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Inspection on 16/04/07 for The Poplars Care Centre

Also see our care home review for The Poplars Care Centre for more information

This inspection was carried out on 16th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 service continues to meet the complex needs of the residents who move into the home. Service users continue to receive a high standard of care based upon individual choice and preferences The robust admission processes help prepare residents for life at Poplars and make them feel welcomed. Residents health and well-being is monitored and maintained through a comprehensive detailed care planning system. This is regularly updated and reviewed by a highly trained, motivated and dedicated staff team. The residents with complex needs and who are highly dependent continue to have their needs met through close working relationships with relevant professionals nurtured by the home. The home has very good systems in place for infection control and health and safety checks. Staff spoken with who worked in the kitchen and laundry areas were trained in the areas they worked in and were clear about the policies and procedures. The home has a vast menu that caters for individual tastes and preferences, and the standards relating to cooking, presentation, and flexibility remain very high. Residents are cared for by a well trained and dedicated staff group, that receive the support they need from the unit managers and the registered manager.

What has improved since the last inspection?

The improvement plan for the year from January 2007 to 2008 has nearly been met by the home and the manager is in the process of compiling another one. The improvements already met are; New carpets fitted throughout the home, overhead tracking for the overhead hoists in bathrooms fitted. Both unit managers are to be enrolled to start NVQ 4, new adjustable height assisted baths fitted. The home has retained its quality assurance ISO status. Planning permission has been applied for, in respect of the new extension to the building. Further improvements are planned for the recreational and leisure facilities.

What the care home could do better:

Once the newly recruited 2nd activities coordinator is in post, the existing coordinator and care staff will receive the support they need, as they have been working hard to maintain the level of activities since the post became vacant.

