Inspection on 12/01/06 for The Village Nursing Home

This inspection was carried out on 12th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Village Nursing Home 04/01/10

The Village Nursing Home 04/08/09

The Village Nursing Home 21/05/09

The Village Nursing Home 09/10/08

The Village Nursing Home 05/10/07

The Village Nursing Home 30/11/06

The Village Nursing Home 14/06/05

The Village Nursing Home 06/01/05

The Village Nursing Home 22/06/04

The Village Nursing Home 23/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Village Nursing Home Church Road Banks Southport Lancashire PR9 8ET Lead Inspector Anne Taylor Unannounced Inspection 12th January 2006 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 Village Nursing Home DS0000025583.V265127.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 Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Village Nursing Home Address Church Road Banks Southport Lancashire PR9 8ET 01704 220061 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) Parkcare Homes (No. 2) Limited Mrs Doreen Whitlow Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (2) of places The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The service should, at all times, employ a suitably qualified and experience manager who is registered with the NCSC. Up to 40 service users in the category OP (Old Age) who need nursing care. Up to 20 service users in the category OP (Old Age) who need personal care only. Up to 2 service users in the category of PD (Physical Disability). Date of last inspection Brief Description of the Service: The Village is a forty-bedded care home with nursing set in its own wellmaintained grounds. Two beds are available for service users with a physical disability and there is a trained nurse on duty at all times. At the time of inspection there were thirty-six people living at the home. Twenty-one were receiving nursing care and fifteen receiving personal care. The home is purpose built, with all accommodation at ground floor level. There is easy access for wheelchair users and the less mobile. All bedrooms have an en-suite facility and there are two shared bedrooms available. Communal space for residents comprises a lounge, dining area and two small seating areas along the corridors. The home has a patio area to the front and garden with greenhouse and patio to the rear. The Village Nursing Home DS0000025583.V265127.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 that took place over six and a half hours in January 2006. Some of the National Minimum Standards assessed had been met and for those not fully met only minor shortfalls were identified. The overall standard of care provided was good and the management team had addressed most issues raised at the last inspection. The inspection involved discussion with the people who lived and worked at the home, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. What the service does well: What has improved since the last inspection? The care planning process now includes residents or their representative. This provides them with an opportunity to be consulted about the programme of care the home provides, discuss any concerns or worries and identify any additional needs or preferences. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 6 Improved training and development opportunities for staff have helped make sure that they have the necessary skills and underpinning knowledge needed to help them to carry out their work safely and effectively. An ongoing redecoration programme has meant that all but 4 bedrooms have been redecorated and had new floor covering. The appointment of a new handyman has improved the management of basic internal maintenance and repair so that residents personal continue to benefit from living in a wellmaintained environment. 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 Village Nursing Home DS0000025583.V265127.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 Village Nursing Home DS0000025583.V265127.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): 3 The pre admission processes were not thorough or detailed enough to ensure needs were properly identified before residents came to live at the home. EVIDENCE: Standard 6 is not applicable to this service, as The Village does not provide intermediate care. Standard 3 was not fully assessed, however progress in meeting the requirement made at the last inspection in relation to preadmission processes was monitored. Records showed that preadmission assessment documents in relation to one new resident had not been completed so the home was unable to show that a full assessment of need had been carried out. Some shortfalls were also identified in the preadmission format used for another resident in that a full and detailed history had not been obtained before they came to live at the home. Not having a full and detailed preadmission assessment means that The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 9 important information might be missed and the delivery of care on or shortly after admission might be adversely affected. The Village Nursing Home DS0000025583.V265127.