003089.V277377.R01.S.doc Version 5.1 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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