CARE HOMES FOR OLDER PEOPLE The Poplars Nursing Home 158 Tonbridge Road Maidstone Kent ME16 8SU Lead Inspector Justine Williams Key Unannounced Inspection 16th April 2007 10:00 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 Poplars Nursing Home DS0000026198.V334155.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 Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Poplars Nursing Home Address 158 Tonbridge Road Maidstone Kent ME16 8SU 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) 01622 752872 01622 674080 poplarsnursing@btconnect.com Tamehaven Limited Mrs Sandra Wilmshurst Care Home 71 Category(ies) of Old age, not falling within any other category registration, with number (71) of places The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Care of one Service User with dementia is restricted to a person whose date of birth is 06/10/1947 Registration is restricted to caring for older people which can include up to five people who may have physical disabilities and 5 people who may have a terminal illness 26th September 2005 Date of last inspection Brief Description of the Service: The Poplars Nursing Home is a registered care home for 71 people with nursing needs. The home specialises in caring for terminally ill residents and has close links with the local hospice, the home also specialises in the care of residents with complex nursing needs. There are also 3 step down beds used by the hospital for individuals who are not quite ready to return home and may be waiting for adaptations to their accommodation or some further input from physiotherapists speech and language therapists or occupational therapists. The home consists of a large main detached house with a large extension. The gardens surrounding the house are well maintained with several access points to the gardens. Car parking is at the front of the building. Two passenger lifts provide access to all floors. The home is divided into two wings with a unit manager responsible for each wing. The home has a large subsidiary staff for administrative, maintenance, housekeeping, catering and laundry duties. The registered Manager oversees all the staff. The home is in a quiet location set back from the main road, but close to the town centre and is accessible via local bus routes. The railway stations are within the town centre some onemile away. The current level of fees payable range from £446.21 to £769.00 per week, hairdressing, chiropody, newspapers etc are in addition to these charges and vary. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was carried out on 16th April 2007 between 9.15 am and 2.30 pm by regulatory inspector Justine Williams. During that time the inspector spoke with residents, staff members, unit managers and the registered manager. Feedback was given during and at the end of the inspection. This report contains assessments made from observation, conversation and records, as well as case tracking. As part of the inspection process comment cards were sent to service users who live at the home and to GP’s, health care professionals, care managers and relatives of residents. The comment cards indicated good levels of satisfaction. Comments made included: “The staff are very helpful and kind” “The home is always very fresh and clean” “The care staff have the right skills and experience to look after people properly and always with a smile and great patience” “I’m pleased to be able to say how delighted we are….” “We are extremely impressed with the home and staff and the quality of care” “I like the fact that residents don’t sit round in a circle watching TV , they are in small groups, some knitting, crocheting etc” “Excellent homes like this one should be supported by the NHS, Social Services etc, to enable patients with less income to enjoy this quality of care, Top up fees can be difficult to produce” “This is an excellent nursing home” “I would like to see a reception desk with a bell to call for help, I think security is an issue” What the service does well: The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 6 The service continues to meet the complex needs of the residents who move into the home. Service users continue to receive a high standard of care based upon individual choice and preferences The robust admission processes help prepare residents for life at Poplars and make them feel welcomed. Residents health and well-being is monitored and maintained through a comprehensive detailed care planning system. This is regularly updated and reviewed by a highly trained, motivated and dedicated staff team. The residents with complex needs and who are highly dependent continue to have their needs met through close working relationships with relevant professionals nurtured by the home. The home has very good systems in place for infection control and health and safety checks. Staff spoken with who worked in the kitchen and laundry areas were trained in the areas they worked in and were clear about the policies and procedures. The home has a vast menu that caters for individual tastes and preferences, and the standards relating to cooking, presentation, and flexibility remain very high. Residents are cared for by a well trained and dedicated staff group, that receive the support they need from the unit managers and the registered manager. What has improved since the last inspection? What they could do better: Once the newly recruited 2nd activities coordinator is in post, the existing coordinator and care staff will receive the support they need, as they have been working hard to maintain the level of activities since the post became vacant. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 7 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 Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from thorough admission procedures and move to the home assured their needs can be met. EVIDENCE: When new residents express an interest in the home they are encouraged to visit if possible, though due to the severity of residents conditions this is often not possible, a family member is then invited to visit and relatives and new residents are given written information about the home to help them reach a decision. The manager or unit managers visit the new resident in their own home or hospital to carry out an assessment. The manager also obtains a copy of the joint assessment done by social services. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 10 Intermediate care is not provided but the home has 3 step down beds used by the hospital for individuals who are fit to return home but may require some ongoing physiotherapy, input from speech and language therapists, occupational therapists, wound care or may be waiting for adaptations to be finished on their own homes. These individuals stay for 6 weeks only. ‘ The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents health and personal care needs are well managed. EVIDENCE: All residents have a plan of care and are involved with the drawing up of the plan. The care plans seen were very detailed and staff use them as a working document. The home has effective systems in place to ensure the care plan is reviewed and updated monthly and arranges additional reviews when changes take place. Each care plan includes a comprehensive risk assessment, including those for risk of falls, and other specific activities the resident does. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 12 The home is introducing a new document called “My life story” for residents to complete, some residents have chosen not to complete them, others are working on them at present. Residents health needs are clearly documented in the care plan and visits to and from healthcare professionals are documented clearly which help with auditing. Residents said they can see their GP when they wish and staff have clear protocols for referring issues to the GP or other health care professionals. The home enjoys close and effective working relationships with health care professionals. All residents are assessed using recognised tools for their risk of developing pressure sores, their moving and handling needs, promotion of continence, nutritional needs etc, and appropriate interventions taken are clearly documented, and updated. The homes practices and policies for dealing with medication are appropriate and take into account the relevant good practice guidance and legislation. Staff were observed talking with residents using their preferred terms of address, and residents said they felt they were cared for with proper regard to their privacy and dignity, never felt embarrassed, and felt comfortable when receiving help with personal care. Residents are asked if they prefer a female or male carer and this is entered into their care plans. