Inspection on 08/11/05 for The Withens Nursing Home

This inspection was carried out on 8th November 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 Withens Nursing Home 24/09/08

The Withens Nursing Home 27/10/06

The Withens Nursing Home 25/04/05

The Withens Nursing Home 16/08/04

The Withens Nursing Home 01/04/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Withens Nursing Home Hook Green Road Southfleet Kent DA13 9NP Lead Inspector Elizabeth Baker Announced Inspection 8th November 2005 09:20 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 Withens Nursing Home DS0000026215.V251678.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 Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Withens Nursing Home Address Hook Green Road Southfleet Kent DA13 9NP 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) 01474 834109 01474 833032 Ranc Care Homes Limited Mrs Colleen Margaret Chandler Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2005 Brief Description of the Service: The Withens Nursing Home is a care home providing nursing care for thirtythree older people. The home is situated within the small village of Southfleet. The home is a modern two-storey converted property with a purpose built extension, set within grounds of approximately one acre. Bedroom accommodation comprises 23 single and five double bedrooms. Seven single bedrooms have ensuite facilities. A number of bedrooms have the benefit of views of the neighbouring countryside and gardens. Bedrooms vary in shape and size. Day space consists of a large lounge and adjoining conservatory. There is a large separate dining room. All accommodation on the first floor can be accessed by a four-person passenger lift. Corridors are fitted with handrails. Southfleet is served by a limited bus service to and from Gravesend, Longfield and New Ash Green. Train services from Longfield and Gravesend regularly connect with London, the Kent Coast and Medway towns. The home is approximately one mile from the A2 and approximately four miles from the main A2/M25 orbital junction. The Bluewater shopping complex at Greenhithe is accessible by private transport. Limited onsite parking is available. There are no suitable off site parking facilities in close proximity to the home. The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over six and a half hours on the 8 November 2005. A partial tour of the home was carried out. Some residents, visitors and staff were spoken with. Three residents and one member of staff were interviewed in private. At the time of the visit the home was full. The Registered Manager Mrs Chandler and the organisation’s Director of Nursing and Operations, Mr R Greaves, were available throughout the inspection process. Some judgements about the quality of care, life and choices were taken from conversations with residents, visitors and staff, as well as direct and indirect observations. Some records were seen as part of case tracking and to assess work on the requirements and recommendations made at the last inspection. In response to the announcement of this inspection the Commission received a total of 39 comment cards from residents (5), relatives/visitors (21), GPs (4), Health and Social Care Professionals (5) and Care Managers (4). Some of their comments have been incorporated into this report. This is the second inspection of this home for the year 2005/06. Not all key standards have been inspected on this occasion, where they were met at the first visit. The report should therefore be read in conjunction with the inspection report dated 25 April 2005. What the service does well: What has improved since the last inspection? Three more health care assistants are now trained to NVQ level II care, and others are awaiting their final assessment results. A hobby therapist has been employed and new activities are being planned with input from residents. Eight bedrooms have been redecorated and the reception room seating has been renewed. This is part of the home’s rolling upgrade and refurbishment The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 6 programme. The odours previously identified were not apparent on this visit. A number of requirements and recommendations made following the last inspection have now been completed. 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 Withens Nursing Home DS0000026215.V251678.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 Withens Nursing Home DS0000026215.V251678.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): N/I EVIDENCE: Standard 3 was met at the last inspection. The home is not registered for intermediate care. Standard 6 is not applicable. The Withens Nursing Home DS0000026215.V251678.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, 10 and 11 Care records do not contain full and precise details to ensure residents’ complete needs and wishes are met. Personal care is offered in a way to protect residents’ privacy and dignity. EVIDENCE: Three care records were inspected as part of the case tracking process. Care records comprise care plans and supporting risk assessments including prevention of falls, skin integrity (Waterlow), moving and handling, oral hygiene, weight charts and nutrition. Generally these supported the care plans. Corresponding admission assessments contained scant information on all the residents’ needs and one had not been completed of the base line observations. Sexuality and specific personal hygiene and social needs are not adequately covered. For example hygiene needs did not include specific details of the resident’s actual preference to what type and how they wished to be shaved. For a resident who requires oral hygiene care, there was no precise information about this. Mr Greaves said care record models are to be reviewed and a new system devised as part of the organisation’s quality assurance programme. The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 10 Care records did not provide adequate information in respect of death and dying and last rites. Assistance details as to how the home may be able to obtain this sensitive but vital information has subsequently been provided to the manager. Specialist clinicians visit the home to provide support when the assessed needs of residents require this. Where appropriate residents are involved in their plan of care. This is particularly important with regard to non-medical matters. The inspection of two medication administration record charts in support of the care plans inspected identified they had been completed appropriately. However in both cases medications had been prescribed on an “administer as required” basis. The corresponding care plans did not include adequate details about when it was appropriate to administer the medication. Through discussion it was identified that the home does not yet have a contract for the correct disposal of waste medications as is required by legislation. Mr Greaves said the organisation is currently in discussions with a waste contractor and expects the matter to be concluded shortly. A resident said staff provide assistance with his personal care needs in a dignified manner. The Withens Nursing Home DS0000026215.V251678.