Inspection on 02/02/07 for The Lady Nuffield Home

This inspection was carried out on 2nd February 2007.

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.

Other inspections for this house

The Lady Nuffield Home 22/01/09

The Lady Nuffield Home 08/12/05

The Lady Nuffield Home 09/08/05

The Lady Nuffield Home 22/02/05

The Lady Nuffield Home 08/07/04

The Lady Nuffield Home 27/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Lady Nuffield Home 165 Banbury Road Oxford Oxfordshire OX2 7AW Lead Inspector Kate Harrison Unannounced Inspection 2nd February 2007 10:30 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 Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 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 Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lady Nuffield Home Address 165 Banbury Road Oxford Oxfordshire OX2 7AW 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) 01865 888500 01865 553040 enquiries@ladynuffieldhome.co.uk The Lady Nuffield Home Mrs Jennifer Lynne Timbrell Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 Brief Description of the Service: The Lady Nuffield Home is managed by a charity governed by a Board of Trustees. The home provides care for up to 30 residents over the age of 65, both male and female. It is not registered to admit those with a physical disability or a diagnosed dementia, but strives to continue to care for those who become so as long as it can meet their needs. The home is situated in the Summertown area of North Oxford and is close to shops, restaurants and other community facilities. The home offers private accommodation in single rooms, many with en-suite facilities, and updated communal areas, including a dining room/conservatory. All rooms have television, digital telephone service and a call system. There are two passenger lifts providing access between the first and the ground floors, for those who find stairs difficult. The gardens provide a useful and interesting outdoor area with trees, paving, lawn areas and seating. The registered manager runs the home with a team of care assistants and kitchen and housekeeping staff and the Board of Trustees oversees this management. The fees range from £427.81 to £543.17 per week. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10.30 hours and was in the service for 6 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that the Commission has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The inspector met several residents on the day, and also spoke to relatives and staff, including the registered manager, the person responsible for maintenance and the chef. The inspector asked the views of the residents, relatives and health and social care professionals about the home through questionnaires (comment cards) that the Commission had sent out. 18 residents, 8 relatives and 13 health care professionals including general practioners (GPs) and district nurses replied to the Commission’s comment cards and their views are reflected in this report. Comments about the home from the residents included ‘ the staff are wonderful’ and ‘a delightful home’. Relatives who replied via the Commission’s comment cards or who spoke to the inspector praised the qualities of the staff and the management of the home. ‘Extremely pleased and grateful’, ‘a very good care home’, and ‘an excellent home’ were some of the comments made All the health care professionals who replied to the Commission’s comment cards were satisfied with the care provided for their clients, and comments from them included ‘an excellent home, ‘good communication’ and ‘very efficient and helpful’. Other comments from them were: ‘staff very efficient and helpful’, ‘excellent care of residents’ and ‘excellent home.’ Equality and diversity matters are addressed well within the home. The manager has good connections with organisations supporting those with mental health need, and staff members treat residents as individuals. The home has the services of a physiotherapist who gives advice to individuals and staff on how to overcome difficulties caused by residents’ physical difficulties. The home has a track record of providing a good service to residents, and this inspection visit found that it continues to do so. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 6 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 summary of this inspection report can be made available in other formats on request. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 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 Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. The home does not provide intermediate care. Quality in this outcome area is good. The home’s manager carries out the pre-admission assessment for the prospective resident and knows that the home can meet the individual’s needs before the resident moves in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager assesses prospective residents before admission to the home. The inspector saw the admission records for two residents, both of whom had been at the home for several respite care periods before moving into the home. One resident had not yet completed the month’s trial period so all the admission documentation was not completed, and all the admission information was available for the other resident. Both residents told the inspector that they were very happy with the admission process, and that they had all the information they needed and said that they knew from their respite experiences at the home that they wanted to live there. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. Residents’ care and medical needs are met in ways that show them respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home uses a commercially available recording system for assessing and planning the care of the residents. The inspector saw the detail of two care plans, showing that the individuals’ needs were assessed and action was taken to meet their needs. The risk assessments carried out include risks of the individual falling and moving and handling residents. The home has started to implement the best practice way of assessing and monitoring residents’ nutritional status. Care plans are reviewed regularly, and medical help sought as appropriate. All the residents said that they ‘always’ or ‘usually’ received the medical support they needed. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 10 Medications are well managed at the home, supported by policies and procedures. The inspector saw residents’ medication records showing that medications are recorded appropriately, and noted that medications, including controlled drugs are stored appropriately. One health care professional said that the home liaises well with GPs and other specialist services to make sure that the needs of the residents are met. All the health care professionals involved said that they were satisfied with the overall care provided at the home. Residents told the inspector that staff members treat them with respect. One GP commented that residents are ‘always treated with dignity and respect’, and relatives said that they can visit their relatives in private. All the residents who replied said that staff listen to them and act on what they say. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. Residents have good control over their daily lives, including activities and food preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an advertised ongoing activities programme and special activities are organised regularly. The majority of residents said that there were ‘always’ activities available that they could take part in, and some told the inspector about their favourite events. The residents make their views known about the way the home is run at residents’ meetings, and can make suggestions if they wish. Residents can generally manage their own time and several were able to leave and return to the home as they wished over the inspection visit. Visitors can see their relatives at the home when they wish to, and relatives said that they are welcomed at the home. Relatives or professionals usually help the residents manage their financial affairs. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 12 The catering arrangements are contracted out to a small local catering company, and produce is sourced locally whenever possible. The chef regularly meets with the residents to discuss menus, and care is taken to make sure that food is well presented to encourage appetite. The majority of residents said that they ‘usually’ or ‘always’ liked the meals at the home. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. Residents know how to complain and they are protected from harm by the home’s policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints home. The majority of address complaints to. information concerning inspection. procedure is appropriate and is well displayed in the the residents know how to complain and whom to No complainant has contacted the Commission with a complaint made to the service since the last The home has appropriate policies regarding the safeguarding of vulnerable adults, and staff members have received training on how to protect vulnerable adults. One resident told the inspector that he felt very safe and secure in the home. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. The home is safe and well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents value the home’s position, allowing them easy access to nearby shops. The home’s gardens, easy access and landscaping also improve the residents’ quality of life. The home’s maintenance person has a system to record any issues that need attention, and contracts are in place to make sure that all the home’s services are safe and well maintained. The home is complying with a recommendation from the environmental health officer to replace the flooring in the kitchen. The housekeeping staff members are responsible for the domestic tasks, and residents praised the quality of the cleaning at the home. The home’s laundry caters for the personal and domestic needs of the residents and there is also an ironing room. The inspector recommends that pedal bins should be used to maximise infection control measures in areas such as bathrooms. The next phase of refurbishment is being planned to renovate the upper floor of the original building. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. Although sufficient carers are available for residents, it is not clear that sufficient numbers of staff members have the necessary training and updating in care issues, and a recommendation is made in this report, so that residents needs will continue to be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s staffing rota shows that sufficient carers are on duty over the twenty-four hours for the needs of the residents, and shows which manager is available if necessary. The majority of residents said that there were ‘always’ staff members available when they were needed. The manager said that the home’s bank staff members usually worked in place of absent colleagues so that the use of agency staff was kept at a minimum. The home encourages care staff to take the National Vocational Qualifications (NVQ) Level 2 in Care course, three carers have the qualification and one is currently taking the course. There is one NVQ course assessor at present in the home and the home has arranged for another assessor’s help so that the numbers of trained staff will increase and the home can meet the national minimum standard of 50 trained staff members soon. The home has an induction programme for new staff that meets the Skills for Care organization standards. The staff members training records are computerised and show that mandatory training is provided, such as moving The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 16 and handling residents. Other training is also provided, and although some carers are taking up the training offered, it is not clear that sufficient numbers of staff have update training in infection control, protection of vulnerable adults, prevention of falls and other care topics. As the level of carers with NVQ Level 2 does not meet the national minimum standard, the inspector recommends that the registered manager undertake an audit of care staff training to make sure that sufficient staff members have the appropriate skills and knowledge. The inspector saw three staff members’ files to check the home’s recruitment procedures, and all the necessary information was available about them. All the necessary information about individuals contracted to provide a service at the home was not available, and the registered manager has, since the inspection visit, taken steps to make sure that the appropriate information is now available at the home. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. The home is well managed by a caring and competent management team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been in post for several years, has gained the NVQ Level 4 in management and several residents commented on her good leadership qualities. She welcomes visitors and makes time to address any concerns as they arise, and has an ‘open door’ policy for visitors, residents and staff. She meets regularly with the Board of Trustees to discuss the running of the home, and has access to the Board whenever necessary. The Board is responsible for the home’s overall financial management, and an administrator works full time at the home. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 18 Quality assurance surveys are sent to residents and relatives twice a year and the results are published, in text and graph form, and are available in the hall to visitors and residents. Comment cards are available throughout the year to anyone wishing to submit comments about the running of the home and the results are collated three times a year. Feedback is encouraged from the residents meetings and from the regular contact the manager has with visitors. Small amounts of petty cash are kept securely and managed for a few residents who have no appropriate person nearby, and the inspector saw that the records are well kept. The home has a health and safety policy statement and provides training for staff on safety topics such as moving and handling residents and fire safety training. Contracts are in place to maintain the home’s gas and electrical appliances. One member of staff is responsible for fire safety at the home, and the home has a fire risk assessment and an evacuation plan in place. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 19 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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP26 OP30 Good Practice Recommendations Pedal bins should be used to maximise infection control measures in areas such as bathrooms. The registered manager should undertake an audit of care staff training to make sure that sufficient staff members have the appropriate skills and knowledge. The Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lady Nuffield Home DS0000013100.V317371.R01.S.doc Version 5.2 Page 22 - 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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