Inspection on 24/11/05 for The Minstrels Nursing Home

This inspection was carried out on 24th November 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 Minstrels Nursing Home 05/12/06

The Minstrels Nursing Home 14/07/05

The Minstrels Nursing Home 22/10/04

The Minstrels Nursing Home 21/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE The Minstrels Nursing Home 90 Sleaford Road Boston Lincs PE21 8EY Lead Inspector Unannounced Inspection 24th November 2005 12:30 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 Minstrels Nursing Home DS0000045171.V266645.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 Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Minstrels Nursing Home Address 90 Sleaford Road Boston Lincs PE21 8EY 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) 01205 369235 01205 358515 Minstrels Healthcare Ltd Diane Roach Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability (1) of places The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 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) The category PD applies to one service user aged 60 who is named in the notice of proposal to register dated 18th May 2005 The maximum number of service users to be accomodated is 48 2. 3. Date of last inspection 14th July 2005 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 grounds 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 DS0000045171.V266645.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The homes manager assisted the inspector during the unannounced inspection. One inspector undertook the inspection spending four and a quarter hours in the home .The inspector toured the building and spoke with the homes manager . There were 44 residents living in the home and 12 were spoken with. A relative of one of the residents was also spoken with. The main method of inspection used was called “case tracking” which involved selecting residents 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? Since the last inspection the home has commenced work to obtain the Investors In People Award. This will demonstrate the organisations commitment to a trained work force.. Training in Nation Vocational qualifications continues and the home is working towards 50 of care staff holing this qualification. The manager has been updating the homes polices and procedure. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 6 Quality assurance audits are in place and residents are being more actively involved in the running of the home. 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 Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5,6 Residents can have confidence that the home can meet their needs on admission and that their rights are protected by contracts being in place. An updated service users guide needs to be provided to assist resident with making an informed decision to live at the home. EVIDENCE: The home has a statement of purpose in place and a service user guide. The statement of purpose was up to date and contained all the relevant information. The service user guide did not contain all of the staff details and qualifications. This needs to be as added so that resident can be clear on who is providing their care and support. A coy of the inspection report is on display in the reception area. The manager confirmed that all residents are assessed prior to admission to the home and if an admission is offered to the resident this confirmed in writing. The home do not keep a copy of the letter. This needs to be done to evidence the assessment process. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 9 Residents spoken to had been living in the home for different periods of time. 2 residents who had been admitted within the past couple of years confirmed that they had been offered the opportunity to visit the home before they were admitted and one resident recalled the start of their stay being for a trial stay. Residents are given copies of the homes contract and terms and conditions document. The home does not provide intermediate care. The Minstrels Nursing Home DS0000045171.V266645.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): 7,8,9,11 Care plan information, is not always in place or an accurate reflection of residents assessed needs. Resident’s health care needs are met. Relevant policies and training evidence that resident’s needs at the time of their death are met. Residents are protected by the homes medication administration policy and practice. EVIDENCE: All residents have a service users plan profile which contains assessments, care plans, risk assessments and other relevant records which evidence the care delivered and required. During the inspection 2 residents service user plans were inspected. One resident had been admitted 2 weeks previously and had an assessment in place. Blank care forms were in place but had not been completed. This does not provide care staff with clear guidance for the care to be delivered. The other residents service user plan had care plans in place. Two of these contained different information to the assessment and what had been recorded in the daily care notes. This was discussed with the manager who confirmed The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 11 that a sample of service users files are audited monthly and if these had been audited these issues would have been identified. Medication records were inspected and were satisfactory. The trained nurse on duty administers all medications to those residents receiving nursing care and a senior care assistant will administer medication to those residents who receive personal care only. 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. Three residents confirmed that they were able to request a Doctor when they needed one and that the home had discussed with them the availability of a chiropodist, and physiotherapists . The home has a policy on the care needs of resident who are approaching the end of their life. The home also has links with the local hospital to admit resident on “End of life “ criteria. To provide a more enhanced and a quality service to the residents the home are providing training in aspects of palliative care. The Minstrels Nursing Home DS0000045171.V266645.