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, 9 The care planning process was thorough enough to ensure that individual needs were clearly documented and involved residents or their representative. Parts of the risk assessment process were not thorough enough to ensure that care is delivered as safely as possible. The systems in place for handling medication were thorough enough to protect residents. EVIDENCE: Standard 7 was not fully assessed however, progress in meeting the requirement made at the last inspection in relation to consulting residents or their representative during the care planning process was monitored. Since the last inspection care plans had been formatted to show who had been involved in developing care plans. A relative had signed the care plans, on behalf of the residents, to show that they had been included in the care planning process and had been given the opportunity to discuss the care The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 11 provided and request any additions or changes. Care plans and assessments had been dated and signed as recommended at the last inspection. A recommendation was made at the last inspection about obtaining advice about the use of bed rails so that any risk to residents who needed bed rails could be properly identified and managed. The manager obtained the information but had not used it to form the basis of a thorough risk assessment. A requirement was made at the last inspection regarding the safe use of bed rails and this remains outstanding. Polices and procedures describing the handling of medication were available within the home so staff had clear guidance to follow. Only trained nurses were authorised to administer medication and a sample list of signatures was kept at the front of the medication file so that checks for compliance could be made. The pre-printed medication administration records (MAR) were generally up-todate and drugs had been receipted correctly. However, the records should show the exact dose of medication administered when medicines have been prescribed with a variable dose. The medication storage was orderly and secure and the refrigerator temperature recorded. It was noted that eye drops had not been dated on first opening, this is recommended to help ensure they are not used for extended periods. New arrangements had been made for the disposal of medicines to reflect recent changes in legislation. A revised procedure was in place and a copy attached to the front of the medication file so that staff were all aware of the new procedures. The Village Nursing Home DS0000025583.V265127.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 The range of social activities available met the expectations of people living at the home. The management arrangements in place at the home, underpinned by organisational policies and procedures, supported residents to maintain contact with family and friends. EVIDENCE: Records showed that attention was paid to helping residents to take part in activities that were already established or developed in the home so that the lifestyle experienced by residents met their expectations and preferences as much as possible. Discussion with residents showed that they were satisfied with the range of activities available and that they were able to choose what events or activities they wanted to join in with. At the time of inspection a group of residents were playing bingo with the activities organiser. They were enjoying this activity and spoke positively about the way in which activities were organised for them. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 13 The statement of purpose outlined the home’s visiting policy and included a statement about residents being able to exercise choice in relation to visitors. This meant that residents and relatives knew what the home’s approach to visiting was and could comply with any policies operated by the home. Residents spoken to confirmed that they were able to see visitors in their own room or in one of the communal areas of the home so the meetings could be private if they wished. Discussion with the manager and staff showed that they understood the importance of residents maintaining contact with their family and friends, as they are still an important part of their life. One resident said, “My daughter visits every day, they always make her welcome, she can come anytime she wants”. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home had a clear and accessible complaints procedure so that residents knew how and who to complain to. EVIDENCE: A complaints procedure was in place and residents spoken to know how and who to complain to. One resident said, “I’d go to the matron if I had a complaint but we don’t have any”. Resident’s spoken to felt that they were encouraged to raise any concerns they might have about the home, that they would be listened to and action would be taken on any issues raised. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: The key environmental standards were not fully assessed at this inspection. Standards 19,25, and 26 were fully assessed at the last inspection. The last inspection report made two requirements about cleaning or replacing badly stained carpets and ensuring that pipe work in bathrooms was properly guarded. A recommendation was made about making sure that the facilities and services comply with the Water Supply (Fittings) Regulations 1999. Some progress towards meeting the requirements had been made in that some pipe work had been covered and some bedroom carpets replaced. However, the two requirements and one recommendation remain outstanding, as work still needs to be done to ensure that residents continue to live in a safe and wellmaintained environment. The Village Nursing Home DS0000025583.V265127.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): 28,29,30 Training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. The recruitment process was thorough enough to ensure the continued protection of residents. EVIDENCE: Training records showed that new staff received induction and ongoing training that provided them with the basic skills needed to carry out tasks allocated to them. Staff spoken to said that training opportunities were good and that regular training courses were held for fire safety, moving and handling and other health and safety topics so that they were kept up to date about safe working practices. National vocational training (NVQ) was available to care staff and some care staff had already achieved level two or three. The manager was aware of the need to ensure that fifty per cent of care staff have completed this training before the national minimum standard can be considered fully met. A recruitment checklist was in place to assist the recruitment process. Records showed that the recruitment process was thorough and took into account the need to protect residents. