CARE HOMES FOR OLDER PEOPLE
The Poplars Nursing Home 158 Tonbridge Road Maidstone Kent ME16 8SU Lead Inspector
Maria Tucker Announced Inspection 26th September 2005 09:30 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 Poplars Nursing Home DS0000026198.V253443.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 Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 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.V253443.R01.S.doc Version 5.0 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 restriced 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 25th April 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 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 set back from the main road, and is accessible via local bus routes. The railway stations are within the town centre some one-mile away. The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The inspection lasted from 09.25 until 14.15 the inspection was conducted by the lead inspector Mrs M Tucker. Time was spent meeting the manager and unit managers and going through various records and documentation. About one hour was spent meeting service users collectively and individually. Three relatives were spoken with. Due to the health of some of the service, it is difficult to gain a full picture of their quality of life, this was made through judgements from observations, speaking with staff and looking at records. A partial tour of the premises was made which included service users rooms and communal areas. The pre inspection documentation was received by the CSCI. 19 comment cards were received, comments included: • “I would be happy to be looked after there myself” • “The staff always seem happy which obviously affects the atmosphere” • “I am very pleased with the care my receives” • “I have always found poplars to be a friendly and busy place” What the service does well:
Service users continue to receive a high standard of care based upon individual choice and preferences. Service users commented “Staff treat me with respect, I can’t think of how it could be improved”, “staff all very nice”. Previous comments during the last inspection included “I like everything really”; “I have help with everything I need”. Service users 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. Service users are admitted following very comprehensive assessments, which ensures the home is fully able to meet their needs. The home works very well with other health colleagues and professionals in assuring the total health care needs are met and that service users with complex health needs have the specialist support they require. The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 6 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; they go out of their way to make food appetising and encourage service users to eat. Service users spoken with commented, “There is quite a variety of food”, “flexible with mealtimes”. A cook commented “I really like it when they can tell you what they want”. What has improved since the last inspection? 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 Poplars Nursing Home DS0000026198.V253443.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 Poplars Nursing Home DS0000026198.V253443.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): Standards 1, 3, 4, 6 were inspected and fully met during the last inspection. 2 Service users have comprehensive information on which to base the decision to move into the home. They can feel confident that their needs will be fully assessed and met. EVIDENCE: Spot-checking during this inspection evidenced that the standards met during the last inspection continue to be met. The home operates a system where there is clear tracking and recording for service users who are admitted into the home. The care plans are comprehensive and contain relevant assessments sought from health care professionals. A service user and relative spoke of how they had a speech therapy assessment conducted prior to moving into the home and this had formed part of their care. Service users are admitted into step down beds, which are currently only provided in single rooms. A service user and their relative spoke of how they
The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 9 found it “unsettling” to move from this room as “within a day or two you get settled”. Their relative expressed how upsetting this experience had been. The Poplars Nursing Home DS0000026198.V253443.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 Service users receive a high standard of professional care developed from comprehensive care planning systems that fully meets their health care needs. EVIDENCE: Service users spoken with were familiar with their care plans and “meetings held” to discuss their care. And “IV had various meeting with people on care”. The care plans were signed and had entries made by relatives with comments such as “..expressed that…feels more confident as the staff treat …like a friend rather than just a patient”. A comment received by a health professional in the comment card said “I have always found staff at Poplars to be extremely helpful. I often place patients with complex health care needs and Poplars give consideration to individual patients needs and ensure they can be met prior to admission. They have cared appropriately for terminally ill patients and give support to family during distressing times”. Care plans contained various signed risk assessments that had been conducted with service users, relatives and other appropriate health care professionals.
The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 11 The medication policies and procedures have been inspected and fully meet the standard. The Poplars Nursing Home DS0000026198.V253443.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, 13, 14, 15. Service users are encouraged to express individual choices and preferences, which are as far as reasonably practicable met. EVIDENCE: Relatives and service users spoke of how they visited frequently and were made welcome, having refreshments offered. The programme of activities were varied and included outside entertainers, which, were greatly appreciated. Service users spoke of how much they enjoyed the musicians and singers stating “marvellous sing-along”. 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 home has a vast menu that offers choice and variety of fresh cooked produces prepared by dedicated trained cooks. Service users commented on how good the food was stating “food very good”, “quite a variety”. The kitchen was very well stocked and individual meals were seen in the freezer that had been individually prepared for a service user to choose from. The Poplars Nursing Home DS0000026198.V253443.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): 16, 17, 18 Service users can feel safe, protected and listened to. EVIDENCE: The home was fully aware of the Mental Capacity Act 2005. A summery of which was left at the home. A copy of a leaflet on the Freedom of information Act 2005 was left at the home. The manager was aware and had considered this. Without exception all service users stated that they had no complaints. One stated, “If I have any problems I ring and they sort it”. The Poplars Nursing Home DS0000026198.V253443.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): 19, 20, 23, 24, 25, 26 Service users live in a comfortable environment, which is safe, accessible and comfortable for service users to live in and enjoy spending time with their relatives. EVIDENCE: A partial tour was undertaken and all areas were found again to be exceptionally clean and tidy and fresh smelling. A service user during the inspection informally approached a staff member, mentioning something was broken. The staff took time out to follow the service user and give assistance. Developments and improvements in the home continue to be made to maintain the home to the high standard in the environment and external grounds. Service users rooms were comfortable and contained personal items and effects making them homely. Staff spoken with were familiar with infection control policies and procedures.
The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 15 Records seen and documentation received in the pre inspection questionnaire evidenced that all the necessary checks and actions are taken to ensure the home meets relevant guidelines and is safe and well maintained. The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 16 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, 28, 29, 30 A competent trained staff team cares for Service users. EVIDENCE: The home employs designated staff for housekeeping; entertainment and care, which ensures that care staff are able to dedicate their time in meeting the direct care needs. There is 24 hour qualified nursing staff provided by 18 staff. There is 39 care staff and 30 ancillary staff. The staffing levels are high and vary according to the needs of the service users. There is a low turn over of staff and a high level of NVQ 2 or above trained staff. Staff receive regular training and planned future training needs are identified. Relatives and service users spoke very highly of the staff and of the service that they provided. The home operates a stringent recruitment policy and procedure and have dismissed a qualified staff who they felt was not as competent as they should have been and as the home expects. The Poplars Nursing Home DS0000026198.V253443.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, 37, 38 Service users benefit from an exceptionally well run and managed service. EVIDENCE: The home is exceptionally well run and managed, the manager being a Registered General Nurse; NVQ assessor and verifier. The manager is pro active in working with outside agencies to raise concerns and issues to better the care of the service users. The home had a relaxed atmosphere where all staff and service users appeared to enjoy each other’s company and interacted in a positive way with genuine concern for each other. Service users spoke highly of the staff. One service user asked the manager “how is the inspection going?” before noticing myself (the inspector) and all staff and service users sharing a laugh together.
The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 18 Copies of minutes of service users were seen. The home has the QMS International plc Audit Reports conducted through an external agency for their quality assurance. The home operates a system where service users are invoiced for items such as toiletries and hairdressers. Service users and relatives spoken with discussed how they managed the personal finances. The Poplars Nursing Home DS0000026198.V253443.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 3 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 X X 3 3 3 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 X 3 3 The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP 2 Good Practice Recommendations It is strongly recommended that it is reviewed that on admission the continuing care ‘step down beds’ the home chooses within a multi-agency framework with a single or a double room. It is recommended that the home develop a selection of the range of risk assessment formats. 2 OP 7 The Poplars Nursing Home DS0000026198.V253443.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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