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 have a relaxed comfortable lifestyle with opportunities to occupy themselves with a range of interests. EVIDENCE: Poplars usually employs 2 full time activities coordinators, 1 post is currently vacant though a new member of staff is due to start in the near future. A range of activities are organised for residents and displayed on the notice board. The home has recently employed the services of a personal trainer to run music and movement classes, other activities on offer are bingo, card making, topical discussions, pub lunches, chopping trips, arts and crafts etc. the home is raising money to buy a snoezelan trolley to take into residents rooms. Residents specific interests are recorded in their care plans and this is kept in the activities folder, and a copy is also held in the main care plan file. The home has the advocacy service ‘care aware’ details of which are sent out with details when an enquiry is made of a possible choice of home. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 14 Residents said their visitors are always made welcome and offered drinks etc. and may visit at any reasonable time. The home is appointing a new hairdresser and some of the residents have been invited to be on the interview panel. The home puts a great deal of importance on providing good, nutritious and varied food. There is a lot of flexibility in the choice and the timings of meals. Residents say the food is excellent and they enjoy the huge variety, and the ability to ask for something different late notice if they don’t fancy what’s on the menu. Hot and cold drinks are offered at frequent intervals throughout the day and these include tea, coffee, orange juice, apple juice, pineapple juice, cranberry juice or squashes. Regular snacks are offered with drinks. Special diets are catered for and these currently include, diabetic, soft and pureed. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents have access to people who listen to any concerns and who will take action to ensure they are protected from abuse. EVIDENCE: The home has a clear policy for dealing with complaints and this is clearly displayed in several areas. The home has recorded 25 complaints since the last inspection, the home records any concern as a complaint even if they are very minor, and the complaint log looked at confirmed this, the homes actions taken to address these issues are clearly recorded. Residents said they felt listened to and that their opinion mattered to the home, they felt comfortable complaining to the manager or any staff member and were confident any issues would be dealt with. The manager signs off all complaints and information from them feeds into the quality assurance system. The home has a comprehensive, and regularly updated adult protection policy, all staff receive regular training and training at induction in adult protection. Staff spoken with had a good understanding of what actions they should take and what constitutes abuse. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 16 The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 17 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a homely, well-maintained and comfortable environment in which to live. EVIDENCE: The home was clean, tidy and free from unpleasant odours. The hallways and bedrooms have recently been re-carpeted and the standard of décor throughout the home was good. The grounds are very attractive with several areas for residents to sit in good weather. The home has been inspected by the fire service and environmental health and is acting on the recommendations made. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 18 Some of the bathrooms have recently been fitted with tracks for an overhead hoist. The home has submitted plans for an extension to provide additional bedrooms, and continues to plan and carry out maintenance and renewal of the building to maintain the standards. The laundry was very clean and organised and has the equipment necessary to deal with foul laundry and to deal with the amount of dirty laundry the home generates. The home has several sluices with automatic sluicing devices for cleaning of commodes. All bathrooms and toilets have liquid soap and disposable hand towels as well as pedal operated lidded bins. Staff are provided with the equipment, knowledge and skills to maintain cleanliness and to manage infection control. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 19 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. Residents are cared for and supported by properly recruited and trained staff. EVIDENCE: The home continues to employ designated staff for housekeeping; entertainment and care, which ensures that nursing and care staff are able to dedicate their time in meeting the direct care needs. The numbers of staff on duty are sufficient to meet the needs of the residents and are adjusted when necessary. Additional staff are on duty at busy times of the day and staffing numbers are adjusted to meet the needs of the residents. Over 50 of staff have attained NVQ qualifications to level 2 or 3 and others are currently studying or enrolling for NVQ’s. The home has a “bank” of casual staff to use rather than use agency staff, but uses these infrequently. New staff receive skills for care inductions. The recruitment practices of the home are robust and personnel files looked at contained all the information required including 2 written references, POVA and CRB check, proof of identity etc. the manager is aware of the changes in regulation and already complies. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 20 Staff receive regular and up to date training in core areas such as moving and handling and fire, as well as other subjects such as dementia, diabetes, care of the dying etc in order that they are able to meet the needs of their residents. The homes 2 unit managers have been put forward for NVQ 4. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 Quality in this outcome area is excellent, This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well managed home. EVIDENCE: The home continues to be exceptionally well run and managed. The manager is a Registered General Nurse; NVQ assessor and verifier. The manager undertakes training to update her skills. Other professionals outside the home say the manager is extremely competent and consistently delivers a high standard of service. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 22 Staff said they are listened to and are involved with making decisions along with residents and their relatives about the home. The home has retained its ISO and this continues to assure the homes quality assurance systems are maintained at a high standard. The manager plans to provide the Commission with a report under regulation 24 in the next 3 months. The home does not manage resident’s finances but uses an invoicing system. Residents are encouraged to manage their own finances for as long as they are able, and ensures help from independent bodies or appropriate family members is sought for those no longer able to manage their finances. The health and safety of resident’s staff and visitors is well managed with equipment being regularly serviced and relevant checks being carried out. Staff receive training in first aid, food hygiene, moving and handling, infection control etc and regular training updates are arranged by the manager. Environmental and fire risk assessments are regularly reviewed and the manager is aware of her responsibilities regarding reporting of incidents and accidents etc. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 23 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X 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 X 4 X 3 X X 3 The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard OP12 Good Practice Recommendations It is recommended that a copy of the activities care plan be kept with the main care plan. The Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Poplars Nursing Home DS0000026198.V334155.R01.S.doc Version 5.2 Page 26 - 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!