Inspection on 14/06/05 for The Village Nursing Home

This inspection was carried out on 14th June 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 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 12/01/06

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 Announced 14 June 2005 09:30 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 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 F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 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 OP - Old age (40) registration, with number PD - Physical disability (2) of places The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Up to 40 service users in the category OP (Old Age) who need nursing care. 1. Up to 20 service users in the category OP (Old Age) who need personal care only. 2. Up to 2 service users in the category of PD (Physical Disability). 3. The service should at all times, employ a suitably qualified and experienced manager who is registered with the NCSC. Date of last inspection 06.01.05 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-nine service users living at the home. Twenty-two were receiving nursing care and seventeen 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 rooms have an ensuite facility and there are two shared rooms. Communal space for service users 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 F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one day in June 2005. 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 of 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. Comment cards completed by residents, relatives and visiting health care professionals have also been used in the compilation of this report 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. All residents spoken to were satisfied with the care they received. They said, “I get whatever I need here”, and “It’s good here and I’m quite satisfied with everything”. What the service does well: Care is provided in comfortable, homely surroundings in which the residents feel safe and well cared for. Good relationships have been developed between residents and staff so that residents feel comfortable and have some control over their lives. Residents are able to make choices about they do so that they have some control over their lifestyle. One resident said, “They (the staff) always ask what I want to wear and what I want to do”. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 6 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 Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 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: Discussion with the manager showed that a trained nurse from the home, who was experienced in assessment procedures undertook assessments for people considering coming to live there. This should have ensured that the assessment process was thorough and sufficient detail obtained to show a clear assessment of individual need. However, the information obtained was too brief and sections of the assessment form were incomplete. Residents or their representative had not been involved in the assessment. This meant that prospective residents could not be certain that their needs and wants had been fully assessed and understood or that the home could meet all their needs. When asked about assessments before coming to live at the home one resident said, “yes, someone came to see me and asked me some questions and then I came here”. Others said, “I knew all about the home before I came, because The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 9 I’m from round here”. “I don’t know if I was assessed or not, I come from round here so knew the home”. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 standard(s) 7, 8 The care planning process was not thorough enough to ensure the continued health, welfare and safety of people living at the home. EVIDENCE: Care records seen showed that each resident had a plan of care drawn up from information gained prior to or on admission to the home. The plans had not been agreed with the resident or a relative. This meant that residents or their relatives did not have some idea of what care they should expect to receive whilst living at the home. It also stopped them from having the opportunity to discuss any concerns and identify any specific needs or preferences. Risk assessments, particularly those relating to the use of bed rails were also too brief and need to be improved to ensure the continued safety of residents Records showed that people living at the home had access to health care services according to individual need so that specialist advice and treatment could be provided. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 11 Residents were settled, appropriately dressed and well cared for. When asked about the care they received residents said, “yes I am happy with the care, I get help with washing and dressing” and “Yes, I get whatever I need”. Staff were able to discuss the individual needs of the people they cared for and how they organised their workload to ensure those needs were met. They made reference to way they used the care plans and attended regular handovers when there was a change of shift, so that they were kept informed of any changes to the care residents needed. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 standard(s) 14 & 15 Day to day working practices at the home enabled residents to make choices and have some control over their lives. Measures were in place to ensure that residents received a well balanced diet they had chosen in surroundings of their choice. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised and residents were given the opportunity to choose the colour scheme of their bedroom when it was due for redecoration. A record of all items brought into the home by residents was kept so that staff knew which items belong to each resident. Residents not able to exercise full control over their financial affairs were mainly helped by a family member. The manager was able to give examples of when she had arranged for an advocate to act on behalf of a resident without a representative to ensure that any decisions made were in the best interests of that resident. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 13 Detailed records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. One resident said, “I have breakfast and tea in my room and lunch in the dining room”. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “It’s (the food) quite good really and there are plenty of drinks and I have bottled water in my room and Horlicks at 8pm”. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 standard(s) 18 Management processes regarding abuse were thorough enough to ensure the protection of any vulnerable residents. EVIDENCE: The home had its own adult abuse policy and whistle blowing policy, in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. Induction training records for new staff included a training pack about abuse with a multiple-choice test at the end to assess knowledge and understanding. An update for existing staff had been arranged for July 2005 so that all staff continued to be made aware of the need to protect the people they care for. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 standard(s) 19,25 & 26 The home was clean, comfortable, and homely and provided an environment that was suitable for it’s stated purpose. Improvements were needed to ensure the continued comfort and safety of residents. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and all accommodation was at ground floor level. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. Residents spoken to were happy with their private accommodation and most had personalised their rooms so that they felt more at home. One said, “I like my room, everything is alright and I have enough space for my things”. A programme for maintenance and refurbishment was in place so that furnishings, fittings and décor in all parts of the home could be renewed and kept up to date when needed. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 16 However, some of the carpets were stained despite repeated attempts to clean them. The carpets must be replaced. Not all pipe work was guarded and hot water pipes present a possible health and safety risk to residents. Pipes should be appropriately covered to ensure the continued safety of people living at the home. The home was clean and free from offensive odours. One resident said, “ My room is always clean and tidy”. One visitor said, “ it’s always clean and tidy, it never smells or anything”. Policies and procedures were in place that identified infection control measures in place at the home. Antiseptic cleansing scrub and protective clothing was available to staff to ensure the risk of cross infection was minimised. In order to comply with current legislation and make sure the water systems are safe, the home should check that the facilities and services available comply with the Water Supply (Fittings) 1999. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The skill mix of and the number of staff on duty was sufficient to ensure the needs of residents were met. EVIDENCE: Staff rotas were in place, which showed the number of staff on duty and the capacity in which they were employed. Staffing levels met the minimum requirements of the previous regulatory body and were rostered in sufficient numbers to ensure the needs of residents could be met. When asked about staff residents said, “the staff are good here”, “staff are very kind”. Observations made during the course of the inspection showed that good, caring relationships had been established between residents and staff so that residents felt safe and well cared for. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The systems in place for managing health and safety matters were not thorough enough to ensure the continued safety and welfare of people living at the home. EVIDENCE: This standard was not fully assessed. However progress had been made on all but one of the requirements made at the last inspection. Action must be taken to make sure the outstanding requirement is addressed so that the health and welfare of residents is not compromised. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x 2 2 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x 2 The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 20 YES 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. 1. Standard 3 Regulation 14(1)(c) Requirement A full assessment 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 31st March 2005 not met). Residents or their representative must be given the opportunity to be involved in drawing up and reviewing care plans. Risk assessments regarding the use of bed rails must be caried 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 31st March 2005 not met). Carpets identifed at inspection must be replaced if cleaning fails to remove the deep stains. (Timescale of 31st May 2005 not met) Pipework in bathrooms must be appropriately covered. Measures to control the risk of legionella must be in place. Version 1.30 Page 21 Timescale for action 30th September 2005 2. 7 15(1) 30th September 2005 30th September 2005 3. 7 13(4)(c) 4. 19 23(2)(d) 31st October 2005 31st October 2005 5. 6. 25 38 13(4)(a,c) 13(3) The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc 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. Refer to Standard 7 7 26 Good Practice Recommendations The home should obtain a copy of the guidelines issued by the medical devices agency regarding the use of bed rails. All assessments and reviews relating to the provision of health care should be dated and signed. The home should ensure that the facilites and services available comply with the Water Supply (Fittings) regulations 1999. The Village Nursing Home F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 F57 S25583 The Village V223484 130605 Stage 4.doc Version 1.30 Page 23 - 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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