Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 03/05/05 for The Carnarvon Nursing Home

Also see our care home review for The Carnarvon Nursing Home for more information

This inspection was carried out on 3rd May 2005.

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.

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

Staff training in this home is exceptional due to the part-time employment of a retired senior tutor in elderly care, who undertook and planned the training of all staff, in the home. The staff work well as a team and residents commented that staff were always helpful.

What has improved since the last inspection?

All rooms had been fitted with appropriate door locks since the last inspection. The number of care assistant either having completed or undertaking National Vocational Qualifications had increased.

CARE HOMES FOR OLDER PEOPLE The Carnarvon Nursing Home 22-24 Carnarvon Road Clacton on Sea Essex CO15 6QF Lead Inspector Lysette Butler Unannounced Tuesday 3rd May 2005 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. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Carnarvon Nursing Home Address 22-24 Carnarvon Road Clacton on Sea Essex CO15 6QF 01255 426628 01255 426628 pauline.green@carnarvon.ansplc.co.uk ANS Homes Limited 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) Ms Carol Anne Johnson Care Home with nursing 57 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (14), Physical disability of places over 65 years of age (57) The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 57 persons) 2 Persons of either sex, aged 45 years and over, who require nursing care by reason of a physical disability (not to exceed 10 persons) 3 Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 20 persons) 4 One named person, aged 21 - 45 years, who requires nursing care by reason of a physical disability 5 Persons of either sex, aged between 60 - 65 years, who require nursing care by reason of a physical disability (not to exceed 3 persons) 6 The total number of service users acommodated in the home must not exceed 57 persons Date of last inspection 2nd August 2004 Brief Description of the Service: The Carnarvon Nursing & Residential Home is in the seaside town of Clacton on Sea and is accessible via public transport that passes the front of the premises. The home is a former Victorian hotel that has been extended and modified. The nearest railway station is Clacton, which is within easy walking distance, as is the seafront. The home has a small amount of car parking spaces to the front of the home. The home provides care for older people of both sexes, who need both personal and nursing care. The home is also registered to provide nursing care, for up to 14 service users, aged 45 years and above with a physical disability, within the total bed compliment of 57. There are three floors accessible by stairs and a lift. All rooms are well furnished and pleasantly decorated. Bedrooms are all 10sqm or over. There is a large combined lounge/ dining room leading out onto small, but well maintained garden. Various outings and shopping trips are organised for service users and regular entertainment is provided. The proprietors are a national company known as ANS Homes Ltd. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took eight hours on Tuesday 3rd May 2005. Twenty-four of the thirtyeight National Minimum Standards were inspected during this visit. It was found that the majority of the standards had been met or partially met. One standard was exceeded. The overall care and well being of the service users was very good; staff and residents were welcoming and happy to speak to the inspector. During this visit the inspector spoke to eight residents; four relatives/significant others; eleven staff members including the administrator; one of the laundry staff; one of the cooks; two Registered Nurses and five care assistants. The inspector also spent time with the registered manager and her deputy. Residents and their relatives expressed satisfaction with the care they received and with the quality of the food offered. What the service does well: 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 Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 6 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 The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 7 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, 2, 3, 4, 5 and 6. The information supplied to prospective residents and their families to enable them to make the right choice of home was good. EVIDENCE: The Statement of Purpose and Service User Guide have both been reviewed within the last six months, but the only change needed was a change of ANS head office address. All residents are issued with a contract and a statement of terms & conditions on admission to the home. The level of qualifications obtained by the staff within the home enabled them to meet the needs of the different residents. The manager or deputy manager carries out the pre-admission needs assessments. The ANS standard form is used, but as this is quiet brief the staff of this home add information as appropriate. The original assessments are kept in the resident’s care file. The assessment is used as the basis of the full admission assessment and compilation of their care plan. The training offered to the staff is tailored to the needs of their job description and the needs of the residents. The cook was due to attend a course on ‘Food for People with Alzheimer’s’. All staff were in the process of undertaking courses in palliative care and the retained tutor ensures that the needs of the current residents is reflected in the training offered. Prospective residents are always offered a half-day visit including a meal. Not many attend the home, but they are not admitted unless either they, or their representative The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 8 have visited to the home first. The home rarely accepts emergency admissions and the last one was more than a year ago. Intermediate care is not offered at this home. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 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, 8, 9, 10 and 11. Health, personal and nursing care is good in this home. Care plans are user friendly and detailed. Privacy & dignity is observed throughout the home. EVIDENCE: Care planning was based on the nursing model of the Activities of Daily Living. Five plans were reviewed during this inspection. Four of them were signed. Care plans were regularly reviewed; changes were made as necessary and were linked to risk assessments. Daily records generally need to be improved but were detailed enough to highlight when changes were needed. There was an overall care plan assessment sheet, which was regularly updated and re-written. Health and personal care procedures were observed to be good. The residents all looked clean, tidy and well cared for. The retained GP visits the home every Monday & Friday, other times as requested. A chiropodist attends the home every three weeks and sees all the residents in rotation or as needed. At the time of this inspection one resident had a pressure sore. The medication procedures were generally good throughout the home. Registered Nurses administer all medications. There was no overstocking and medications were regularly reviewed. At the time of this inspection four residents were self-medicating. The controlled drugs register was checked; it was correct and up-to-date. The local dispensing pharmacist undertook regular medication audits. All medication administration records were checked and were generally complete. However there The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 10 were a number of signature omissions on the medication administration records of the ground floor unit. The protection of the resident’s privacy and dignity was evident in the way the staff conducted themselves when communicating with them. A number of resident’s had their own telephone lines, which they were billed for separately. All residents were dressed in clean, well laundered, age appropriate clothing. Care staff were observed knocking on residents doors and using their preferred name. Issues of privacy and dignity are included in the homes induction programmes. Bereavement policies & procedures were good. There was space on the care plans to include information about the resident’s wishes upon their death; however this was not completed on the files reviewed at the time of this inspection. The manager reported that she was undertaking training with all care staff who were reluctant to ask appropriate questions regarding residents’ wishes’ on their admission. Staff generally feel happier to ask relatives but this was not evident in the plans reviewed. All trained staff attended bereavement training and visited the crematorium. On average four care assistants a year were also attending the training. (At the time of this inspection approximately 50 of the care staff had been trained.) Palliative care training was also ongoing in the home. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 11 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) 13. The home has good contact with the community and the residents take part in local events, where appropriate. EVIDENCE: During this visit there were a number of visitors to the home. All spoken to felt welcomed when they visited and stated that they were enabled to visit in private with their relatives if they wished to. At the time of this inspection none of the residents had asked for any visiting restrictions. The manager holds four relative meetings each year and operates an ‘open door’ policy for residents, visitors and staff, to enable them to discuss problems as they arise. Resident activities include utilising local amenities, like the bowling alley and local theatres. There were two regular volunteers to the home and a local member of the ‘Pets as Therapy’ scheme attended the home with his dog on a weekly basis. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 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) 17. The rights of the residents are protected by the staff in this home. EVIDENCE: At the time of this inspection all residents were on the electoral register. For the general election two days following this inspection postal votes had already been submitted and extra staff were planned for the day so that residents could attend the polling station in person if they chose to. Four residents were using the services of an advocate at the time of this inspection. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 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, 22, 24 and 26. The environment is generally good. It is always clean and tidy when inspected. EVIDENCE: There had been no change to the fabric of the building since the last inspection. The regular maintenance man had recently broken his arm so the manager had employed a second person two days a week to help him. The home was well maintained and the grounds were neat and tidy. The home was clean and tidy with a homely, domestic feel. It was light and airy. All required regular checks were up-to-date. Bed rails were assessed monthly. One resident was paying for two rooms, of which one was used as a bedroom and one as a lounge. All hoists and assisted baths were serviced yearly, as was the call system in the home. An occupational therapy assessment of the home has not been carried out. The proprietors (ANS) were investigating employing a Occupational Therapist to assess all their homes. Since the last inspection locks had been fitted to all bedroom doors. Only one of the double rooms was being shared at the time of this inspection, by a married couple. During this visit there were no unpleasant odours throughout the home. The housekeeping staff kept the home clean and tidy. The layout of the laundry was good and encouraged good hygiene procedures. Hand washing facilities and instructions were available throughout the home. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 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) 28 and 30. The training opportunities and subsequent qualifications of the staff at this home was very good. The training of the staff enables them to look after all the needs of the current residents of the home. EVIDENCE: National Vocational Qualification training was on going in the home. At the time of this inspection twelve care assistants had obtained level two or above; two were undertaking the course. There were a total of twenty-five care assistants at the home, therefore by the end of this year in excess of 50 of them will have National Vocational Qualifications. The home has it’s own National Vocational Qualification assessor. Two care assistants who had obtained National Vocational Qualifications at level two had recently left the home to undertake nurse training. There were also three adaptation nurses working at the home. (Adaptation nurses are nurses who have trained outside of the UK and are undertaking a 6-9 month, assessed period of nursing work experience before being registered with the Nursing & Midwifery Council.) Agency staff had not been used in the home for a number of years. The home still employs a nurse tutor for two/three days a week. The tutor is a retired senior lecturer in Care of the Elderly. She keeps all records of training undertaken and arranges for all staff to have statutory yearly up dating sessions. She also carries out new staff inductions. Teaching sessions were repeated on each floor to cover as many staff as possible, without disrupting care too much. The manager works closely with the nurse tutor so that any issues can be picked up and integrated into the training programme quickly. Night training sessions were also arranged and all night staff training was up-to-date. There were training videos that were used as necessary and the home owns it’s own resuscitation ‘doll’ for CPR training. The tutor also undertakes induction training for housekeeping staff. There were various local free training courses that were being utilised by the staff of the home. Staff were paid for training they undertook out of their work hours. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 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, 34, 35 and 38. The overall management and administration of this home is good ensuring that the residents are safe. EVIDENCE: The manager is a Registered Nurse and has the Institute of Health Service Management certificate. She had recently completed a leadership course offered by the proprietors ANS. Lines of accountability were clear and understood by all the staff. The ethos in the home was good. Residents, staff and visitors spoken to all said they were happy with the atmosphere and the care offered. Insurance certificates were on show and were valid until 31/5/05. The manager was aware of the imminent end to the certificate cover and was expecting the new certificate within the following few weeks. The administrator for the home was still appointee for three residents at the time of this inspection. Four residents were looking after their own finances. Cash was not kept by the home; all purchases/services were invoiced to the residents or their representatives. Clear records were kept and were available for review. A list of their own possessions was kept taped to the inside of the service user’s wardrobe, to enable the relatives or staff to add any new possessions brought in. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 16 All required certificates and service records reviewed during this visit were valid. The accident book was fully completed; accidents/incidents were highlighted in service user files and copies of each were kept on file. The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 17 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x 2 x 3 x 3 STAFFING Standard No Score 27 x 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 x 3 3 x 3 3 x x 3 The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 18 NO 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. 2. Standard 9 11 Regulation 17(1a), Schedule 3(3i) 12(2) Requirement The manager must ensure that all medication administration records are fully completed. The manager must ensure that the residents wishes regarding procedures to be followed upon their death, must be documented. Timescale for action 31st July 2005 31st July 2005 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 22 Good Practice Recommendations The manager should consider having an occupational therapy assessment carried out throughout the home by an appropriately trained professional. (This is a repeat recommendation.) The Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex, CO1 1RJ 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 Carnarvon Nursing Home 156-105 S15320 Carnarvon Nursing Home V156663 030505 Stage 4.doc Version 1.30 Page 20 - 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!