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): 14 The independence of residents is respected and assisted. EVIDENCE: Standards 12, 13 and 15 were met at the last visit and have not been reinspected. Residents are supported in handling their own financial affairs where they have requested to do so. Bedrooms visited had been individualised by personal affects. Following the appointment of a new hobby therapist, residents meetings are again taking place. This allows residents to voice their views, opinions and suggestions on the services, activities and facilities provided by the home. The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 12 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): N/I Standards 16 and 18 were inspected and met at the last visit. EVIDENCE: The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 13 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, 21, 23, 24 and 26 The home has a rolling maintenance and redecorating programme creating a comfortable environment for residents to live in. Carpets must be maintained in good condition to prevent potential risks to residents, staff and visitors. EVIDENCE: The home was clean, warm and odour free at this visit. Some “old” stains are still visible in certain areas of corridor carpets both on the ground and first floors. A particular area of ground floor corridor carpet is frayed and presents a potential trip hazard. Since the last inspection part of the front fence has been replaced, two new refrigerators have been acquired, the lift floor has been renewed and the reception room seating has been replaced. Eight bedrooms have been redecorated and one resident commented that they had been involved in the colour scheme of their room. A resident said they particularly liked their room because they can see into the gardens from the bed or chair, and they get enjoyment from this. Sadly not all rooms provide such good views. The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 14 The sluice room inspected had been de-cluttered of inappropriate items and allowed easy access for cleaning and operational purposes. A comment card respondent added that they are not able to meet and talk with their [relative/friend] in private. The home does not currently have a room for private meetings or indeed for residents and or staff to use for quiet or contemplative purposes. The home has a variety of beds, including adjustable height models, which are provided to residents on an assessed needs basis. Special pressure relief and preventative equipment is also supplied when required. Screening is provided in double bedrooms and a resident recalled that it was appropriately used when she occupied such a bedroom. The Withens Nursing Home DS0000026215.V251678.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): 27, 28 and 29 Staff morale is good resulting in an enthusiastic workforce that works positively with residents to improve their quality of life. EVIDENCE: A review of two staff files indicated that systems are in place for recruiting and appointing staff. However the maintenance of the two files did not provide for a coherent audit. As reported previously Mr Greaves said all records and files are now subject to review as part of the organisation’s quality assurance programme. Since the last inspection three more health care assistants have successfully completed their NVQ level II care course. Other health care assistants are in the last stages of their course. Thirty-five percent of unregistered care staff are now appropriately trained. Registered Nurses and health care assistants were seen carrying out their duties in an unhurried manner. In addition to care staff, staff are employed for activities, administration, catering, cleaning, laundry and maintenance. The home also has the support of the organisation’s Director of Nursing and Operations, who ensures he is always contactable. The new hobby therapist spoke enthusiastically about her role and about proposals she has discussed with residents for future activities. The Withens Nursing Home DS0000026215.V251678.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): 31, 32, 33, 35, and 38 The system for resident consultation has improved enabling them to voice their opinions on the services and facilities provided at the home. EVIDENCE: Mrs Chandler has run the home for almost ten years and has the necessary qualifications to manage a care home providing nursing care. Residents, visitors and staff spoke freely about their experiences of the home during the inspection process. The home keeps small amounts of monies on behalf of some residents at their request and convenience. Following recommendations made at the last inspection the administrator now records details of the source of credit amounts received on behalf of individual residents in respect of their personal monies. This enables better auditing. The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 17 Mrs Chandler reported that results of the homes own satisfaction surveys are now published and made available to prospective residents and their advocates by inclusion in the service user guide. Although the problem with fluctuating lighting continues, the home is in correspondence with the energy company responsible for the supply in order that the power surge problems can be satisfactorily resolved. Despite the home being in discussion with the parish and borough councils, the problem with car parking continues. Indeed on the day of the inspection cars had to be moved around in order for visitors to drive safely away from the home. The location of the home does not allow for safe road parking or indeed reversing onto the road. The fire safety logbook identified regular checks of the home’s fire safety system and equipment are carried out. The returned pre inspection questionnaire records regular maintenance and service checks are carried out on the home’s equipment. The Withens Nursing Home DS0000026215.V251678.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 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 2 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 2 The Withens Nursing Home DS0000026215.V251678.R01.S.doc Version 5.0 Page 19 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 OP19 Regulation 23 Requirement Worn and stained carpets must be repaired or replaced. (Timescale of 31 December 2005 not yet expired) The electricity supply to the home must be improved. (Timescale of 30/09/05 not met but problem acknowledged by energy supplier who is liaising with provider) Arrangements are made for the disposal of waste medication to comply with current legislation. Timescale for action 31/12/05 2 OP38 23 30/04/06 3 OP9 13 31/12/05 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 Refer to Standard OP7 OP9 Good Practice Recommendations Care plans must contain precise details of all residents’ individual needs, wishes and preferences including personal hygiene, sexuality and oral hygiene. Precise administration details of “when required” medication must be recorded. DS0000026215.V251678.R01.S.doc Version 5.0 Page 20 The Withens Nursing Home 3 4 5 6 7 OP11 OP19 OP19 OP20 OP28 Care records must include details of residents’ wishes and preferences in respect of death, dying and last rites. Damaged internal doors must be repaired or replaced. (This was not inspected or discussed on this visit). The home must have appropriate safe parking to reflect the size of the home. A room should be available for private meetings and quiet purposes. Fifty percent of care staff must be trained to NVQ level II care. The Withens Nursing Home DS0000026215.V251678.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 © 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 Withens Nursing Home DS0000026215.V251678.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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