Inspection on 05/12/06 for The Minstrels Nursing Home

This inspection was carried out on 5th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Minstrels Nursing Home 24/11/05

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 Moya Dennis Key Unannounced Inspection 5th December 2006 09:00 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 Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 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.V322547.R01.S.doc Version 5.2 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 accommodated is 48 2. 3. Date of last inspection 24th November 2005 Brief Description of the Service: The Minstrels is registered to provide care for 48 people, needing either residential or nursing care, The home is situated on a main road in a residential area of Boston, approximately one mile from the town centre. It is on a bus route and parking is available in the grounds of the home. The building is modern in design and laid out over two levels, served by a lift. A residential care home and sheltered accommodation flats, also owned by the company, are situated on the same site. The Manager of the home is Mrs Diane Roach. Fees range from £336 to £512 per week. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced visit to the home in December 2006. It formed part of a key inspection and focussed on standards in the key areas that most affect the quality of life for residents. Information already held, such as the service history and incidents notified to CSCI since the last report, was used to plan the visit. As part of this unannounced inspection we looked at the quality of information given to people about the care home. People who used services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. We spoke to the registered manager, nurse-in-charge, eight members of staff, 5 residents and a visiting community nurse. Their responses have been used in this report. The inspection method used was to case track the care received by a sample of residents by looking at their records and discussing their experiences of care with them. Forty-seven people were resident in the home. The manager was present throughout the inspection and was given general feedback at the end of the visit. What the service does well: What has improved since the last inspection? The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 6 Outstanding requirements from the previous inspection had been met. The home had achieved the Investors In People Award, demonstrating commitment to a trained work force. The manager had completed the Registered Manager’s Award. Care plan recorded a wide range of information that explained clearly how the needs of service users should be met. The service users guide had been updated to reflect all the staff details and qualifications. Copies of the letter sent to residents, confirming the home could meet their needs, are now on residents’ files. Residents or relatives’ signatures evidenced that they had been involved in drawing up care plans, and in reviews. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from a good pre-admission assessment and support. They could be assured that the home could meet their needs. The home did not provide Intermediate Care. EVIDENCE: The home had a Service Users Guide and Statement of Purpose, detailing the services provided by the home, and staff qualifications. Copies were given to service users and/or their family. Prospective service users and their representatives were invited to visit the home before deciding to move there. The manager or a senior member of staff conducted a full assessment of need for each prospective resident and completed a care plan, fully involving the resident and their family. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 9 All new residents were informed in writing that the home could meet their assessed needs; a copy of this letter was kept on their file. The care records of 3 service users were inspected. All contained evidence that residents received contracts and terms and conditions. Care records were well maintained and contained a risk assessment for all identified areas of risk. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were clear and residents were protected by sound risk assessments. Residents could be assured that end of life arrangements would meet their needs. EVIDENCE: Three residents’ files were inspected. All contained a social history, including former employment, significant event and family structure. Care plans contained clear direction regarding needs such as pressure area care, dementia, pain management and sleep. Risk assessments related to needs such as moving and handling, falls and challenging behaviour. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 11 A visiting community nurse said the manager was, “ … competent and confident in what she does. Communication is very good in this home. I’m happy with the quality of care residents get here”. She said she was confident that any given health care advice or instruction would be appropriately implemented. Medication records were inspected and seen to be satisfactory. The nurse on duty administered all medication. All staff responsible for dispensing medication had received appropriate training. One resident said, “Carers are very helpful. I like to be called by my first name; it’s friendlier. They are like my family but they always treat me with courtesy”. Residents had access to the home’s cordless phone for making and receiving calls; several people had private phones in their own room. Care plans contained information relating to end of life arrangements. Staff showed knowledge and understanding in delivering care to terminally ill people, and in supporting relatives. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents were supported to maintain as much choice and control in their lives as possible and had access to a range of activities and entertainments. EVIDENCE: Staff were able to take residents out in wheelchairs to local shops and supermarkets. The home had a mini-bus for larger groups or longer excursions. The home employed an activities co-ordinator for 32 hours each week. She was trained, and could provide individual physical therapy to residents who wished to maximise their mobility potential. Residents chose activities; popular pastimes were bingo, sing-a-longs, darts, miniature basketball, shopping trips, one-to-one conversation, art and crafts and visits to local garden centres. Professional entertainers came to the home every month and residents said they particularly looked forward to these visits. Although there was an activities programme, this could be changed at any time to reflect residents’ choices and preferences. One residents said, “There’s always enough to do here”. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 13 Residents were assured upon admission to the home that visitors are welcome anytime, and that visiting was not restricted. Residents confirmed that this was so. The manager said visitors were able to use the small library, residents’ own rooms or even her office if they wished to speak to residents in private. Two residents welcomed the inspector into their rooms. These were clean, warm and homely. Residents were able to bring personal items from their former homes. They confirmed that the standard of hygiene was consistently high. Both said that beds were well made, early each morning. Residents were offered 3 main meals a day, plus snacks. Menus were on a four-week rota and residents were involved in meal planning. Fresh fruit, vegetables and meat were bought from local suppliers and catering staff were able to change suppliers if they were dissatisfied. All residents said they enjoyed the food. One said, “It’s not just the food; meal times here are a social occasion. It’s the time we get together for a chat and a good laugh with the staff”. Kitchen staff were aware of the dietary needs of all residents and provided soft, liquidised, low fat and diabetic options. Staff sat with residents who needed support with eating and gave help in a sensitive, discreet way. Various items were provided to protect residents’ clothing at mealtimes and kitchen staff showed sound values in not referring to them inappropriately as ‘bibs’. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were aware of the home’s complaints policy and they are protected by robust protection policies. EVIDENCE: One anonymous complaint about the home had been received since the last inspection. This had been dealt with appropriately within the home’s complaints procedures. Residents said they were able to raise issues at resident’s meetings if necessary. They said they had had no cause to complain but knew how to do so, if necessary. One resident said, “I’d just tell the matron; I know she’d sort it”. There was evidence of staff training in adult protection and staff demonstrated awareness and understanding of protection issues. They were aware of ‘whistle- blowing’ and confident they would be supported if they needed to take such action. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a safe, homely environment with a good standard of decoration and furnishing. Aids and adaptations enabled them to maintain as much independence as possible. EVIDENCE: The home employed a maintenance worker and had an ongoing maintenance programme. Redecoration had been carried out since the last inspection. The manager inspected all parts of the building every 6 weeks. All faults or deficiencies were reported and acted on at once. All areas of the home were clean, tidy, well maintained. Residents said, …“It’s very homely and comfortable … I like to spend time in my own room; it’s my little palace”. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 16 Lounges were well furnished and residents said they enjoyed looking at the garden, which they were able to sit out in during warm weather. The dining room was welcoming and tables were attractively set up. The home provided an assisted ‘Parker’ bath, an over bath hoist, grab rails, raised toilet seats and shower seats. All bathrooms, toilets and en-suite facilities were wheelchair accessible. Some residents required specialist nursing pressure mattresses, which were checked by staff every night. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels were satisfactory to meet the needs of residents. Residents were protected by the home’s recruitment procedure. Staff were well trained and supported in their roles to provide care. EVIDENCE: Records evidenced that staff received induction training, which included fire safety, policies and procedures, adult protection, introduction to residents and confidentiality. Staff said they also had access to training in more specialist areas. They said, “The manager is very big into training. She makes sure we’re all up to date with standards and equipment ... She asks what we may need ... if we say we need training on something, it’s provided.” Staff said there were enough people on duty to meet the current needs of residents. Most residents said that staff were ‘always’ or ‘usually’ available when needed. The manager had identified, through quality assurance systems, that more staff were needed at particular times. She employed one worker to make beds and another to provide tea and snacks to residents. Staff had more time to care for residents, and residents benefited from having social contact with more people. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 18 More than 50 of staff had attained an N.V.Q. (National Vocational Qualification) in care. Three staff files were inspected. All evidenced that recruitment checks had been undertaken and all information required in Schedule 2 of the Care Homes Regulations was kept on file. One recently recruited member of staff confirmed she had been recruited in line with this procedure and had completed induction training. Breaks in employment had been discussed at interview and investigated but not evidenced. The manager agreed that this could be addressed by including interview notes on file in future. The home’s training plan included mandatory and specialist training courses. The manager agreed that staff profiles in the service user guide would be updated to reflect courses undertaken. The Minstrels Nursing Home DS0000045171.V322547.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): 31,32,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provided leadership, guidance and direction to staff to ensure residents received a good standard of care. Records were well maintained; there were satisfactory procedures for handling residents’ monies and the health and safety of residents was promoted. EVIDENCE: Residents and staff said the registered manager was very approachable. Comment registered include, “She’s efficient … flexible and human, with a good sense of humour”. The manager was qualified to run the home, being a trained nurse with many years experience in providing care for older people. Residents were aware of the management arrangements and said they felt confident to talk over any problems they had with the manager or staff. The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 20 Residents and staff meetings were held, and both meetings had an agenda and were minuted. The home had a recognised quality-monitoring award, Investors in People award. The manager had daily contact with residents and invited their comments and suggestions. Staff meetings, residents’ meetings and visitors’ suggestions were all used to review the service and further improve it. Recent suggestions that had been acted upon were employment of extra staff for bed making and taking the tea trolley round the home and tray cloths and condiments on trays for resident who wished to eat their meals in their rooms. The home had a range of policies and procedures and these were regularly reviewed and updated. Records showed that equipment was regularly checked and serviced and there were systems to monitor any maintenance issues. Records of three residents’ personal allowances were sampled and found to be satisfactory. Discussions with staff and inspection of records confirmed that staff received regular supervision. Any training needs were identified and fed back to the manger, who arranged the relevant training. Staff signed supervision notes to confirm the content of meetings. Fire safety and training records were satisfactory, as were water temperature and general maintenance records. Environmental risk assessments were reviewed regularly. The Minstrels Nursing Home DS0000045171.V322547.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 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 X 3 3 X 3 The Minstrels Nursing Home DS0000045171.V322547.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. 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. Refer to Standard Good Practice Recommendations The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Minstrels Nursing Home DS0000045171.V322547.R01.S.doc Version 5.2 Page 24 - 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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