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Inspection on 14/07/05 for The Minstrels Nursing Home

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

This inspection was carried out on 14th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is well decorated and maintained to a high standard. The gardens are landscaped and residents enjoy the atmosphere of the home. The residents spoken with see the home as very homely and the staff to be kind and patient. Residents are able to pursue hobbies and interests. Residents spoken with said that they received the care they needed and were satisfied with the homes catering arrangements. Interactions between residents and staff demonstrated that the staff team had the necessary skills. A comprehensive supervision programme operates for all staff.

What has improved since the last inspection?

It was a requirement from the last inspection that a system needed to be in place to demonstrate what choice of food was provided. The home now displays the menu daily and residents are involved in producing the menus. Bathrooms have been redecorated and made to look more homely. 3 staff have commenced on an induction programme. Relevant risk assessments are in place and the maintenance person who has attended a course on this subject tests all portable electrical items.

CARE HOMES FOR OLDER PEOPLE The Minstrels Nursing Home 90 Sleaford Road Boston Lincs PE21 8EY Lead Inspector Kathryn Emmons Unannounced 14 July 2005 08:30 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 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 Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Minstrels Nursing Home Address 90 Sleaford Road Boston Lincs PE21 8EY 01205 361852 01205 358515 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Minstrels Healthcare Ltd Diane Roach Care home with nursing 48 Category(ies) of OP Old age - 48 registration, with number PD Physical disability - 1 of places The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1) The home is registered to provide personal care for service users of both sexes whose primary needs falls within the following categories: Old age, not falling within any other category (OP) (48) Physical Disability (1) 2) The category PD applies to one service user aged 60 who is named in the notice of proposal to register dated 18th May 2005 3) The maximum number of service users to be accomodated is 48 Date of last inspection 22 October 2004 Brief Description of the Service: The Minstrels Nursing Home provides accommodation and personal or nursing care for up to 48 residents. The home is located in a residential area of Boston close to the town centre. The building is modern in design and laid out over two levels which are served by a lift. The ground the home is situated in also provides a residential care home and sheltered accommodation flats, also owned by the company. The Manager of the home is Mrs Diane Roach. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook the inspection spending three and a half hours in the home. The inspector toured the building and spoke with the homes manager and responsible individual. The inspector spoke with 7 residents, 1 visitor and one health care professional who attended the home. The main method of inspection used was called “case tracking” which involved selecting clients and tracking the care they receive through checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection? It was a requirement from the last inspection that a system needed to be in place to demonstrate what choice of food was provided. The home now displays the menu daily and residents are involved in producing the menus. Bathrooms have been redecorated and made to look more homely. 3 staff have commenced on an induction programme. Relevant risk assessments are in place and the maintenance person who has attended a course on this subject tests all portable electrical items. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 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 standard(s) 1,2,3,6 Residents are provided with information to assist them in making an informed choice about living at the home. Residents are given information, which informs them of their rights and the service they can expect. Lack of written confirmation that needs can be met does not provide residents with confidence that their needs will be met. EVIDENCE: The home does not provide intermediate care facilities. All prospective residents are assessed prior to admission to the home. It was not evidenced that all residents received written confirmation that their needs could be met. Residents were given a copy of the service users guide and statement of purpose. These documents are regularly reviewed and updated by the manager. 2 Residents spoken with and one visitor confirmed that contracts and terms and conditions of residence had been provided. One resident stated that they had had this document explained to them, prior to them signing it. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 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 standard(s) 7,9 Residents care needs are being identified and met. Access to health care professionals is satisfactory which ensures residents’ health needs are met. Medication systems ensure medication is administered in a safe manner. EVIDENCE: 2 Residents service user plans were inspected. The care plans were clear to follow and contained sufficient information for care to be delivered correctly and safely. Reviews were taking place within agreed timescales. One plan evidenced that the resident had been involved in the compilation of the care plan. The other did not reflect resident involvement. One resident spoken with said that they had been involved but was also “fed up with lots of questions being asked”. Medication records were inspected and were satisfactory. The trained nurse on duty administers all medications. Medication training is provided for all staff responsible for dispensing medication. Residents spoken with all said that they were satisfied that their health care needs were met. There was evidence within care files to see that residents had been visited by the doctor when needed. On the day of the inspection a The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 10 chiropodist was in attendance at the home. They confirmed that they attended the home every 6 weeks and that all newly admitted residents were given the choice of seeing the chiropodist. