Inspection on 25/10/05 for The Triangle Nursing Home

This inspection was carried out on 25th October 2005.

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.

Other inspections for this house

The Triangle Nursing Home 10/06/08

The Triangle Nursing Home 06/06/06

The Triangle Nursing Home 01/08/05

The Triangle Nursing Home 20/01/05

The Triangle Nursing Home 19/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Triangle Nursing Home London Road Wheatley Oxfordshire OX33 1YW Lead Inspector Philippa MacMahon Unannounced Inspection 25th October 2005 02:00 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 Triangle Nursing Home DS0000027186.V260560.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 Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Triangle Nursing Home Address London Road Wheatley Oxfordshire OX33 1YW 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) 01865 875596 01865 873992 Chiltern Care Homes Limited (part of the Southern Cross Healthcare Group) Amanda Longford Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Terminally ill over 65 years of age (3) of places The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of service users must not exceed 28. On admission persons should be aged 60 years and over. Date of last inspection 1st August 2005 Brief Description of the Service: The Triangle Nursing Home is a purpose built home registered for 28 service users, built about 12 years ago. It is located in the village of Wheatley on the old A40 approximately three miles east of Oxford. The Triangle is home to 28 older people who require nursing care. The accommodation is provided on two floors. There are 26 single rooms and one shared room. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second inspection in the inspection year. The inspector did not cover all of the standards on this occasion. Much of the inspection was taken up with talking to residents, relatives, staff and visitors to ascertain their views of the service provided. Resident’s individual care plans were examined, and the home’s medication system. The registered manager was not on duty and the nurses in charge were most welcoming and cooperative, throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Restore the hot water supply in the home to be fully operational throughout. Ensure that nutritional assessments are carried out and regularly updated for all residents, whether they are on a short stay or permanent basis. Omission codes on the medication administration record must be clearly identified. The programme of activities needs to cover more than one day a week. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 6 The communication and social interaction between the staff and the residents should be improved. The menus have not been changed for sometime and should be reviewed to include seasonal changes. The carpet in the main hall is still awaiting replacement or repair. 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 Triangle Nursing Home DS0000027186.V260560.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 Triangle Nursing Home DS0000027186.V260560.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): 0 The inspector did not make a judgement on the outcomes within this section as none were inspected on this occasion. EVIDENCE: None of these standards were assessed on this occasion. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 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): 7, 8, 9. All residents in the home have a care plan in which their assessed care needs are identified and the action required to meet those needs. Overall the residents’ care needs are met with the exception of nutritional status in short stay residents. The medication system in the home is well ordered and protected by policies and procedure. Residents are able to administer their own medication following an appropriate risk assessment. EVIDENCE: The inspector examined a sample of care plans and, overall, they were found to reflect the residents’ care needs and how these will be met. Further discussion with the residents whose care plans had been examined supported the “picture” described in the care plans. The residents and relatives spoken to are very appreciative of the care provided and felt that they are in very good hands. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 10 The inspector noted that two of the residents (who are at the home on a short stay basis) did not have a nutritional assessment carried out. One of these people on admission was assessed as having a problem with weight loss, and has not been weighed since. It is a recommendation that all residents admitted to the home, whether on a short stay or permanent basis, should have a nutritional assessment carried out and ongoing monitoring of the person’s nutritional status. The inspector examined the medication system and found it to be in good order and well managed. When the care assistants apply prescribed lotions and creams the nurse enters an omission code of 0 on the medication administration record at the appropriate date and time. However, this is not then identified in the appropriate box at the bottom of the record as being applied by care assistants. It is a good practice recommendation that if the omission code 0 is used, that a description of its use should be written in the appropriate space on the medication administration record. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 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): 12, 13, 14, 15. The social interaction between staff and residents is poor. There is a very limited provision of activities to meet the residents’ needs. The residents receive a wholesome and nutritious diet. EVIDENCE: Residents spoken to expressed that the home provided for all their needs and that they were very happy with the service provided. However, there was also comment that the activities only happened on a Wednesday and that they would like more. One visitor spoken to expressed concern that on numerous occasions when visiting the home it was apparent that there was little or no communication with the residents sitting in the lounge, not even passing comments from the staff. It is recommended that the registered manager should, with her staff, look into ways of improving the communication and social interaction with the residents on an ongoing basis. Visitors said that they were always made to feel very welcome at the home, and were looking forward to the Autumn Fayre that was coming up. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 12 There was a diary of events leading up to Christmas prominently placed so that any visitors could make a note and come and support these events, if possible. Discussion with residents showed that they were given choices and control over their lives. The menus were examined and found to show that a wholesome balanced diet was offered. One resident said that “the food is excellent”, and another that they were able to choose what they had to eat. However, another expressed that the menus had remained the same for a long time. It is recommended that a review of the menus should be made to take in seasonal differences. The Triangle Nursing Home DS0000027186.V260560.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): 0 The inspector did not make a judgement on the outcomes in this section as none were inspected on this occasion. EVIDENCE: None of these standards were assessed on this occasion. The Triangle Nursing Home DS0000027186.V260560.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): 0 The inspector did not make a judgement on the outcomes in this section as none were inspected on this occasion. EVIDENCE: None of these standards were assessed on this occasion. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The inspector did not make a judgement on the outcomes in this section as none were inspected on this occasion. EVIDENCE: None of these standards were assessed on this occasion. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 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): 38 The registered manager and staff are well aware of health and safety issues, and the welfare of the residents. EVIDENCE: The home has been without hot water for almost two weeks. A new boiler was fitted and has not worked effectively since. The home is waiting for a call from the suppliers. A contingency plan has been implemented with a risk plan for staff to take hot water to the residents for washing purposes. This has worked well as hot water is available in the kitchen and laundry. Nine days after the inspection the inspector contacted the home to find out if the hot water supply had been reinstated. The situation remains the same although the contractors had carried out further work. It is unsatisfactory that the home is without a hot water supply for over three weeks, and it is a requirement that the hot water supply to the home must be made fully operational. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 17 The inspector had been notified of the situation and today has been assured that the suppliers will be out first thing the next morning to fix it. The carpet in the main entrance hallway has still not been replaced or repaired since the last inspection in August 2005 when a recommendation was made. The carpet, in the inspector’s view, could cause a trip hazard to both the residents and the staff. It is a requirement that the carpet in the main corridor on the ground floor must be repaired to ensure that there is no potential trip hazard to the residents, staff or visitors. The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 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 3 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 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 OP38 Regulation 13(2)(c) Requirement It is a requirement that the carpet in the main corridor on the ground floor must be repaired to ensure that there is no potential trip hazard to the residents, staff or visitors. It is a requirement that the hot water supply to the home must be made fully operational. Timescale for action 14/11/05 2 OP38 23(2)(j) 14/11/05 The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 20 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 OP8 Good Practice Recommendations It is a recommendation that all residents admitted to the home, whether on a short stay or permanent basis, should have a nutritional assessment carried out and ongoing monitoring of the person’s nutritional status. It is a good practice recommendation that if the omission code 0 is used that a description of its use should be written in the appropriate space on the medication administration record. It is recommended that the registered manager should, with her staff, look into ways of improving communication and social interaction with the residents, on an ongoing basis. It is recommended that a review of the menus should be made to take in seasonal differences. 2 OP9 3 OP12 4 OP15 The Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Triangle Nursing Home DS0000027186.V260560.R01.S.doc Version 5.0 Page 22 - 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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