Inspection on 30/01/08 for The Mews Nursing Home

This inspection was carried out on 30th January 2008.

CSCI found this care home to be providing an Adequate service.

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 Mews Nursing Home 16/12/08

The Mews Nursing Home 28/09/07

The Mews Nursing Home 23/08/06

The Mews Nursing Home 07/02/06

The Mews Nursing Home 05/10/05

The Mews Nursing Home 09/02/05

The Mews Nursing Home 11/06/04

The Mews Nursing Home 02/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE The Mews Nursing Home Southburn Terrace New Herrington Houghton Le Spring Tyne & Wear DH4 7AW Lead Inspector Mr Tom Moody Unannounced Inspection 30th January 2008 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 DS0000018210.V359642.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. DS0000018210.V359642.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Mews Nursing Home Address Southburn Terrace New Herrington Houghton Le Spring Tyne & Wear DH4 7AW 0191 512 0097 0191 512 0959 the.mews@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd 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) Mrs Pauline Mary Fox Care Home 50 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (50), Physical of places disability over 65 years of age (40) DS0000018210.V359642.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2007 Brief Description of the Service: This home provides 50 places for elderly persons. This includes 5 respite places for persons requiring palliative care. The current scale of charges is between £410 and £643. The home is purpose built and the internal space is generous. There are a variety of lounge and dining areas. The bathrooms and WC’s have handrails and appropriate equipment for disabled service users. The home is constructed in a traditional style incorporating brick and a tiled roof. It has two floors with passenger lift access to the upper floor. Ground floor access is level. The home stands in grounds shared with another care home. The garden area is well maintained and there is adequate parking. There is a secure patio area for service users. The home is located in a village, in a suburban area. There are local facilities close to the home including shops. DS0000018210.V359642.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection visit took place over one day in January and was carried out by a single inspector. Information was obtained before the site visit from several sources, including the provider’s self-assessment. Records were examined and a tour of the premises took place. Discussion took place with the acting manager and other members of staff. The midday meal was observed and the inspector also spoke to service users, staff, and visitors throughout the inspection. The feedback from service users and relatives was generally positive and they have welcomed recent improvements, although some expressed reservations about continuity of management arrangements. The home is reasonably well equipped with aids and adaptations suited to the client group’s age and lifestyle preferences. The home has plenty of space in all areas. It is popular with service users and their families. What the service does well: Relatives confirmed that they are able to visit the home before their family members move in there. Service user’s said they got on well with staff members, saying, “The staff are fine”, or, “They’re all canny lasses.” Service users said they are happy with information and choice of home. Visitors are encouraged to come in at any time and visitors were seen to come and go throughout the time of the site visit. The home has a good level of equipment. A number of modern, adjustable, beds with built in rails are available, as well as pressure relieving aids. Bedrooms are pleasantly decorated and the occupants have personal items and possessions in their rooms. DS0000018210.V359642.R01.S.doc Version 5.2 Page 6 The grounds are landscaped and service users and relatives have access to a sheltered garden area. Service users relatives spoke of their satisfaction with the care provided Relatives are able to raise issues with staff members and the acting manager. Several other relatives spoke of the willingness of the area manager to listen to their concerns, and his easy availability. Regular meetings take place to encourage service users and relatives to raise issues. What has improved since the last inspection? Staff morale has improved largely due to the appointment of a temporary manager. A significant number of staff have signed up for NVQ training programme. The activities co-ordinator encourages service users to take part in small-scale activities. Staff spent time with service users, talking to them, even when they were not carrying out care tasks. The care plans continue to be improved and a new documentation is being introduced. A life history has been introduced and this provides good background information about service users. Some bedrooms have had new carpets fitted. Kitchen hygiene is much improved and new equipment has been provided. The kitchens now have a good stock of fresh, frozen, dried and tinned ingredients. Menus have been reviewed as a result of surveys carried out to find out service users preferences. The service users have an improved choice of meals. One said they’d, “had a lovely omelette, cooked just right”. Other service users said that they enjoyed the food in the home, making comments such as, “I enjoy the food.” DS0000018210.V359642.R01.S.doc Version 5.2 Page 7 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. DS0000018210.V359642.R01.S.doc Version 5.2 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 DS0000018210.V359642.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have contracts, good sources of information and assessments that ensure that their needs are met. EVIDENCE: The home has appropriate policies and procedures and the manager and administrator confirm these are unchanged. The providers self assessment states that they offer a clear presentation of the service to new residents. This includes; Service User Guide, Terms and Conditions of residence, Statement of Purpose and Printed copies of the latest CSCI Inspection Reports are made available to enquirers. DS0000018210.V359642.R01.S.doc Version 5.2 Page 10 Relatives confirmed that they are able to visit the home before their family members move in there. Service users said they are happy with information and choice of home, although some said this was done by relatives. Care planning documentation records this and portrays an accurate assessment of service users needs. DS0000018210.V359642.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is enough information in care plans to ensure that practices in the home are meeting all of service user’s healthcare needs. Service users are protected by a safe system of medication that is properly operated by staff. EVIDENCE: The care plans continue to be improved and a new documentation is being introduced. The care plans that were sampled contained a good level of information, including risk assessments. A life history has been introduced and this provides good background information about service users. Care plans have been updated in line with changes in service user’s needs. The care carried out in the home was appropriate and carried out in a way that ensured the dignity of service users. DS0000018210.V359642.R01.S.doc Version 5.2 Page 12 The Manager said that a regular audit of care plans is carried out and the records of these were seen. Doctor’s visits were recorded, as were specialist services such as diabetic screening and speech and language therapists. Medication storage was secure and administration was properly recorded. DS0000018210.V359642.