Inspection on 25/04/06 for The Andover Nursing Home

This inspection was carried out on 25th April 2006.

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

The Andover Nursing Home 13/05/10

The Andover Nursing Home 06/07/09

The Andover Nursing Home 08/07/08

The Andover Nursing Home 13/12/05

The Andover Nursing Home 04/07/05

The Andover Nursing Home 14/02/05

The Andover Nursing Home 26/05/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE The Andover Nursing Home Weyhill Road Andover Hampshire SP10 3AN Lead Inspector Mrs Pat Hibberd Unannounced Inspection 25th April 2006 09:00 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 The Andover Nursing Home DS0000012147.V288852.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. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Andover Nursing Home Address Weyhill Road Andover Hampshire SP10 3AN 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) 01264 333324 01264 332063 Mr P J Puddepha Mr B J Puddepha Mr Martin Watt Care Home 79 Category(ies) of Dementia - over 65 years of age (41), Old age, registration, with number not falling within any other category (49), of places Physical disability (15), Physical disability over 65 years of age (15) The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. A total of 15 service users may be accommodated in the PD and PD (E) categories. 13th December 2005 Date of last inspection Brief Description of the Service: The Andover Nursing Home is a privately owned, purpose-built care home for service users over the age of 65. The home is registered to provide personal and nursing care to older persons, older persons who are physically disabled and older persons who have dementia. Conditions of registration also allow for 15 service users below the age of 65 with physical disabilities to be resident at any one time. The home provides accommodation for 79 residents over four floors. There are 55 single bedrooms and 12 double rooms, all with en-suite facilities. The home is divided into two units. Unit one is on the lower ground and ground floors and provides care for elderly residents. Unit two is on the first and second floors, providing care for residents with dementia. Each unit has sitting and dining areas and there is a large lounge off the front entrance. The home is in a residential area of Andover, on a main road and close to local amenities. The home has a large garden to the rear and a small seating area at the front; there is a car park at the front of the home. The current scale of charges range between £430.50 - £685.00 dependent on whether the resident is self-funding or, funded through social services. The fees do not include hairdressing/papers/magazines/telephone or chiropody. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection for the inspection year 2006/2007. All key standards were inspected on this occasion.The inspection took place over six hours and the inspector was able to tour the home, view a number of bedrooms and the communal areas.Discussions were held with the Home’s manager and ten permanent staff members. Time was spent with a number of residents with a view to gaining an understanding of care provided and to observe staff interaction and support as detailed in care plans. Ten residents’ care plans were viewed and their care provided by the Home in all areas of their life assessed and discussed with both the manager and staff. Prior to the inspection three resident and two relative comment cards were received by the commission of which views expressed as to the service provided by the Home and included within this report. The commission also received a completed pre inspection questionnaire from the Home of which information provided is included within this report. Residents spoken to indicated that they wished to be referred to as “resident” within the report. The manager Mr Martin Watt will be referred to as Matron. There were no requirements on this occasion. What the service does well: The standard of care in the home is good and based on comprehensive assessments of the needs of both newly admitted and existing residents. In general care plans ensure that residents receive the individualised support and help that they require although further detail is required in some care plans: referred to in the “what they could do better “ and body of the report. The home promotes the right of residents to make choices for themselves and exercise personal autonomy. The matron was able to demonstrate how the needs of residents from ethnic minority groups would be addressed and resources that would be utilized to ensure the service best reflected their needs. Comments from residents through discussions held and comment cards received included “they are very kind “ “ the staff help me a lot “ and “ I like everything”. Residents described the home’s bedroom accommodation positively and all bedrooms seen,were well maintained and furnished and equipped. The Matron has a wealth of experience and the home’s staff team, a number of relatives and the residents all considered him to be approachable and supportive to their needs. Management systems and procedures in the home work well including, managing medication, staff training and health and safety. