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Inspection on 01/02/06 for The Old Rectory Nursing Home

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

This inspection was carried out on 1st February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 manager and her staff continue to provide a good standard of care to the resident group. It was evident from the management of the episode of infection, that staff at the Home made strenuous efforts to provide all the care that was required for the residents and to implement all the necessary infection control measures. The staff team continues to work well together for the benefit of the residents. Staff training, development and supervision are ongoing.

What has improved since the last inspection?

The registered provider has carried out the refurbishment of the kitchen and the entrance hall. New kitchen equipment has been provided. Parts of the floor coverings have been renewed. Further refurbishment and decoration are planned. New nursing staff have been recruited to complement the existing team. The recruitment procedures have been improved to ensure that all pre-employment checks are sought and received before staff start working at the Home. Care and complaints documentation have been improved.

CARE HOMES FOR OLDER PEOPLE The Old Rectory Nursing Home Church Street Armthorpe Doncaster DN3 3AD Lead Inspector Ramchand Samachetty Unannounced Inspection 11:45 1 February 2006 st 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 Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Rectory Nursing Home Address Church Street Armthorpe Doncaster DN3 3AD 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) 01302 832032 01302 832032 David Mitchell Mrs Gail Sharon Bullock Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Approval has been granted for this home to provide care for one named person under the age of 65 years. 21st September 2005 Date of last inspection Brief Description of the Service: The old Rectory is a care Home providing both nursing and personal care for up to 35 residents in the category of older people. It is privately owned by Mr. David Mitchell and managed by Mrs. Gail Bullock. The Home is situated in the village of Armthorpe, within reach of local shops, a library, pubs and other local amenities. It is well served by public transport. The Home is a two-storey building, which has been extended to provide its current accommodation. There is a passenger lift to facilitate access between the floors. There are 35 single bedrooms and 6 of them provide en-suite facilities. There are some garden areas to the front and side of the Home. There are car parking spaces at the front of the building. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 1st. February 2006, starting at 11.45 hours and finished at 15.45 hours. Unfortunately, on the day of this inspection, there was an episode of a viral infection in the local area and residents and staff at the Home had been infected, leading to diarrhoea and vomiting. The registered manager and her staff had taken prompt action, in line with guidance from the local health protection service, to control the further spread of infection within the Home. This inspection was therefore undertaken as a desk exercise. The inspector was able to review progress achieved from the last inspection, check the handling of medicines and examine procedures for the management of residents’ personal allowances. The inspector would like to thank the manager and the registered provider and other staff for their co-operation during this inspection. What the service does well: What has improved since the last inspection? The registered provider has carried out the refurbishment of the kitchen and the entrance hall. New kitchen equipment has been provided. Parts of the floor coverings have been renewed. Further refurbishment and decoration are planned. New nursing staff have been recruited to complement the existing team. The recruitment procedures have been improved to ensure that all pre-employment checks are sought and received before staff start working at the Home. Care and complaints documentation have been improved. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 6 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 Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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): The key standards were inspected at the previous inspection. EVIDENCE: The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 the following standard(s): 9. The handling and administration of medicines at the Home is safe and satisfactory. A few minor shortfalls require remedial action. EVIDENCE: The Home has a policy and procedures for the management of medicines. The administration of medicines is undertaken by registered first level nurses only. A sample of medicine administration records was checked. They were adequately maintained. However, in some instances hand written amendments were not signed and dated by staff who made the alterations. Therefore, authorisation for such amendments could not be established. The storage of medicines used for service users was checked. Medicines for internal and external use were not stored separately. The receipt of medicines was recorded, but it was difficult to track the exact amount of certain items of medicines because the amount carried over was not recorded. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 10 Although the registered manager has supervision of staff administrating medicines, there was no regular audit of the management of medicines at the Home. It is recommended that such a system be put in place and that its outcomes are recorded and made available for inspection purposes. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 the following standard(s): The key standards above were checked at the previous inspection and were fully met by the Home. EVIDENCE: The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 the following standard(s): 16. The management of complaints has been improved for the benefit of service users, and is satisfactory. EVIDENCE: The management of complaints was discussed with the registered manager. She explained that records of complaints investigation were no longer kept in service users’ care files. A separate file is now available for such records and is kept secure and confidential. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26. Structural alterations and some refurbishment have been undertaken which have considerably improved the physical environment for the residents. Good hygiene standards continue to be maintained. EVIDENCE: It was not possible for the inspector to tour the premises at this visit because of an outbreak of diarrhoea and vomiting that was affecting residents and staff at the time. In discussion with the manager and the registered provider, it was established that the refurbishment work in the kitchen had been completed and new equipment has been installed. The entrance hall has been redesigned and has been made more welcoming and less intrusive for residents. Some areas have been provided with new carpets and have been decorated. The manager also informed the inspector The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 14 that the internal ramp, which was occasionally used along an upstairs corridor, had been removed and was no longer in use for health and safety reasons. The areas seen by the inspector were clean and tidy. Residents were barrier nursed in order to contain and stop the spread of infection at the Home. Visitors were also appropriately advised. Staff worked effectively as a team to ensure that all measures of infection control were appropriately implemented. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 and 29. The numbers and skill mix of staff are currently sufficient to meet residents’ needs, in particular, their nursing needs. The Home’s recruitment procedures have been improved and offer adequate protection to the vulnerable client group. EVIDENCE: In discussion, the registered manager evidenced the appointment of three new first level nurses. There are now six qualified first level nurses in employment at the Home. Three of them work full time. The manager explained that she was able to meet the staffing notice issued by the previous registering authority. As she has a keen interest in clinical issues, she would occasionally assist with nursing duties. The recent staff recruitment was successfully undertaken and all pre employment checks being completed in time for the new recruits to start working. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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 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 and 35. The Home continues to be well managed for the benefit of the resident group. Residents’ financial interests are appropriately safeguarded. EVIDENCE: It was evident at this visit that the registered manager and her staff team were well organised to manage the outbreak of a viral infection at the Home. Although there were disruptions in the day- to- day activities at the Home, essential services were maintained and residents’ care and welfare were prioritised. It was also noted that the Home had achieved the ‘ Investors In People Award’ in December 2005. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 17 The Home receives the personal allowance for 34 residents from the Doncaster Metropolitan Borough Council. It pays out these sums of money back to the residents concerned and a record of this transaction is kept. The Home manages the personal allowances of six residents. The registered provider has power of attorney for one resident who has no other relative to help. Accounts of all income and expenditure are appropriately maintained. Receipts are also kept to show all expenditure incurred. A sample of the accounts was checked. They were found to be correctly maintained. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 19 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. 1. Standard OP9 Regulation 12, 13 Requirement The receipt, storage and handling of medicines must be improved. Timescale for action 25/05/06 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 OP9 Good Practice Recommendations A regular audit of the management of medicines at the Home should be undertaken and its outcomes recorded. The Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 Old Rectory Nursing Home DS0000015869.V273069.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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