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are having more of their social and recreational needs met by staff and this has improved the quality of life in the home. Quality and quantity of basic foodstuffs has improved and increased choice and improved menus means that service users nutritional needs are properly met. EVIDENCE: Kitchen hygiene is much improved. The kitchens have a good stock of fresh, frozen, dried and tinned ingredients. The manager said that menus have been reviewed as a result of surveys carried out to find out service users preferences. The menus have changed and they now have two choices of hot main meals. The style and choice is very much traditional English food. Alternatives were offered to service users who did not want either of the main choices, and the service user involved in this said “they’d had a lovely omelette, cooked just right”. DS0000018210.V359642.R01.S.doc Version 5.2 Page 14 Other service users said that they enjoyed the food in the home making comments such as, “I enjoy the food.” Visitors are encouraged to come in at any time and visitors were seen to come and go throughout the time of the site visit. Relatives commented favourably on the changes taking place in the home, and of the care their relatives received. Although some commented that the home still had improvements to make, other made comments such as, “I am very happy with the care he gets.” The activities co-ordinator encourages service users to take part in small-scale activities. Staff spent time with service users, talking to them even when they were not carrying out care tasks. Service user’s confirmed they got on well with staff members. Some said, “The staff are fine”, or, “They’re all canny lasses.” DS0000018210.V359642.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and most relatives are comfortable about raising issues with staff and the management team and are protected by the homes procedures. EVIDENCE: Service users’ relatives spoke of their satisfaction with the care provided and most confirmed that they are able to raise issues with staff members and the acting manager. Regular meetings take place to encourage service users and relatives to raise issues. Several other relatives spoke of the willingness of the area manager to listen to their concerns, and his easy availability. Staff receive training in adult protection procedures. DS0000018210.V359642.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is safe, the home is generally well maintained and decorated but the replacement of sluice equipment and other upgrading must be completed to ensure service users needs are met. EVIDENCE: The kitchen is now much cleaner and new equipment, such as crockery, has been provided. There is no odour in the sluice rooms but the old disposal machines have not yet been replaced and the extractor fans are still not working effectively. Some bedrooms have had new carpet fitted and the manager said there is a programme of gradual replacement, although the rather dour, industrial, black carpet remains in many corridor areas. DS0000018210.V359642.R01.S.doc Version 5.2 Page 17 All bedrooms are pleasantly decorated and the occupants have personal items and possessions in their rooms. All fire precautions were observed at the time of the site visit. The home has a good level of equipment with a number of modern, adjustable, beds with built in rails available. Pressure relieving aids were in use and the home has suitably adapted bathrooms and toilets for service users requiring extra support. One of the shower rooms has poor flooring and drain covers but the manager spoke of this being due to be upgraded. The home is clean in all areas and there were no unpleasant odours. An induction loop system has been installed in one ground floor lounge. Unfortunately staff were unfamiliar with the equipment and were unable to make this work properly so it remained unavailable to any person who needed it. DS0000018210.V359642.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. While there are sufficient staff to meet service users needs, not all of them have appropriate qualifications to enhance their competencies, in promoting service user’s well-being. Recruitment is appropriate and protects service users from unsuitable carers. EVIDENCE: Staff and manager have confirmed that extra management hours have relieved the pressure on clinical staff. Staff appeared more relaxed and have more time to spend on interacting with service users. Care staff have confirmed they are undertaking NVQ training and some remarked that their new manager was good at motivating and persuading them to undertake this. Staff records confirm that recruitment processes are followed and that staff are provided with mandatory training and induction training. One of the registered nurses spoke highly of the support she received from the manager. DS0000018210.V359642.R01.S.doc Version 5.2 Page 19 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The inclusive management style of the temporary manager has improved the running and efficiency of the home. However the appointment of a permanent manager must remain a priority, to ensure continuity of good care and quality of life, for service users. EVIDENCE: The acting manager is an experienced registered nurse who holds a management qualification. The manager has improved practice in the home and introduced new ideas, such as consultation on menus, to improve the quality of life of service users. DS0000018210.V359642.R01.S.doc Version 5.2 Page 20 He has involved relatives and instituted regular meetings with them. Relatives are pleased with the improvement in the management of the home and one said, the manager’s”great.” Although not all of the outstanding requirements from the previous report have been met, there are time and resource constraints that prevent “instant” solutions. The new manager does feel supported by the company and relative also feel the area manager is supportive. Staff morale has also improved but some staff did express doubts about what will happen when a permanent manager is appointed. Although the current manager will be in post for some time, it is still the intention of the company to recruit a permanent manager. Several service users and relatives spoke of the number of management changes and everyone said they would wish for greater stability in the management arrangements. The service users personal allowance is securely kept and accounted for. It is banked in a no-interest bearing account, but individual accounts are maintained and these are audited regularly. DS0000018210.V359642.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 3 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 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 3 3 3 DS0000018210.V359642.R01.S.doc Version 5.2 Page 22 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. 2. Standard OP22 Regulation 16, 23 Requirement Equipment must be provided for those with sensory deficits. This requirement is outstanding from previous reports. 3. OP28 18(1) (a)(c)i A minimum of 50 of staff must be trained to NVQ level 2. This requirement is outstanding from previous reports, although it is acknowledged that staff are undertaking training. 5. OP36 8 (1)(b)(iii) The home must appoint a permanent manager in charge. 31/10/08 31/10/08 Timescale for action 31/03/08 DS0000018210.V359642.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000018210.V359642.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000018210.V359642.R01.S.doc Version 5.2 Page 25 - 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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