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 6 The home has a ‘friends of the home’ group who continue to have fund raising events to raise extra money for the residents’ additional activities. What has improved since the last inspection? What they could do better: Some care plans require additional information to ensure the arrangements for all residents’ health/social care needs are met. A risk assessment undertaken of the floor to ceiling windows located on the first floor needs to be documented. Any risks identified must be addressed and kept under review. Staff must be kept informed. Please contact the provider for advice of actions taken in response to this The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 8 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 The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 9 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): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre admission process undertaken ensures that residents needs can be met. The Home does not provide intermediate care. EVIDENCE: The Matron explained that prior to a resident being admitted to the home a full assessment of need would be undertaken by either himself, his deputy or, one of his senior staff nurses. The assessment would be undertaken for both selffunding residents and, those referred through the Social Services care management process. The process of assessment would normally include a visit to the Home enabling prospective residents to meet staff and other residents and view their accommodation. On admission all residents would be given a service user guide of the Home detailing the services and facilities available. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 10 In the event of an emergency admission a review would take place of the situation on the next working day when all relevant parties would be involved. In addition to the care management assessment The Andover Nursing Home has a very comprehensive pre admission assessment form that covers all aspects of the residents’ abilities and capabilities. Included in those assessments would be an individuals health care needs/religious and cultural needs, physical well being, including a manual handling assessment, risk of falls, communication, mental health assessment and nutrition assessment. A discussion was held with the Matron in relation to a recent admission of a resident whose first language is not English. It was evident that resources had been sought and utilised creatively to ensure staff could communicate with the individual and, that their dietary and cultural needs were met. The matron indicated that he would continue to seek further advice and resources to meet the individuals’ needs as they change. This was seen as an area of good practice. Prior to admission those residents requiring nursing care are assessed by an appropriately trained NHS registered nurse using an appropriate nursing assessment tool. Four files viewed of recently admitted residents indicated that an appropriately trained member of staff had undertaken detailed assessments. One resident and a relative spoken to confirmed that they had been involved in the process of assessment and were aware of the facilities in the Home and their terms and conditions of residence. The Home does not provide intermediate care. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 11 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): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are generally detailed although some require additional information to ensure the arrangements for all residents’ health/social care needs are met. The Homes’ medication policy and procedure is being adhered to. The home provides an environment that ensures service users are treated with respect and that their privacy is protected . EVIDENCE: Each resident has an individual care plan that includes risk assessments relating to needs identified. The care plan is jointly agreed with the resident and their representative (if the resident agrees) and the Home. Residents spoken to indicated that their care plans and risk assessments are reviewed monthly with them by their key worker (the person who mostly works with the individual). For those residents who would have little or no concept of a care plan discussions would be held with their representative as required. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 12 Copies of care plans are held in residents’ bedrooms of which a number were seen and discussed with the individual. One resident commented “ staff talked to me about the care I need “ At the yearly review the resident, representative, key worker, care manager and a manager will discuss both the care plan and risk assessments to ensure they still meet the needs of the resident. A review can be called at any time should a residents needs deteriorate/change. Ten care plans of residents were examined. A number of which related to individuals who are accommodated in Unit 2 that accommodates residents with complex nursing needs/diagnosis of dementia. In general the documentation was detailed and the plans were based on the assessments the home carried out in order to identify what help individuals needed. The plans generally set out the actions staff had to take and what specialist equipment was needed to provide the support and assistance each person required. All nursing and care staff spoken to were fully aware of the contents of the care plans that were sampled and the assistance that the individuals concerned required. The care plans /documents included assessments of the potential risks to residents treatment of pressure sores, malnutrition, and falls. Strategies for eliminating or reducing the risk of harm had been identified and implemented e.g. pressure-relieving aids were in place should a resident develop a pressure sore. (The Matron indicated that there are currently no residents with pressure sores). There was documentary evidence that care plans were evaluated and reviewed regularly.Discussions relating to residents’ needs are further discussed at the commencement of each shift.However, there were a number that required some areas of care to be more specific in their instructions to staff. For example, one care plan indicated that “ensure appropriate oral hygiene to be maintained” with no detail as to how the care was to be undertaken.However, in discussion with service users care was being appropriately provided by care workers and, they had no complaints. The Matron agreed to ensure all care plans were detailed in their instruction to staff. There are a number of GP practices providing health care to the Home. All residents have access to a dentist, chiropodist, optician, continence advisor, occupational therapist and district nurses. The home had written policies and procedures concerned with the management and administration of medication. A range of reference material about medication was readily available. Medication is kept in locked and secured medicine trolleys and cupboards and also where required in a medical refrigerator. Controlled drugs were stored securely and in an appropriate metal locked cabinet. Medicines were dispensed from their original containers with nursing staff responsible for the management and administration of medication in the Home.Staff indicated that residents are observed or supported to take their medication at all times. There are currently no residents who self medicate. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 13 Much time was spent with residents and staff with a view to gaining an understanding of how the home are endeavouring to treat residents with dignity and respect and uphold their privacy. Residents indicated that staff don’t open their mail, address them by their preferred name, knock before entering their bedroom, have access to a phone and wear what they like. Individuals can get up and go to bed when they choose. Core value training is provided as part of induction and ongoing if required and identified for example following supervision. Further observations of staff supporting residents with an activity demonstrated that choice was being promoted at the same time ensuring resident’s abilities were recognised and they were treated with dignity and respect. However, during the inspection one resident indicated that they would like the curtain; used as providing privacy for them in the double room they shared, be sewn together as it would sometimes “gape” open. This was brought to the attention of the Matron and was addressed immediately. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 14 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users experience a varied life at the home that meets their individual needs. Visitors are welcome. Meals are hot and menus are varied ensuring that the dietary needs of residents are met. EVIDENCE: The home has an activities room with full and part time activities organisers that are available for group and individual activities. Residents indicated that they receive notification of forthcoming activities in the Homes’ monthly newsletter. The inspector saw the April Newsletter and the activities for the month included bingo, whist, painting, crosswords, video, movement to music, and a “Queen’s 80th Birthday party”. The newsletter was seen to be in large print and, could be provided in audiotape if required. Support is provided for residents who may have difficulty reading or understanding the various formats the information is provided in to ensure they are informed of forthcoming activities. For residents with complex/ deteriorating mental health needs a variety of activities would be offered with an activities coordinator spending time with The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 15 residents with a view to gaining an understanding of interests that may offer stimulation. Staff have further received training in Dementia (Alzheimer’s society – Yesterday, Today and Tomorrow) of which a number of staff spoken to indicated that they found beneficial in working with residents to identify interests that they have or wish to pursue. One resident told the inspector that she enjoyed going to play bingo in the activities room. Information as to forthcoming activities was also displayed on the notice board. A staff member was observed supporting a bingo session of which residents had been given a choice as to whether they wished to partake in. Staff should be commended for their sensitivity and support that was observed as being offered to residents. For example one was resident was given time to decide if they wanted to join the activity and an explanation of what the activity entailed. There are a number of services of various faiths held throughout the year. Details of religious beliefs are gathered as part of the pre assessment process with the Matron indicating that all faiths would be encouraged and supported. There are three hairdressers who attend the Home with a room designated for residents to have their hair cut, washed and/or set and permed. Residents spoken to indicated how much they enjoyed attending the hairdressers. Visitors are welcome but cannot enter into the home unnoticed, as the reception area is located by the front door with visitors being required to sign in. There are a number of attractive communal areas for residents to sit quietly or entertain their visitors in private On the day of the inspection the Home had provided a room for a resident to entertain a number of visitors with a lunch and drinks being provided. The resident told the inspector that she had had a wonderful time and couldn’t thank staff and management enough for looking after her and her guests throughout the day. The home is divided into four floors. The lower and ground floor being described as “unit 1 “ and the first and second floor “unit 2 “. Both units have a dining room/lounge and kitchenette, provided with microwave, kettle and refrigerator where beverages can be made. Residents confirmed that they are given