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Inspection on 05/05/05 for The Cambridge Nursing Centre

Also see our care home review for The Cambridge Nursing Centre for more information

This inspection was carried out on 5th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

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

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. The activities include visits from a "Pat" dog and a local ice cream van. The home is an accredited training centre for NVQ training and also has overseas nurses doing adaptation training under the supervision of Homerton College School of Nursing. The home is also approved to take student nurse and cadet nurse trainees for practical experience. 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.

What has improved since the last inspection?

The has been some redecoration and re-carpeting since the last inspection. There are many new specialist reclining chairs to enable the very frail to get out of bed and sit in a chair in comfort. The deputy manager has beendesignated head of nursing care giving her a distinct clinical role in the supervision of senior nurses and overseeing the nursing care plans.

CARE HOMES FOR OLDER PEOPLE Cambridge Nursing Centre (The) 5 High Street Chesterton Cambridgeshire CB4 1NQ Lead Inspector Jenny Cangy Unannounced 5 May 2005 @ 11:00 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. Cambridge Nursing Centre (The) Version 1.10 Page 3 SERVICE INFORMATION Name of service Cambridge Nursing Centre Address 5 High Street Chesterton Cambridgeshire CB4 1NQ 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) 01223 323774 01223 352136 robert.york@ansplc.co.uk ANS Homes Ltd. 1 Battersea, London SW113PZ Robert York Older People with Nursing 90 Category(ies) of OP 90 Dementia(Elderly)40 registration, with number of places Cambridge Nursing Centre (The) Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: one named person under 65 years with dementia. Date of last inspection 22/09/04 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 cntre 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. Cambridge Nursing Centre (The) Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector conducted an unannounced inspection over a period of seven hours. On arrival the manager and deputy were not in the home. A Registered Nurse welcomed the inspector. The inspector toured the building and met service users, relatives and staff. Staff were busy attending to service users. The inspector was able to gain the views of staff with regard to their workload and training availability. The inspector met with the manager and the deputy on their return and made checks on records, policies and procedures. It should be noted that not all standards were inspected at this visit. Those not inspected or not met will be inspected at the next visit. What the service does well: What has improved since the last inspection? The has been some redecoration and re-carpeting since the last inspection. There are many new specialist reclining chairs to enable the very frail to get out of bed and sit in a chair in comfort. The deputy manager has been Cambridge Nursing Centre (The) Version 1.10 Page 6 designated head of nursing care giving her a distinct clinical role in the supervision of senior nurses and overseeing the nursing care plans. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cambridge Nursing Centre (The) Version 1.10 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 Cambridge Nursing Centre (The) Version 1.10 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 The inspector was satisfied that service users have sufficient information to make a choice about moving into the home. The inspector was satisfied that pre admission needs assessments are thorough and no service user will be accepted if their needs cannot be met. Letters are sent to service users and their representatives to state whether the home can meet their needs. EVIDENCE: There is a detailed service user guide and statement of purpose issued to all new service users. This is also displayed in the home’s reception area. The pre–admission assessment follows a printed format that is completed at the assessment and then forms the basis of the care plan. A standard letter is sent to all prospective service users to either accept or refuse their admission on the ability of the home to meet their needs. Cambridge Nursing Centre (The) Version 1.10 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 standard(s) 7-9 All service users have their health, personal and social care needs met. Service users have access to chiropody, opticians and dentists. Medication is well managed, appropriately stored, administered and recorded. EVIDENCE: The manager is having discussions with a representative of the PCT to prevent unnecessary hospital admissions and to speed up discharge from hospital. There is a retained GP who provides day to day healthcare and does regular rounds of the home. The manager would like to develop more nursing care strategies to prevent hospital admission for example intravenous fluids and medication. Currently the GP providing support is not able to agree to this. The manager is preparing a report for the Patient Care Trust with regard to this. The home has visiting healthcare professionals for chiropody, eye tests and dentistry. The home uses the Boots monitored dose system of medication (MDS). All staff that administer medication have specific training. At the time of inspection only one service user held their medication. The senior Sister on each unit takes responsibility