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Residents are provided with a varied diet with preferences catered for. Residents are able to have community inclusion and contact with visitors is facilitated in a positive manner. EVIDENCE: Residents spoken with confirmed that they were able to have visitors when they chose to. One resident said that their relatives were always made to feel welcome. One visitor spoken to said that the home always kept them updated on their relatives welfare and that there was always a senior member of staff available to speak with if necessary. Residents gave examples of how they could be involved in community participation if they chose to, such as going to the local town centre attending coffee mornings and local church groups. The home operates a four-week menu. A new chef has been recruited in the past few weeks. Residents spoken with all said that the food was “very good”, ”delicious” and that there was always a choice of main meal and desserts. Specialised diets are catered for including a soft diet and diabetic diet. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 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 standard(s) 16 There are robust procedures for handling complaints, which provided residents with assurance that their concerns will be taken seriously. EVIDENCE: The home has a complaints procedure in place. It was confirmed by the manager that all staff receive training in the management of complaints. Residents spoken with all said they were aware of whom to speak with if they had any concerns. The manager confirmed that no complaints had been received since the last inspection. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 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 standard(s) 19,21,24,26 Residents live in a safe environment. The standards of decoration and furnishing are good, providing residents with a comfortable and homely place to live. There are aids and adaptations to ensure the needs of residents with a physical disability can be met. EVIDENCE: Residents spoke positively of the décor of the home and the facilities offered. Residents said that they thought the bathrooms upstairs were “lovely and much more homely”. Toilets inspected were able to accommodate residents who used wheel chairs and had been furnished to provide a more homely atmosphere. Raised toilet seats and grab rails were in place. Two cleaners are employed for 5 mornings a week. No adverse odours were noted and residents stated that they were satisfied with the cleaning of their bedrooms and felt that the home was always “clean and tidy”. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 14 Bedrooms were inspected with resident permission. The bedrooms were bright and airy and 2 had specialist nursing mattress in place. All residents said they liked their bedrooms. Call bells were in place and there was lockable furniture in place. The doors had locks fitted. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected on this occasion EVIDENCE: Not inspected on this occasion. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36,38 The home benefits from a manager with good leadership skills. The supervision system in place provides a care team with up to date skills and a good quality of care delivery. Record keeping is robust and evidences resident safety is promoted. EVIDENCE: The registered manager is Mrs Diane Roach. Mrs Roach is a trained nurse with many years experience of working with in the Older Person sector. Mrs Roach is an experienced manager and holds the Registered Manager Award. Residents spoke highly of Mrs Roach and said that she was “approachable, kind and professional”. The home operates a supervision system, which is managed by the Senior Night Sister. All grades of staff receive supervision sessions. Where training needs are identified these are fed back to the manager who then arranges the relevant training. Supervision sessions are also used to review the quality of The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 17 the care being provided and any issues are addressed. Staff sign their supervision notes to confirm the discussions held. Maintenance and servicing records were well organised and it was evidenced that risk assessments for the environment including fire safety arrangements were regularly reviewed. The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x 4 x 3 The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 19 NO 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. 1. Standard OP 3 Regulation 14(1)(d) Timescale for action The registered person must 31 October ensure that prospective residents 2005 receive written confirmation that their pre admission assessment needs can be met The registered person must 31 October ensure that residents, where 2005 possible are involved in the compilation of their care plan. Requirement 2. OP 7 15(1) 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. Refer to Standard Good Practice Recommendations The Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road off Whisby Road Lincoln, LN6 3QN 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 Minstrels Nursing Home C53-C04 S45171 TheMinstrels V237816 140705 Stage 4.doc Version 1.20 Page 21 - 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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