Inspection on 26/10/05 for The Haven Nursing Home

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Haven Nursing Home 22/05/07

The Haven Nursing Home 26/04/06

The Haven Nursing Home 11/05/05

The Haven Nursing Home 02/11/04

The Haven Nursing Home 28/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Haven Nursing Home New Road Ash Green Coventry CV7 9AS Lead Inspector Louise Thompson Unannounced Inspection 26th October 2005 09:30 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 Haven Nursing Home DS0000042690.V262228.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 Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Haven Nursing Home Address New Road Ash Green Coventry CV7 9AS 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) 02476 368100 02476 644008 Regal Healthcare Homes Ltd Mrs Valerie Lewis Care Home 61 Category(ies) of Dementia - over 65 years of age (61), Old age, registration, with number not falling within any other category (61) of places The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 Brief Description of the Service: The Haven Nursing Home is registered to provide nursing care for up to 61 elderly service users, this includes a specialist registration to provide dementia care. The current owner Regal Health Care Homes Ltd has owned the Haven for a number of years. The home is located on the outskirts of Bedworth, with the City of Coventry close by. The Haven was originally a school; this was converted and extended to provide single storey accommodation for the elderly service user group for which the home caters for. Communal facilities include a large lounge diner, a smaller lounge diner, quiet room and a small sitting room at the front entrance to the home. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection and took place over one day between the hours of 9.30 am and 4.30 pm. This was the second inspection this year. To gain a full overview of the homes achievement this report should be read in conjunction with the unannounced inspection report of 11th May 2005. Staff co operated fully with the inspection. The registered manager was present throughout the inspection. The inspection process involved a tour of the home, talking with the manager, examining records and care plans, observation of care practices along with discussions with residents, staff and relatives visiting on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The recording of medicines needs further review to ensure that medicines are given correctly. Policies and procedures in place for the protection of vulnerable adults need minor review to provide a safe environment for the people living in this home. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 6 The main lounge area is large, extremely busy and can get noisy at times. Recommended best practice for those with dementia is to provide smaller environments with less noise. The layout of this lounge is being considered with the planned improvements. To ensure that the home is safe and comfortable for people living there the furniture, carpets and furnishings showing signs of wear need replacement. Bath and shower rooms which residents are not able to use should be refurbished so that residents are able access the bath/shower safely. 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 Haven Nursing Home DS0000042690.V262228.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 Haven Nursing Home DS0000042690.V262228.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): These standards were not assessed at this inspection EVIDENCE: The Haven Nursing Home DS0000042690.V262228.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): Standard 9. Generally the systems for the management and administration of medications are satisfactory. An improvement in recording of medicines received/disposed and specific directions for medicines prescribed as required are necessary, to ensure that all medication received into the home is administered as prescribed. EVIDENCE: The inspector observed the systems and procedures for the management and administration of medicines. Generally these were found to be satisfactory. A number of medicines received into the care home had not been signed as checked and received on the MAR sheets. Records observed for medicines returned to pharmacy had last been completed in August. The manager said that this was due to changes in the means of disposal of unused medications. Several medications prescribed to be given as required did not specify the criteria for their administration. This could lead to inconsistencies with the administration of these medications. A number of residents are prescribed psychotropic medications the manager said that the Consultant Psychiatrist visits regularly to monitor and review this. The Haven Nursing Home DS0000042690.V262228.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): Standards 12, 14 and 15. The home provides a regular varied programme of social and leisure opportunities, which meets the expectations, abilities and preferences of residents. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. EVIDENCE: The inspector observed residents participating in the afternoons planned activity, which included an exercise group followed by “Play your Cards Right.” A monthly programme of social and leisure opportunities is available to all residents, which includes opportunities both in the home and trips out of the home. Recent trips out include visits to the motorcycle museum and local garden centres. The activity organiser said that she spends time in the mornings with individual residents who are unable/do not wish to join in-group activities. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 11 The majority of group activities are held in the large lounge. This lounge area can be very busy and noisy with a large number of interruptions and distractions. Future plans include the redesign of this lounge and provision of additional lounge areas, which will provide a more suitable environment. Work is progressing on developing life histories for those residents with dementia. Framed photographs of many of the residents are located on the doors to their bedrooms. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents’ tastes and choices. The inspector observed lunchtime. The dining room tables were attractively laid and staff were readily available to assist residents where necessary. Residents said that the meals were very good and suitable choices were available at mealtimes. The manager said that work is progressing slowly on the provision of photographic menus to assist resident choice at mealtimes. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 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): Standard 16 and 18 Systems for the management of complaints are satisfactory residents can be confident that their concerns are listened to, taken seriously and acted up on. Staffs knowledge and understanding of adult protection issues are good. Policies and procedures in place for the protection of vulnerable adults need minor review to provide a safe environment for the people living in this home. EVIDENCE: Residents and two visitors told the inspector that if they had any concerns about any aspect of the service they would discuss these with the manager. The complaints procedure is located in the hallway and is included in the Service User Guide. There were no complaints recorded in the home’s complaint register since the last inspection. Policies and procedures relating to the protection of residents are available. The procedure to be followed in the event of abuse requires minor review in line with local vulnerable adults procedures. Discussions with the manager and staff demonstrated a good understanding of recognising the types and signs and symptoms of abuse. Staff knew how to report any allegations of abuse. Staff had attended an abuse workshop’ held at the home. The manager had a good understanding of when and how to refer staff to the POVA list. Training on adult protection, restraint and whistle blowing is provided twice a year for staff members to attend. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 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): These standards were not specifically assessed at this inspection. EVIDENCE: The home has secured planning permission to improve the facilities available to residents. This includes reducing the number of shared bedrooms and improving lounge and bathing facilities. The manager said that they were aiming to commence the building work in May 2006. Redecoration is ongoing with fifteen bedrooms completed since the last inspection and new carpet/flooring fitted in two rooms. A number of carpets were stained and worn in parts and were in need of replacement. Similarly some furniture within the home was worn. The manager said that once the building works was completed areas within the home would be refurbished and carpets/furniture replaced. The carpets were being cleaned on the evening of the inspection. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 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 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): Standard 27 and 29 After a period of instability in staffing there is now a good complement of staff reducing the need for use of agency staff and offering a greater consistency of care within the home. The procedures for the recruitment of staff are satisfactory and protect the residents. EVIDENCE: Since the last inspection the manager has recruited into the vacant posts and reduced the use of agency staff. Duty records showed that the previously agreed staffing levels were being met with an additional carer provided on the morning shift wherever possible. The number of residents with dementia is gradually increasing. At the time of this visit 40 residents with varying degrees of dementia were being cared for by the home. The home is a training placement for student nurses with one student on night duty who remains supernumerary. The inspector examined the records of two staff members, who had recently been appointed and were on induction. Each file contained evidence of suitable CRB and first POVA checks, references and all other information as required by the standard. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 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 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): Standard 36 and 38. Staff are appropriately supervised to ensure that they have the support, skills, practices and knowledge to meet the residents needs. Health and safety management in this is home satisfactory EVIDENCE: Discussion with staff and the manager shows that care staff receives regular supervision. Records of supervision are maintained and were observed during the inspection. Certificates for the service and maintenance for most major systems were available the manager said that these were done by appropriately qualified personnel. The manager said that the electrical wiring and electrical equipment examination was arranged for November 2005. Reports of visits by the Fire Officer and the Environmental Health Officer were observed during the inspection. The manager said that since the last inspection a survey has been completed on the flat roof and action taken where indicated. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 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. 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X 3 The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement Timescale for action 30/11/05 2 OP19 16, 23 3 OP22 16, 23 The registered manager must ensure that records are maintained of medications entering the home and records of disposal of any medications. The MAR sheet must indicate the reason for administration for those medications, which are prescribed as PRN. MAR sheets must be dated and signed when medications have been reviewed and changes made to the medication. (Old timescale of 30.06.05 part met) The manager must provide a 31/12/05 timed action plan to the Commission for the proposed building works. This must include a timed plan for the replacement of carpets, furniture and furnishings once the building work is completed. A timed action plan for the 31/12/05 refurbishment of bathroom facilities must be provided to the Commission. The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 18 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 OP9 OP12 Good Practice Recommendations The inspector recommends that the medication policy/procedure include: prn medications, verbal changes, covert administration and drug errors. The inspector recommends that the activity organiser attend training on activities for the older person with dementia. This would enable the home to further develop the range of activities available to those with dementia. The inspector recommends that the Adult abuse procedure is reviewed to include the arrangements for reporting abuse in line with local authority vulnerable adults guidance. The inspector recommends that the manager regularly review the dependency levels of residents and increase staffing levels accordingly. The inspector recommends that the manager consider the use of dementia care mapping as a tool to monitor the quality of the care to those residents with dementia. The inspector recommends that the Fire risk assessment is reviewed. 3 OP18 4 5 6 OP27 OP33 OP38 The Haven Nursing Home DS0000042690.V262228.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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. 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