for the ordering, safekeeping and disposal of medication. They also audit the records to ensure they are up to date. Cambridge Nursing Centre (The) Version 1.10 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 standard(s) 12, 13 & 15 Service users have access to varied activities on a daily basis. These are planned to meet the interests of a cross section of the service users. Visiting is open and relaxed. Service users’ views are sought on all aspects of life in the home. Meal times are unrushed and the food well presented and appetising. EVIDENCE: On service user notice boards around the home the inspector noted a full activity program and posters advertising a VE Day 60th anniversary party planned for the next Sunday. Staff and residents had been preparing for this over the previous weeks and the service users were expressing great interest in this. The activity program is updated monthly by the activity organiser. The inspector was able to meet a variety of relatives and friends of service users. They were able to tell the inspector of the involvement they have in the home. Families are invited to all activities. The inspector was able to observe the main meal and see the menu choices offered. The inspector noted that tables were properly laid with tablecloths, cutlery and condiments. A new summer menu is planned and service users are invited to a meeting to discuss it. Meals are served at two sittings to ensure everyone has a choice of meal times and locations and those that need assistance to eat can be aided by staff in an unhurried atmosphere. The inspection day was also general election day and service users were able to tell the inspector they had used their postal Cambridge Nursing Centre (The) Version 1.10 Page 11 votes. A group of service users were watching a video film in one of the lounges. Cambridge Nursing Centre (The) Version 1.10 Page 12 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 Service users and their relatives know how to make a complaint and what to do if not satisfied with the outcome. EVIDENCE: The complaint procedure is included in the service user guide and displayed on notice boards around the home. People spoken to by the inspector were able to tell her what they would do if they were unhappy with any aspect of the home. Cambridge Nursing Centre (The) Version 1.10 Page 13 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 The home is a safe, well-maintained environment for the service users to live in. EVIDENCE: The inspector toured the home and found it to be clean and fresh throughout with only one small area where there was an unpleasant smell. The inspector later observed domestic staff shampooing the carpet in that area. All chemicals and cleaning equipment was kept in locked cupboards. The home is well decorated and in a good state of repair. Cambridge Nursing Centre (The) Version 1.10 Page 14 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) 30 The home has staff in sufficient numbers and skills to ensure the needs of the service users are adequately met. EVIDENCE: The home is an accredited NVQ training centre with Edexcel a nationally recognised training organisation. At the time of inspection 20 staff were undertaking NVQ training. There were 4 overseas nurses undergoing adaptation training and the home had student nurses on placement. One staff member has attended a “Train the trainer” course in Prevention of Adult Abuse. There was a staff notice board with notification of numerous training events and NVQ trainee meetings. The inspector observed good levels of staff at all times during her visit. Staff have readily available training for all grades of staff. Ancillary staff have training in health and safety and the use of any machinery they use. Cambridge Nursing Centre (The) Version 1.10 Page 15 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 The home is well managed by the manager and his team of senior staff. Service users and staff are able to approach him readily and he provides clear leadership to all staff. EVIDENCE: The manager is a first level nurse with a high level of management training. He has a head of nursing services and a team of Sisters to oversee the care of the service users. The service users appear to know the manager and are relaxed in his company, as are the staff of all grades. Cambridge Nursing Centre (The) Version 1.10 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 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 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 4 3 x x x x x x Cambridge Nursing Centre (The) Version 1.10 Page 17 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. 1. Standard 7 Regulation 15(c) Requirement The registered person must ensure that care plans are compliles in consultation with the service user or their representative and are signed where possible by the service user or representative ti acknowledge agreement. Any reviews should also be conducted with the service user ot their representative and endorsed. A representative of the organisation must carry out a visit at least once a month, prepare a report and send a copy to the manager and the CSCI as detailed in regulatio 26 Timescale for action 30 June 2005 2. 37 26 By the 30th May 2005 and monthly therafter. 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 Good Practice Recommendations Cambridge Nursing Centre (The) Version 1.10 Page 18 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Cambridge Nursing Centre (The) Version 1.10 Page 19 - 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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