Inspection on 08/12/05 for The Lady Nuffield Home

This inspection was carried out on 8th December 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 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 Lady Nuffield Home 22/01/09

The Lady Nuffield Home 02/02/07

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 Lilian Mackay Unannounced Inspection 8th December 2005 10:00 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.V272136.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 Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 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 jenny@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.V272136.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: The Lady Nuffield 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 Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday. The purpose of the visit was to see how the home is meeting the National Minimum Standards for care homes for older people. This inspection consisted of a sampling of the home’s policies and procedures, residents’ and staff records, other documentation. Talking to staff, residents and visitors and a tour of the home. Additional feedback was obtained by means of questionnaires completed by residents, social and health care professionals and relatives. Three permanent residents were admitted since the last inspection 09/08/2005 and three new members of staff were employed. The home has a qualified and well-experienced manager who has been registered since 1995. There are at least four care staff on duty between 08.00 to 14.00, three from 14.00 to 21.00 and two staff awake on duty from 21.00 to 08.00. Feedback from residents indicated that they feel well cared for, have their privacy respected, have suitable activities provided for them, enjoy the food and feel safe. Their feedback indicates that who to communicate with if they are unhappy with the care they are receiving needs highlighting. Staff feedback was very positive. Staff commended management for the high quality of the training given which enables them to do their jobs to a very high standard. One member of staff said, “That is why I like working here.” Another staff member commented, “ We all work really hard and look after each and every one of them [residents] to ensure they are happy.” Feedback from health and social care professionals in contact with the home was very positive. This indicated that the home communicates clearly and works in partnership with them, that there is always a senior member of staff to confer with, that staff demonstrate a clear understanding of residents’ care needs, that any specialist advice given is incorporated into the care plan and that management or staff take appropriate decisions when they can no longer manage residents’ care needs. Their feedback indicated that how to obtain a copy of the CSCI inspection reports needs highlighting. Health and social care professionals in contact with the home were satisfied with the overall care provided. Comments included, “Staff always helpful – high levels of communication.” Feedback from relatives or visitors to the home was positive. This indicated that they are made welcome in the home at any time, that they can visit their relative or friend in private and that they are satisfied with the overall care provided. Their feedback indicated that how to obtain a copy of the CSCI inspection reports needs highlighting. Comments included – “ I’d like staff to The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 6 take them [residents] out for coffee. The front door is a bit of a problem now. X has problems with her trolley.” “There’s always a parking problem. In the parking it is staff cars.” “X would love more frequent baths. She has one [a week] at present.” “The staff are lovely - very caring - for us they are very good.” “The manager runs the home very well.” “A thoroughly good home.” “We think Lady Nuffield Home looks after our relative extremely well.” “Very good, very caring staff. The manager manages a good “ship” and the staff get on. I’ve walked along the corridor this morning and they’ve [staff] all smiled at me. I enjoy coming here.” The inspector would like to thank the manager, staff, visitors and residents for their hospitality, courtesy and co-operation during this inspection. What the service does well: What has improved since the last inspection? A system for monitoring that monthly reviews are undertaken timely has been put in place. Residents’ records now include their photographs. Staff now double-check entries on medication sheets with the medication received and both sign to confirm the instructions are correct. Written risk assessments are kept on those residents who self medicate. All radiators are now either guarded for safety or have low surface temperatures. There is an additional member of staff on duty between 07.00 and 08.00. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 7 The home now systematically carries out its own CRB checks on staff to update those undertaken by previous employers of staff. Evidence of identity including a recent photograph, birth certificate, passport etc are now kept in the staff records. A certified induction course, related to the Skills for Care induction and foundation courses has been introduced to ensure all areas of care are covered at induction prior to staff commencing NVQs. 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 Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 8 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.V272136.R01.S.doc Version 5.0 Page 9 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): 3,6. Residents receive a written statement of the Terms and Conditions of the home. Respite care, not intermediate care, is provided. EVIDENCE: Prospective residents are given a copy of the Resident’s Guide containing the Terms and Conditions of the home. This information about the home is very informative. Intermediate care is not provided but respite care is. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 10 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): 7,8,9,10. All residents have care plans. Residents’ health care needs are fully met. Residents are responsible for their own medication, where appropriate, and are protected by the home’s medication policies and procedures. Residents confirmed that they are treated with respect and their right to privacy is respected. EVIDENCE: Monthly reviews are undertaken of residents’ care plans and a system for monitoring that these reviews are undertaken timely has been put in place since the last inspection. Residents’ care records now include their photographs. Residents confirmed their satisfaction with the overall care provided to the inspector at this time. The physiotherapist was in the home today doing exercises with those residents referred by the manager for this. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 11 She is employed for two hours a week. Residents’ physical well being is promoted through in-house music and movement sessions. Residents from the Summertown area are able to keep their own GPs when they come to live at the home and appreciate how close the surgery is to them. A chiropodist visits the home every five weeks. Only one resident was looking after her own medication at this time and she has lockable storage for storing this safely. Staff record medications administered meticulously, double-checking and signing alterations made to residents’ medication records. A Suggestions and Complaints file, prominently located at the entrance, is used to obtain feedback on the service. Consideration should be given to how this can be organised to ensure privacy for the people making these. Residents spoken to confirmed that staff are respectful and respect their privacy. