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Please note that the information on this website is now out of date.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 23/02/06 for The Cottage Nursing Home

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

This inspection was carried out on 23rd February 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.

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

Service users needs were met. Relatives spoken to on behalf of the service users gave positive feedback to the inspector about living at the home. Care plans were written to a high standard. Healthcare assessments were recorded. The premises of the home were maintained to a high standard. Relatives stated that they are happy with the service users rooms. The home was clean, tidy and free from odour at the time of the inspection. Staffing levels were adequate. Quality monitoring is undertaken, and feedback was noted to be positive. Service users money was held by the home in a satisfactory manner. Accident records were held in an easily referenced way.

What has improved since the last inspection?

There were not requirements made during the previous inspection, and the inspector had not visited the home for many years.

What the care home could do better:

Out of date documentation should be archived to avoid misleading information. The validity of the modified Waterlow score should be assessed. A pressure relieving mattress was set incorrectly for the service users weight. Medication management must be improved in the two areas identified.

CARE HOMES FOR OLDER PEOPLE The Cottage Nursing Home 80 High Street Irchester Northants NN29 7AB Lead Inspector Sarah Smart Unannounced Inspection 09:30 23 February 2006 rd 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 Cottage Nursing Home DS0000012649.V285388.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 Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Cottage Nursing Home Address 80 High Street Irchester Northants NN29 7AB 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) 01933 355111 01933 355129 The Cottage Nursing Home Limited Mrs Agnes Ernestina Arthur Care Home 53 Category(ies) of Dementia - over 65 years of age (53) registration, with number of places The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Age range for service users in the category of DE 50 years and above. Nursing (N) to a maximum of 53 beds. The home may provide Personal Care (PC) for up to 3 Service users within the category DE (E) and DE. Room 54 must not be occupied by a wheelchair user. Date of last inspection Brief Description of the Service: The Cottage is a recently extended care home located in the village of Irchester. Irchester is situated close to the main A45 road, facilitating easy access to the main towns of Wellingborough, Rushden, Kettering and Northampton. The home can accommodate up to 53 service users in the category of Dementia, over the age of 50 years. Accommodation is provided over three floors, in a mixture of single and shared rooms. There are a number of communal areas throughout the building, and access to all floors is provided by lifts. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.30 and 12.30pm. . Preparation for the inspection included review of the previous inspection report, requirements and recommendations, and took approximately 1.5hours. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, staff rota, tour of the premises, quality monitoring, service user finances, and staff and service user interviews. Two service users were case tracked. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst two relatives were spoken to in detail about the experiences of service users within the home. What the service does well: What has improved since the last inspection? What they could do better: The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 6 Out of date documentation should be archived to avoid misleading information. The validity of the modified Waterlow score should be assessed. A pressure relieving mattress was set incorrectly for the service users weight. Medication management must be improved in the two areas identified. 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 Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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 Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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): 3 Service users needs are met. EVIDENCE: From observing care practices, service users documentation, and speaking to staff the inspector was satisfied that the service users needs are met by the home. Needs assessments were recorded in the service users files, along with information provided by other healthcare professionals. Intermediate care is not provided by the home. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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): 7,8,9 Personal and healthcare needs are met in all but one instance. Management of medication could be improved. EVIDENCE: Care plans for two service users were viewed. The service users files contained numerous documents titled care plans, some of which gave conflicting information to the reader. The inspector established that many of these documents were care plans from some time ago, which were no longer in use or valid. The retention of such documents in the current file could be misleading, and causes reading and understanding of the service users needs to be difficult. The inspector strongly recommends that out of date documents are archived in a separate area of file. The current care plans were written to an acceptable standard, and gave the reader clear instruction as to the service users needs. A relative of a service user who has recently moved into the home stated that she has been involved in the content of her mothers care plan. Healthcare assessments were recorded in each instance. The home uses a modified version of the Waterlow score for pressure sore risk assessment, and The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 10 the manager should ensure that the results given by this modified version are accurate. One service user case tracked had a pressure relieving mattress on his bed, however the mattress was set for a weight of 100kg, whereas the service users file indicated that he weighed considerably less than this. Several documents indicated that referral to other healthcare professionals was required, and whilst there was no documentary evidence of this, the owner stated that such referrals had been undertaken. A sample of medication was viewed. It was observed on both floors of the home that the medication cupboard keys are not stored securely, and were not held by staff, but in the treatment rooms where medication was stored. This is unsafe practice. Storage and administration records in the treatment rooms was satisfactory. During the tour of the premises, several items prescribed for named service users were found in rooms belonging to other service users. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed during this inspection. EVIDENCE: These standards were not assessed during this inspection. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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 the following standard(s): These standards were not assessed during this inspection. EVIDENCE: These standards were not assessed during this inspection. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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 the following standard(s): 19,20,21,22,23,24,25,26 The premises were fit for purpose. EVIDENCE: The environment of the home was noted to be maintained to a high standard. All areas of the home are accessible to service users, including a pleasant garden area. The home offers several communal areas throughout the home. This includes an activity room. Activities were noted to be occurring during the inspection. Several bathrooms and shower rooms were viewed. These areas were satisfactory. Several items of equipment were observed during the inspection, and staff spoken to stated that the provision of equipment is satisfactory, and is all in working order. A sample of service users bedrooms were viewed. These areas were personalised by the individual, and furnished to a high standard. Gates were noted to be in use across several of the staircases in the home. The owner advised that the fire officer is aware of their use. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 14 All areas of the home were noted to be clean and tidy. There were no malodours at the time of the inspection. Relatives spoken to stated that the rooms occupied by the service users are satisfactory, and the service users are happy at the home. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 15 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 Staffing levels are adequate. EVIDENCE: The staff rota was viewed. this indicated that there is two trained nurses and 7 carers on during day time shifts, and one nurse with 4 carers on duty over night. Relatives spoken to stated that staffing levels appeared to be adequate. In some instances staff were working excessive hours, with only one day off per week. The owner stated that this is their choice, and that their performance is monitored. Staff verified this. The English language spoken by staff whose first language is not English was noted to be satisfactory. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 16 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): 33,35 The home is adequately managed. EVIDENCE: The owner stated that random quality monitoring is undertaken. This involves sending questionnaires to staff, relatives of service users, and professionals who visit the home. A sample of feedback was noted to be generally positive. Some money is held by the home on behalf of service users. This was noted to be stored securely, and inspection indicated that records and money held corresponded accurately. The owner stated that money is available to service users at all times. Accident records are maintained on a useful “at a glance” type chart. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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 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 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X x The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 18 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. 1 Standard OP8 Regulation 12(1) Requirement Pressure relieving mattress setting must be regularly checked to ensure they are appropriate, and records must be maintained to reflect this. Medication keys must be held by a staff member at all times. Medication must only be used for the service user for whom it is prescribed, and must not be used communally. Timescale for action 20/03/06 2 3 OP9 OP9 13(2) 13(2) 15/03/06 15/03/06 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 2 Refer to Standard OP7 OP8 Good Practice Recommendations Out of date care documentation should be archived. The manager should ensure that the validity of the Waterlow score is not compromised by using an adapted, or modified version. The Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Cottage Nursing Home DS0000012649.V285388.R01.S.doc Version 5.1 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!