CARE HOMES FOR OLDER PEOPLE
The Cambridge Nursing Centre 5 High Street Chesterton Cambridgeshire CB4 1NQ Lead Inspector
Mrs Jenny Cangy Unannounced Inspection 30th November 2005 10:00 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 Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 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 Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Cambridge Nursing Centre Address 5 High Street Chesterton Cambridgeshire CB4 1NQ 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) 01223 323774 01223 861781 robert.york@ansplc.co.uk ANS Homes Limited Robert Charles York Care Home 90 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (40), Old age, not falling within any other of places category (90) The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One named person under 65 years with dementia Date of last inspection 5th May 2005 Brief Description of the Service: Cambridge Nursing Care Centre is a purpose built nursing home on two floors with the upper floor accessed by passenger lifts. It is situated just off at the junction of Elizabeth Way and Chesterton High Street not far from the centre of Cambridge. The home is spacious, light and airy and has attractive gardens that are accessible to the residents. All service user bedrooms are spacious and have en-suite facilities. All rooms are single. The home is arranged in units with each unit having a sitting room and dining room. The home has a dementia care unit for 40 service users. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and commenced at 11:00. The Manager and Head of Nursing Care were present in the home and had input into the inspection process. Since the last inspection the home has been acquired by BUPA Homes but continues to trade under the Original company name. There have been no changes in the day to day operation of the home. The first part of the inspection was conducted in the manager’s office reviewing the records and standards. Returned service user and relative questionnaires were also reviewed and the overall response was excellent with many praising the home, its management and staff. One questionnaire with several negative comments was discussed fully with the manager and head of nursing and the issues raised will be investigated and dealt with. A tour of the home followed and many staff and service users were met and several relatives were spoken to. A session with the activity organiser was observed where service users were using new hymn books and CD’s to participate in a hymn singing session in one of the lounges. The home was found to be in good decorative order and clean a fresh throughout. Staff were found to be helpful and positive despite the uncertainty created by the take over of the home. The manager leaves the home at the end of December and the Head Of Nursing has been appointed to replace him ensuring continuity to both service users and staff. What the service does well:
There is an excellent activities program and the manager and his staff make an effort to mark all the major events of the year with appropriate celebrations. There is a full programme of Christmas activities displayed on each area notice board. The home is an accredited training centre for NVQ training and almost all of the care staff have NVQ level 2 in care or are in the process of working towards it. The home also has overseas nurses doing adaptation training under the supervision of Homerton College School of Nursing. The manager likes to involve service users in planning menus and activities and to express their views at regular meetings. Lunch is served at two sittings to enable service users more choice of meal times and dining areas. This also enables staff to dedicate more time to service users that need assistance with eating. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 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 The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 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): 2&5 These standards are met but new contracts will be issued under the BUPA terms and conditions. EVIDENCE: BUPA has written to all concerned re the change of ownership and will be issuing new contracts. One service user was met who is currently having a trial period in the home. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 10 Service users care and social needs are met and privacy and dignity is paramount. EVIDENCE: Care plans are compiled with the service users or their representatives and signed by them when agreed. Service users and their representatives are included in the reviews. All service users’ rooms have locks with keys available if the wish. Staff knock on doors before entering rooms. Staff were observed treating service users with respect and kindness and service users spoken to confirmed this. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 10 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): 14 Service users are able to exercise choice in all aspects of their daily lives and are encouraged to do so. EVIDENCE: Menus offering choices were displayed around the home. There are regular meeting for both service users and their families to allow them to participate in the running of the home. Returned questionnaires indicated choice was available. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 11 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): 17 & 18 All legal rights are maintained. EVIDENCE: All service users are included on the electoral roll and able to exercise their right to vote. Legal representatives are welcome into the home and private facilities provided if needed. Independent advocacy will also be sought if needed. Staff have training in the Protection of Vulnerable Adults (POVA) and any concerns of any form of abuse would be referred to the POVA team for investigation. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 12 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): 20, 21, 22, 23, 24 &26 This purpose built well maintained home meets the minimum standards for the environment. EVIDENCE: The home has a variety of lounges and dining rooms and the gardens are well kept, safe and accessible to those who wish to use them. All rooms have ensuite toilet and washing facilities and there are ample toilets, bath and shower rooms. Rooms are spacious and bright and service users are able to personalise them. All aids and equipment are provided as required. All health and safety requirements are observed and a housekeeping team ensures the home is clean and fresh. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 13 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 The home is fully staffed by good skill mix of staff and ensures service users are in safe hands at all times. EVIDENCE: The home is well staffed by a mix of qualified nurses and carers supported by administration, catering and domestic teams. There is in-house maintenance available. Staff training is excellent with the majority of care staff being qualified to at least NVQ level 2 in care. There is a team of qualified nurses in each of the four areas each led by a senior sister and supervised and supported by the Head of Nursing care. All new staff follow a full and approved induction programme and all appropriate pre employments checks are carried out. Any overseas staff are checked to see that they are free to work in the UK and able to speak English. The will be supported to improve their English if needed. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 14 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): 33, 34, 35, 36, 37 & 38. The home is managed by a very experience manager supported by a team of administrators and care staff who ensure the needs of the service users are paramount. EVIDENCE: All health and safety regulations are monitored and checks recorded. Appropriate financial records are maintained for the safe keeping of personal allowances. All staff have regular formal supervision by their line manager, cascading down from the home manager. All records are maintained as required. The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 15 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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 X 4 3 3 4 4 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 3 3 3 The Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Cambridge Nursing Centre DS0000024271.V260379.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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