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): 12,14,15 Residents dietary preferences are catered for. Residents are living in a home which supports them to make decisions regarding the running of the home and how they live their life. EVIDENCE: Service users made positive comments regarding the lifestyle they had at the home. Residents gave examples of how they were empowered to make decisions regarding the running of the home. A couple of residents said they directed their care and could choose when they were given assistance. Residents meeting are held and minutes are maintained of these. A visitor spoken to said that their relatives care was of a high standard and that staff were aware of residents emotional needs as well as delivering physical care. Residents made positive comments regarding the food and said that the food was plentiful and that specialised diets such as diabetic and high fibre were provided for. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 residents feel safe living at the home and have confidence that their concerns will be listened to. Staff receive training in Safeguarding Adults protocol. EVIDENCE: It was evidenced through staff records and speaking with residents that training had been provided in Safeguarding Adults. Residents were clear who to speak to if they had any concerns and the home provided information on advocacy services. The homes policy on safeguarding adults, known as adult protection is reviewed and updated regularly. The manager confirmed that safeguarding adults training is part of the homes induction and that regular updates are provided. Inspecting the training diary and care staff records evidenced this. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion EVIDENCE: Please see last inspection report for more detail regarding this section. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 Staffing levels provide residents with a safe environment and are sufficient to meet resident’s holistic needs. Recruitment procedures need to be more robust to protect residents. Staff are receiving training to ensure they are competent to do their job. The skill mix in place ensures resident’s needs are met at all times EVIDENCE: At the time of the inspection the home accommodated 44 residents. 27 of these received nursing care and the other residents had been admitted for personal care only. The manager is responsible for writing the duty rota. Various months duty rota were inspected. The number of staff on each shift remained static as did the skill mix of nurses care staff and hotel service staff and there was evidence that when shifts had sickness attempts had been made to get these shift covered. At the time of the inspection call bells were answered promptly, staff did not seem to be rushing about. The inspector activated a call bell and this was answered promptly. Residents said that they were satisfied with the care they received and that staff responded to their requests for help promptly and with kindness and patience. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 16 Two staff recruitment records were inspected. It was evidenced that a Pova (Protection of Vulnerable adults) check was in place, as was a criminal records bureau check. It was identified that this member if staff had worked a shift before these document were in place. . There was no evidence that this member of staff had undertaken an induction. The second file inspected only continued one reference and there was no evidence of what training this care staff had undertaken. The job description contained on this file was for a job role the member of staff did not undertake. The manager confirmed that staff recruitment documents were in place however they were at the organisations head office. The manager stated that records evidencing the checks had been undertaken would be placed in the file at the home. A training diary is in place and it evidences a record of what training has been provided and who attended this. Training included areas such as health and safety, adult protection ,risk assessment and rehabilitation therapies. Residents spoken to said they felt safe living in the home and felt that staff who cared for them were knowledgeable and understood the individual care needs they had. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38 The home benefits from a manager with good leadership skills. The supervision system in place provides a care team whose abilities and skills are regularly reviewed and assessed. The provision of updated policies provided residents with a safe environment and care practice, which reflect current good practice. is robust and evidences resident safety is promoted. Arrangements for managing resident finances provide residents with a safe system. 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 “always keeping an eye on the home” and would” always stop for a chat” and “never rushes you”. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 18 Policies are updated to reflect the ethos and practices of the home. Record keeping is robust and evidences resident safety is promoted. Those residents who have money looked after by the home are confident that their valuables are safe guarded. The procedure for maintaining records of valuables was robust and was audited regularly by the homes manager. 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 DS0000045171.V266645.R01.S.doc Version 5.0 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 3 x 1 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 3 x x x x x x x x 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 3 3 x 3 x x 3 The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1)(d) Requirement The registered person must ensure that prospective residents receive written confirmation that their pre admission assessment needs can be met Timescale for action 31/01/06 2. OP7 15(1) 3 OP1 5(1) 4 OP29 19 Previous Timescale 31 October 2005 The registered person must 31/01/06 ensure that residents, where possible are involved in the compilation of their care plan. The registered person must 31/01/06 ensure that the service users guide contains all the necessary information including staff details and qualifications. The registered person must 31/01/06 ensure that all recruitment information including 2 written references and a criminal record bureau check and protection of vulnerable adults check are in place, prior to commencement of employment. The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 21 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 The Minstrels Nursing Home DS0000045171.V266645.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Lincoln Area Office 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 DS0000045171.V266645.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!