choice within the home including staff asking them how they wished to spend their day, personalisation of their bedrooms and meals (as detailed below).Observations of staff interaction with residents throughout the day indicated that staff were offering choices in services/care provided. Residents have access to their records that are securely held in the office. The Andover Nursing Home has a large kitchen with a number of kitchen staff including qualified chefs employed. On the day of the inspection there was a chef on duty supported by two kitchen staff members. All were aware of what meals they needed to prepare The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 16 for the day and the kitchen procedures. The chef explained that he had received training in communication to enable him to engage with residents who had difficulties in expressing their wishes.The kitchen environment was clean and spacious. Records relating to food and fridge/freezer temperatures were up to date. In discussion with a number of residents the quality of food was considered very good. One resident told the inspector that the food is “ good I like everything and there is choices “ Another resident told the inspector that “ I am happy with the food”. Menus for the last four weeks were viewed. They were varied and the chef confirmed included fresh meat, fish, vegetables and fruit. Special diets can be provided for which include vegetarian,liquidised and for minority ethnic groups. The Matron advised that a new menu is being introduced following a response to a recent survey undertaken with residents. It was seen to offer additional options for residents who will be given the menu a day in advance to give them time to make a choice- with support as required. Meals can be taken in the dining room or resident’s own bedroom with one resident indicating that they had been given the choice on admission as to where they might eat their meals. A hot food trolley now provides a means of ensuring food delivered to the upper floors of the Home arrives hot and edible. Due to the needs of residents accommodated on these floors it was difficult to gain an understanding of their views as to food served. However, staff indicated that the food is now hot when it arrives. They further explained that for those residents who are unable to express their wishes due to their mental health needs, menu preferences would be obtained initially from their representatives on admission. Observation of their preferences would be monitored thereafter. Care plans were generally detailed in the support individuals required to eat their meals. Where required a food/fluid chart would be completed to enable staff to monitor an individual’s food intake to ensure they were getting sufficient nutrients and a balanced diet/fluids. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 17 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has a robust and effective complaints procedure which residents and interested parties feel able to use. Policies and procedures and staff training and awareness ensure residents are protected from abuse. EVIDENCE: The Home has a complaints policy and procedure that is held in the main office in reception and the offices’ on all four floors of the Home. It is available in large print/alternative languages and audiotape if required. All residents and significant others (usually relatives) are advised of the Home’s complaints procedure on admission and at reviews. All residents are given a copy with their service user guide with a further copy pinned to the notice boards in the home. The manager indicated that the Home would hope to address all complaints and strive to reach a satisfactory conclusion for the individual. The procedure provides details of the commissions address and telephone number in the event of the complainant being dissatisfied. Complaints leaflets were viewed in the reception area of the home. The pre inspection received indicated that there have been five complaints made to the Home from both residents and relatives of which two had been substantiated, one Partially substaniated and two were still being investigated.From discussions held with the manager and documentation viewed it was evident that complaints were being appropriately dealt with. One questionnaire received from a resident raised issues relating to being unsure as to who they would speak to if they had a problem. This was followed The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 18 up during the inspection with the individual who was able to confirm that they would talk to staff if they needed to. In discussion with a number of other residents they indicated that they would talk to staff if they were unhappy. “ I would talk to the Matron – he is very approachable “ “ the Matron and staff would help me if I had a problem”. Three relatives indicated that they had a copy of the Home’s complaint procedure and would be happy to talk any issues through with the Matron. The home has polices and procedures in relation to abuse and whistle blowing. A copy of The Department of Health “ No Secrets” document is held in the Home. The Matron told the inspector that he has completed a ‘train the trainers’ course in Adult Protection and is now undertaking the training in-house for all staff. In discussion with three permanent staff members it was evident that they were aware of their role and responsibilities in the event of a disclosure / observation of abusive practice. Documentation viewed confirmed that agency staff employed have received the relevant training. There were no agency staff on duty on the day of inspection. There have been no allegations of abuse reported to Social Services since the last inspection. The Matron explained the system used to record any monies held for residents that was considered satisfactory. All residents have lockable storage in their rooms. For those residents who are not able to manage their own money arrangements are in place to ensure they have access to money when required. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 19 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements in place for maintaining the home ensure that the residents live in a clean,hygenic ,safe and comfortable environment with sufficient lavatories and washing facilities. EVIDENCE: The inspector was able to view all areas of the Home that is based on four floors divided into two “units”. The lower and ground floor described as “unit 1” and the first and second floor as “unit 2”. The Home’s main entrance accommodates a reception area where visitors are required to sign the visitor’s book and, read the fire evacuation procedures. The home has 77 bedrooms of which 55 single bedrooms and 12 doubles have en-suite facilities. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 20 There are a further 8 bathrooms and 18 toilets. The Home has a number of specialist baths and walk in showers. The bedrooms are spacious some having special beds, hoists and equipment. All bedrooms have a call bell available and lockable storage. Upper floor windows have restrictors. There are sufficient communal areas for residents to enjoy a quiet place to sit or relax with other residents. There are kitchenettes on all floors providing opportunities for residents/visitors to make drinks/light snacks. The standard of furnishings and fittings and decoration is good with an ongoing programme of redecoration. The home was clean. In general all areas were free from unpleasant smells although in the areas accommodating residents with complex needs there were some odours. The staff nurse explained that there is an ongoing cleaning programme of carpets to ensure any spillages are dealt with as soon as possible. There is an enclosed garden with a water feature for residents to enjoy although some residents would require support to access the garden. One resident who uses a wheelchair to mobilise around the Home confirmed they could access the garden independently via ramps provided. Residents indicated that they enjoyed the private facilities in their bedroom and found the environment” warm and pleasant”. The Home’s maintenance man undertakes routine maintenance. The Fire Officer last visited on 11/1/2005 and the Environmental Health Officer (EHO) 1/2/2006.Requirments identified by the EHO have been met. All residents and visitors spoken to said that the communal areas were comfortable and that the building was kept clean. Staff were observed during the inspection undertaking cleaning tasks and all staff were also observed at different times using protective clothing appropriately. There were a range of written policies and procedures available that were concerned with infection control and staff spoken to confirmed that they had received training in the subject. There were “gel” hand disinfection dispensers located strategically in the buildings and there were sluice disinfectors located on all floors of the home. The home’s laundry facilities were suitably sited and equipped and procedures for managing soiled items were appropriate. Clinical waste bins are appropriately stored and collected weekly by an external contractor. One area relating to the floor to ceiling windows located on the first floor was discussed with the Matron. Despite staff indicating that they had not had any issues /concerns as to resident’s safety the Matron said that risks to residents had been considered but not documented. It was agreed that a risk assessment would be written, any risks identified addressed and kept under review. Staff must be kept informed. This was agreed to be undertaken immediately and will be followed up at the next inspection. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 21 The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 22 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): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The diverse needs of resident’s accommodated are met by the skill mix of the appropriately recruited and trained staff group. EVIDENCE: The Home employs a management team of a Matron, deputy, senior staff nurses and senior care assistants. All members of the management team have designated roles and responsibilities. The staffing in the Home is organised into two staff teams. One team for Unit 1 and one for Unit 2.Rotas viewed indicated that there is always a qualified nurse on duty and sufficient carers to support the residents accommodated. There are designated cleaning staff for both Units and domestic and laundry assistants. Staff spoken to indicated that they considered there to be sufficient staff and time to meet the needs of individuals accommodated. Residents further indicated that their needs were being met and staff were available as and when they needed support. There are 62 care assistants of which 30 have achieved National Vocational Qualification (NVQ) in care at level 2 or above with a further 7 currently completing the course. The records of 4 staff recruited to work in the home were inspected. It was apparent that the home carried out all the necessary pre-employment checks The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 23 to ensure that the individuals were suitable to be employed to work with vulnerable adults before they actually started work in the home. Work permits had been obtained where required. A range of training is provided for staff with all new staff undertaking the Skills For Care induction programme that includes core values,health and safety, fire procedures,moving