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 12 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): 12,13,14,15. Residents’ lifestyle in the home meets their expectations and preferences and satisfies their needs. Residents are supported and encouraged to maintain contact with family, friends and representatives if they wish. Residents are helped to exercise choice and control over their lives. Residents spoken to were generally happy with the food provided. EVIDENCE: The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 13 Although the home does not employ an activity organiser residents had the opportunity to attend a variety of seasonal activities in the run-up to Christmas. The in-house activities offered include music and movement, art and poetry groups and weekly Communion. The mobile library visits fortnightly. Residents spoken to confirmed that they were happy with the activities available to them. Whilst there is a phone on the first floor for residents’ communal use, most residents have their own telephones. The staff organise birthday parties. The home’s policy on Community Contact promotes contact with family, friends and the wider community. The inspector saw many visitors to the home during this inspection and they appeared relaxed and friendly with staff and residents. Single bedrooms ensure that residents’ privacy is protected. Residents spoken to about this confirmed that their privacy, independence and opinions are respected. Staff were observed knocking before entering residents’ rooms. Residents were generally satisfied with the food. Meals are served in residents’ own rooms or in the attractive, well-lit, fresh dining room. Choices are available at all meals and a vegetarian alternative is available in addition to the set menu. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 14 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): 16. Residents and their representatives and friends can be confident that their complaints will be listened to, taken seriously and acted upon. Standard 18 was assessed at the last inspection. EVIDENCE: The home’s complaints procedure is compliant with the Regulations and National Minimum Standards. Records are kept of any complaints made including details of the investigation and any action taken. The complaints information is also available on cassette for the visually impaired. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 15 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): 19,26. For the most part the environment is safe and well maintained. The home is kept clean, pleasant and hygienic. EVIDENCE: Grab rails are required in the flat entry shower on the first floor. Occupational therapy assessments of this, the front entrance and the Beechwood Road entrance have been carried but the recommended adaptations have not been made yet. All radiators are now either guarded for safety or have are low surface temperature radiators. The decor is well maintained. The landscaped front garden on Beechwood Road is very attractive. Staff should ensure that bins are available in all areas with paper towel dispensers. The premises were clean, hygienic and fresh smelling in all areas visited at this time. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 16 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): 27,29,30. The numbers and skill mix of staff meets residents’ needs. Standard 28 was assessed at the previous inspection. Residents are protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: The staff rotas examined indicated that there are at least four care staff on duty from 08.00 to 14.00, three from 14.00 to 21.00 and two staff awake on duty from 21.00 to 08.00. The number of staff on duty appeared adequate to meet resident’s needs. Residents spoken to confirmed this to be the case. Staff commented on how hectic it can get between 05.00 to 08.00 and 21.00 to 23.00. Recently an additional member of staff has been put on duty between 07.00 and 08.00. One relative commented, “I do not consider there to be enough staff on duty overnight. Two members of staff for 30 increasingly dependent residents is worrying. “ The inspector did not find evidence to support this view at this time. The staffing levels provided are in line with the Staffing Statement agreed with the home in 2001. One relative commented, “It is good to see the recent increase to four staff on in the evening.” The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 17 It is recommended that back up phone calls are made to both referees before staff are appointed. Staff are given a copy of the General Social Care Council’s code of conduct. The home now systematically carries out its own CRB checks on staff to update those undertaken by previous employers. Staff records now include a recent photograph, birth certificate, passport etc. The home’s application form now records dates of employment and there is an application form for young people to apply for work experience. The home uses “Welcome to Social Care for Older People” the Oxfordshire County Council induction booklet, which is related to the Skills for Care induction and foundation courses. This ensures all areas of care are covered at induction prior to staff commencing NVQs. A certified induction course, related to the Skills for Care induction and foundation courses has been introduced to ensure all areas of care are covered at induction prior to staff commencing NVQs. The NVQ training of four staff was affected when the company they were doing this with went into liquidation and they have had to start this again. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 18 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): 31,33,35,37,38. Residents live in a home which is run and managed by a manager who is fit to be in charge and able to discharge her responsibilities fully Residents’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Residents’ finances are safeguarded. The home’s record keeping and policies and procedures safeguard residents. Residents’ health and welfare are protected but for safety the propping open of fire doors must cease.. EVIDENCE: The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 19 The manager is a registered nurse of considerable experience and has an NVQ Level 4 in care and the Registered Managers Award. One member of the care staff said that she would like more staff meetings. Feedback is actively sought through residents meetings and individual discussion. The home now has a system for reviewing the quality of the care provided by the home. A quality assurance exercise was undertaken in 2005 but the results of this had not yet been collated at this time. Members of the Board of Trustees undertake proprietor’s monthly-unannounced visits religiously. These reports include feedback from residents. These are well recorded and copies sent to the CSCI for information. The Service User Guide explains the extent to which the home manages residents’ money, valuables and financial affairs. Staff made all the requested policies and procedures available. It is recommended that the Equal Opportunities policy is amended to include sexual orientation. The manager is asked to submit evidence that the fire risk assessment was reviewed in the previous 12 months. There was a trailing flex in Room 12. The use of carpet off cuts should be discontinued and these replaced with mats lying flush with the floor. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 20 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 3 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 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 3 The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 21 yes 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. 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 3 4 Refer to Standard OP19 OP29 OP37 OP38 Good Practice Recommendations Make the adaptations identified in the areas assessed by the occupational therapist. Make back up phone calls to both referees before staff are appointed. Amend the Equal Opportunities policy to include sexual orientation. Submit evidence that the fire risk assessment was reviewed in the previous 12 months. The Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Lady Nuffield Home DS0000013100.V272136.R01.S.doc Version 5.0 Page 23 - 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. 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