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 17 Discussion with the manager showed that she was aware of her responsibility to appoint suitable staff that would be able to provide good care and the continuing need to protect people living at the home. Records showed that staff had received a statement of terms and conditions of employment and a job description so that they knew what their responsibilities were and what was expected of them. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 18 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, 33, 35, 38 Residents lived in a home, managed by a responsible person who was able to make sure the home met its stated purpose and was managed and organised in a way that helped make sure the service was run in the best interests of residents. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. The systems in place for managing health and safety matters were thorough enough to ensure the continued safety and welfare of people living and working at the home. EVIDENCE: The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 19 Records showed that the registered manager is a first level registered nurse who has extensive experience of running and managing a care home for this client group. The registered manager is due to retire in the next year and does not plan to complete a relevant management qualification. This has not affected her ability to manage the home and ensure that it meets its stated purpose, aims and objectives so that residents feel safe and well looked after. One resident said, “ I am very happy here and I am well looked after”, another one said, “It’s very good here, we are looked after”. Discussion with staff showed that the manager provided leadership and direction so that every one knew what their role was and what was expected of them. A system was in place to monitor the quality of service delivered so that the home could be made aware of its strengths, weaknesses and whether residents were satisfied with the service they received or not. This was achieved by sending out satisfaction questionnaires each year. The feedback obtained was collated and a summary made available to so that residents could be reassured that their views were acknowledged and contributed to the running of the home. Discussion with the manager showed that feedback from the survey was used as a means of improving and developing the service. An annual development plan was not available so the inspector was not able to confirm that feedback from residents had been included in it. The home handled few personal allowances for residents. Satisfactory written and computerised records of any personal allowances received for residents were kept, which showed income expenditure and any remaining balance. The administrator was able to discuss the management procedures in place at the home and how they protected the financial interests of residents. Any valuables or money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so a clear audit trail of income and expenditure was available if needed. When asked about access to their money one resident said, “my family looks after my money, if I want anything I ask the staff and they sort it out”. Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. A risk assessment that outlined action to be taken to control the risk of legionella had been developed by the parent company but had not been fully implemented at the home so the risks weren’t fully managed. Discussion with staff indicated that they had received instruction in relation to safe working practices, such as moving and handling training and first aid The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 20 training so that they had been provided with the theoretical knowledge to make sure they were up to date with current good practice and able to carry out procedures safely. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14(1)(c) Requirement A full assessment of need must be carried out on residents before they come to live at the home. Residents or their representative must be given the opportunity to be involved in the assessment process. (Timescale of 30th September 2005 met). Risk assessments regarding the use of bed rails must be carried out. The assessment needs to identify the risks associated with their use, management strategies to reduce the risk and be kept under review. (Timescale of 30th September 2005 not met). Carpets identified at inspection must be replaced if cleaning fails to remove the deep stains. (Timescale of 31st October 2005 not met) Pipe work in bathrooms must be appropriately covered. (Timescale of 31st October 2005 not met). Measures to control the risk of legionella as identified in the home’s risk assessment must be DS0000025583.V265127.R01.S.doc Timescale for action 03/03/06 3. OP7 13(4)(c) 28/02/06 4. OP19 23(2)(d) 31/03/06 5. OP25 13(4)(a c) 31/03/06 6. OP38 13(3) 31/03/06 The Village Nursing Home Version 5.0 Page 23 in implemented. 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 2 3. 4. Refer to Standard OP9 OP9 OP26 OP38 Good Practice Recommendations Prescribed medications with a limited shelf life should be dated when opened. Medication administration records should show the dose of medicine administered when it is prescribed with a variable dose. The home should ensure that the facilities and services available comply with the Water Supply (Fittings) regulations 1999. The registered manager should ensure that measures to control the risk of legionella as identified in the home’s policy and risk assessment are fully implemented. The Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Village Nursing Home DS0000025583.V265127.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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