and handling, infection control, food hygiene and adult protection. Discussions were held with two recently appointed staff members who indicated that they felt well supported, were receiving a good induction and enjoyed working in the Home. A discussion was held with the Matron regarding any training that may be required for staff to meet the needs of individuals from ethnic minority groups accommodated. The Matron was able to give an example of utilising relatives and staff with relevant knowledge and experience and, obtaining information from the intranet. In discussion with two staff they demonstrated awareness of legislation and discrimination and how they considered it may impact on their practice. One example being consideration of cultural backgrounds and delivery of care including dietary needs. All overseas nursing staff working in the Home undertake training to meet the requirements of the Nursing Midwifery Council prior to commencing employment. Further training provided includes continence awareness,wound care – PCT/Otex training (laundry equipment) . Training planned is varied and includes fall prevention/COSHH awareness/senior care assistants’ training and updates/tissue viability/first aid (resuscitation) and effective supervision skills. Staff spoken to indicated that they felt competent to carry out their role and welcomed the training received. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 24 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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and has good systems in place ensuring residents health and safety, rights and best interests are safeguarded. EVIDENCE: The Matron Martin Watt has a range of responsibilities and indicated that these are reflected in his job description. This include ensuring the written aims and objectives of the Home are met, policies and procedures are implemented, the budget is properly managed and residents are aware of their terms and conditions of residency. Mr Watt is a Registered Mental Nurse (RMA) and has achieved the Registered Managers Award. From discussions with staff and residents and documentation viewed, Mr Watt provides effective leadership and management of the Home. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 25 Residents were seen to respond positively to the Mr Watt who was able to demonstrate throughout the inspection his understanding and knowledge of residents’ needs. Whilst resident meetings are also held the manager indicated that not all residents are able or wish to fully engage in the meetings. However, staff indicated that daily discussions and observation of residents needs contribute to the daily running of the Home. Systems currently implemented to ensure there is an effective quality assurance and monitoring of residents’ views include care plan and risk assessment evaluations on a monthly basis – or sooner if required and monthly visits undertaken by the Owner of which copies of the outcome of those visits are forwarded to the commission. A quarterly satisfaction survey is undertaken of a quarter of all residents ensuring all residents’ views are sought (with support from representatives/relatives where required) during the year. The survey asks questions relating to the physical environment/health and well being/daily life and privacy and security. During the last inspection residents indicated, through comment cards and conversation with the inspector, that they would like more choice in their daily lives. The Matron invited an independent visitor to speak to the residents and undertake a survey of their concerns likes and dislikes. The results of this survey have been evaluated with 33 of the 79 residents responding to the survey. Menus have been developed offering a wide range of choices and times for getting up and going to bed are reflective of residents’ individual wishes. The Matron indicated that he will continue to develop ways in which residents with complex needs can contribute to future surveys undertaken including video/audio formats. This will be followed up at the next inspection. The home had a range of written policies and procedures copies of which were kept in the Home’s main office and on the two Units. Staff spoken to said that they were helpful and could be referred to for guidance and that they informed their practice. The policies and procedures were reviewed regularly and updated as necessary. Comprehensive and clear records being kept indicated that risk assessments for safe working practices had been completed and that all systems and equipment in the home were tested and serviced at intervals and with the frequencies either required according to relevant regulations or good practice. These included: • Fire safety equipment • Electrical wiring • Gas appliances and central heating • Portable electrical appliances • Hoists and slings • Lifts • Clinical equipment • Hot water systems –(tested for temperature and the presence of Legionella). The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 26 The Home has a fire evacuation plan of which staff were able to describe their role and responsibilities within the plan should there be a fire in the Home. The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 27 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 2 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 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 The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 28 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. Refer to Standard Good Practice Recommendations The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 The Andover Nursing Home DS0000012147.V288852.R01.S.doc Version 5.1 Page 30 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!