Inspection on 21/09/05 for Swallownest Care Home

This inspection was carried out on 21st September 2005.

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.

Other inspections for this house

Swallownest Care Home 12/03/07

Swallownest Care Home 07/09/06

Swallownest Care Home 15/03/06

Swallownest Care Home 08/03/05

Swallownest Care Home 06/07/04

Swallownest Care Home 06/01/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Swallownest Nursing Home Chesterfield Road Swallownest Sheffield S26 4TL Lead Inspector Marina Warwicker unannounced 21 September 2005 12:30hrs. 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. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Swallownest Nursing Home Address Chesterfield Road Swallownest Sheffield S26 4TL 0114 2540608 0114 254 8846 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) Highfield Care Homes No 2 Limited Helen Firth Care home with nursing 65 Category(ies) of Old age, registration, with number not falling within any other category (65) of places Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8 March 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 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of Swallownest care centre was carried out on 21st September 2005 (around lunch time and evening) between 12.30 pm and 5pm. The inspector had a tour of the premise with the home’s manager and spoke to residents, relatives who were visiting and the staff on duty. What the service does well: What has improved since the last inspection? The staff have started receiving formal supervision. The manager has introduced a new staff structure within the three units. The effectiveness of this will be measured during future inspections. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 6 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 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.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 Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.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) 1,3,4&5 The home provides the prospective residents and their families with sufficient information to make an informed choice. Before moving into the home service users take part in a professional needs assessment by the placing authorities and are assured by the home that the identified needs will be met. Each resident is provided with a statement of terms and conditions once decided by the resident with the help of the care manager and / or the relatives to take up permanent residency at the home. EVIDENCE: Two relatives, six residents and staff said that there was information available to check what type of care was offered at the home. However, the information needs to be updated to reflect the change of organisation. Four care plans were identified and discussion took place between the manager and the Inspector about the paperwork being in transition to Highfield Care Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 9 Home format (see standard 37). The manager said that the care plans consisted of needs assessments by the placing authorities for the respective residents. There were also copies of the home’s individual assessments of the residents prior to admission to indicate how the identified needs were to be met. Manager informed the Inspector that she/he audited each files regularly and feedback to staff on his/her findings. The service users and the relatives said that they were confident that the home was suitable when they made the choice. Four service users were randomly selected and the manager said that they had contracts, which had been agreed by the home and the service users. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.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) 8,9,10&11 All residents have care plans. In order to meet individual needs, the care plans are completed fully at the earliest possible opportunity by staff. The staff ensure that the health and social care professionals from the hospitals and from the community are involved when necessary to provide a seamless service. The qualified nurses and the trained health care support workers managed the medication. The residents are treated with respect and the staff value their right to privacy. Therefore the residents are able to live in a comfortable and happy environment. Most relatives are consulted about funeral arrangements when the staff feel it appropriate, so that the residents’ last wishes are respected. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 11 EVIDENCE: The individual care plans will be checked by the inspector in a future inspection. The staff said that none of the permanent residents in the home had the capacity to self-medicate; therefore the staff administered the medication. The inspector questioned four residents to find out whether they would have preferred to self medicate. Those who spoke to the inspector preferred the staff administering medication. The manager said that all service users’ medication was annually reviewed by the GP. The inspector ascertained during staff interviews that most of the care staff read the care plans and got involved in the planning and the changes made to the individual’s care plans. The manager said that the residents’ last wishes were documented in the care plans. The staff interviewed had a good understanding and knowledge of caring for those who were dying and supporting the family. There had not been any formal training on palliative care, pain management or bereavement counselling. The staff confirmed this. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.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) 12,13,14&15 The service users have the opportunity to exercise their choice in relation to routines of the day, personal and social relationships, religious observance, choice of food, frequency of meals and meal times. There is provision for leisure and social activities to avoid boredom among service users. Activities stimulate the residents and give them some self worth and independence. Visitors are encouraged and residents are able to maintain contact with family, friends and members of the local community. Thus the residents are able to maintain outside contacts. 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: The service users and relatives said that the home was very flexible when it comes to service users getting up in the morning and going to bed. However there were some comments made in relation to the unit providing nursing care; that those residents who have breakfast early in the morning often have to wait in the dining room since there is not enough staff to transfer them to Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 13 the lounge until late morning (see standard 27). The manager was informed of this during inspection so that this could be rectified. The service users said that the staff helped them keep in touch with family and friends. The residents and the relatives said that service users did have activities and often the same ones took part. The inspector suggested to the manager that the activities co-ordinator was made aware of these comments and a record is maintained for all residents of the activities they like joining in and how often they had been involved. The relatives said that they were made welcome by the staff and that the staff worked very hard. The residents and the relatives commented on the choice of food and how good it was. This was an unannounced inspection and the staff were not aware of the inspector’s visit. The inspector entered the home during lunchtime and witnessed the staff helping residents with feeding. A number of residents were in the dining room having their lunch. Four residents said that they had plenty to eat and did not need any snacks in between meals. But they were able to get a hot drink anytime if they wanted. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17&18 The relatives and the residents are given the opportunity to raise any concerns and complain to staff or the manager. This is to enable residents to voice their opinion of the service and also for the staff to review and make improvements to areas of concern. The residents are enabled by the staff to exercise their legal rights and for those who lack capacity, an advocate service is offered. Such arrangements help residents to receive independent advice and help. The home has a complaints policy. The staff were familiar with the procedure but need to know the timescales and be aware that records of all complaints are kept by the manager. The management gives opportunity for staff to attend courses on adult protection and allegation of abuse. This is to protect service users and staff. By training staff they become conversant and therefore able to take appropriate action in such circumstances. EVIDENCE: The home had a complaints policy, which the staff were aware of. The relatives and residents said that when they have concerns they spoke with the staff or the manager. Staff told the inspector that when anyone complains, depending on the issue if appropriate they take immediate action to resolve it and then inform the Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 15 person in charge. The manager said that they had records of all the complaints. Some of the staff have had training on Adult Protection and action to be taken if there was allegation of abuse. The care staff said that they would tell the manager. Although this is true in the day-to-day management the staff must be aware of the procedures and expected action to be taken by the management. Not all the staff had attended training in the above areas. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24&25 The layout and the location of the home is suitable for it’s stated purpose. The home is clean and some residents’ rooms are personalised. Domestics are employed to carry out housekeeping duties. The rooms are naturally ventilated The home has adequate numbers of toilets and bathrooms. There is a maintenance programme in order to keep the home in good repair. There are pleasant outdoor areas, which can be used by the residents and relatives during good weather. The residents use the lounges on the ground floor during day and night. EVIDENCE: During the environment check the inspector found the home to be clean and comfortable. The inspector observed packs of red bags on the floor of the Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 17 doorway of some bedrooms. It was confirmed by staff that the occupants of the rooms had infections where they needed to take precaution. The inspector informed that such practice infringes on residents privacy and dignity and the bags should be removed (relevant to Standard 10). There were three areas for the service users and families to use as communal lounges. The individual accommodation was satisfactory and some service users had their own possessions in their rooms. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 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 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 The staffing rotas are formulated on most occasions with the correct staff numbers and skill mix of qualified nurses, senior carers and health care support workers so that the service users are able to receive appropriate care. There was documentation showing staff training and recruitment practices. Thus promoting a safe environment for service users. EVIDENCE: On the day of the inspection the staff complement was adequate. The service users said that the staff worked hard and also worked well as a team. Four recruitment files were checked and most information was available. However, the home must address the following areas: The staff must have a satisfactory CRB clearance before starting work at the home, for emergency use all staffs’ next of kin contact number should be sought, explanation for any gaps in employment history must be explored and any staff who are transferred within the company need their files transferring with them to the present employment address. The manager gave the Inspector a copy of the training matrix. There were gaps in the training records. However, the records indicate that all staff working at the home had received fire safety training in the last 12 months. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 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 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) 31,32,33.35.36.37&38 The service users control their own monies except where they state that they do not wish to do so or they lack capacity. There are safeguards in place to protect the interests of the service users. The home has adopted policies and procedures to induct new staff, offer training and supervise them so that the service users receive a high quality of care from trained staff. The records required by the Care Homes Regulation for the protection of service users and the running of the business is maintained. The management takes responsibility for the health, safety and welfare of the service users and staff at the care home. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 20 EVIDENCE: Four service users’ finances were checked. The families of these service users handled the finance and the service users had some of their pocket money managed by the home. This was appropriately recorded and the administrator said that the residents could have access to the money when they wanted. Four staff training files were checked and four staff were interviewed. It was evident that the staff received supervision, however, not at regular (i.e. six times in twelve months) intervals. The manager said that she/he was addressing this by reorganising the staff structure so that supervision could be cascaded to appropriate staff. Generally the record keeping was satisfactory. There have been comments made under other sections of this report. Not all staff had attended training in Moving & Handling, Health & Safety, COSHH, First aid and Food Hygiene. The manager was aware of this. Most of the safety checks and service of equipment were up to date. Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 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 Standard No 16 17 18 Score 2 3 2 3 3 3 x 3 2 2 2 Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 22 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 36 Regulation 18 Requirement All staff must have regular supervision. Timescale 31/05/05. Staffing levels must reflect the dependancy of the residents. Timescale 31/05/05. Staff must be available during the peak times of care so that residents are seen to promptly. Staff must not be employed without a satisfactory CRB clearence. Explanation for any gaps in employment history must be explored and any staff who are transferred within the company need their files transferring with them to the address of employment. All staff working at the home must receive mandatory training. All care staff must receive formal training on palliative care, pain management and dealing with bereavement. All staff must attend training on handling allegation of abuse and 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 23 Timescale for action 21/11/05 2. 27 18 21/11/05 3. 29 19, Scedule2 19 Immediate. 4. 29 21/11/05 5. 30,11,16, 18,38 18 Swallownest Nursing Home 6. 10 18 protection of vulnerable adults. Staff must be familiar with the homes procedures although they may not be directly involved i.e. timescales for complaint investigation, keeping records of all complaints. . The residents privacy and dignity must be respected at all times. Therefore when residents are barrier nursed the staff must use methods that do not infringe on the residents privacy. 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 12 Good Practice Recommendations All residents interests should be recorded and opportunities for stimulation through leisure and recreational activities in and outside the home should be made available. The staff should ensure all residents are included in the different activities. For the purpose of emergency contact the manager should have all staffs’ next of kin contact address and telephone number. The staff should be trained and a timescale should be set for all paper work to be transfered to comply with the present organisation approach. 2. 3. 4. 29 37 Swallownest Nursing Home 20050922 Swallownest X00015 UN Stage 4 S3089 V184009 J55.doc Version 1.40 Page 24 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court, Bold Street Sheffield S9 2LR 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. 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