Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 06/01/06 for Throckley Nursing & Residential Home

Also see our care home review for Throckley Nursing & Residential Home for more information

This inspection was carried out on 6th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a stable staff team who have worked at the home for many years. They are keen to raise standards and give quality consistent care to each resident. The residents and their visitors said that the staff "work hard" and that " nothing is a trouble to them". The staff put a lot of effort into arranging activities both within and outside the home. Residents said that they always had something to do if they wanted to join in, other residents said that they preferred their own company and this was respected by the staff. Meals are nutritious, well presented and residents can choose what and where to eat. The staff and residents are kept informed about the running of the home. Residents and their visitors said they would be able to raise a concern or complaint and felt confident that any issue would be dealt with as soon as possible.

What has improved since the last inspection?

Several of the requirements from the last inspection have been addressed. Refurbishment and redecoration continues to improve the communal areas of the home. New corridor carpets are currently being laid and the bedroom carpets are being replaced as part of a planned programme. This has improved the general housekeeping and tidiness of the home.

What the care home could do better:

Whilst redecoration and improvements to the building have taken place further work must be done to make sure the home is safe and comfortable for the residents. A full review of the bathing facilities and practices is needed to ensure the residents have suitable access to equipment that meets their needs. The outstanding requirements from previous inspection reports must be dealt with without further delay this includes repair and replacement of the kitchen flooring, review of the practice of hand washing commode pots, access to effective hand washing, general infection control practices and ensuring all light cords and emergency call cords are accessible and easy to clean.

CARE HOMES FOR OLDER PEOPLE Throckley Nursing & Residential Home Ponteland Road Throckley Newcastle Upon Tyne Tyne & Wear NE15 9EP Lead Inspector Mrs Irene Bowater Unannounced Inspection 6 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 DS0000040481.V258041.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. DS0000040481.V258041.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Throckley Nursing & Residential Home Address Ponteland Road Throckley Newcastle Upon Tyne Tyne & Wear NE15 9EP 0191 267 5655 0191 229 1119 throckleygrange@highfield-care.com 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) Southern Cross Home Properties Limited Mrs Elizabeth Ann Brennan Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places DS0000040481.V258041.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th April 2005 Brief Description of the Service: The home is purpose built and located in the centre of Throckley. It is close to all local amenities and is on a local bus route. The home caters for up to 50 older persons and has a maximum of 35 nursing care beds. There are spacious communal areas, dining rooms, separate smoking lounge and a passenger lift services all areas. The home has 44 single bedrooms and 3 companion rooms, including 3 with en-suite facilities. The home has assisted bathing facilities situated close to residents bedrooms. Externally there are accessible gardens, patio areas and car parking is available. The home has access to a shared mini bus for outings. DS0000040481.V258041.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 tool place over six hours. The home has had one additional visit in September 2005.That visit was to assess the progress to meet the requirements from the inspection carried out in April 2005. This inspection focused on these requirements, standards that had not been assessed and the quality of life experienced by the residents. An inspection of the home was undertaken and nine staff, thirteen staff and two relatives were spoken to throughout the day. Various records were also inspected. What the service does well: What has improved since the last inspection? Several of the requirements from the last inspection have been addressed. Refurbishment and redecoration continues to improve the communal areas of the home. New corridor carpets are currently being laid and the bedroom carpets are being replaced as part of a planned programme. This has improved the general housekeeping and tidiness of the home. DS0000040481.V258041.R01.S.doc Version 5.0 Page 6 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. DS0000040481.V258041.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 DS0000040481.V258041.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, 5. The comprehensive admission assessments ensure the residents care needs will be met. Pre admission visits enables residents to test the home to ensure it will meet their needs. EVIDENCE: All residents who move into the home have a comprehensive assessment carried out by care mangers and the home manager. The manager confirmed that visits are carried out at the hospital or the resident’s home if required. These assessments form the bases of the care planning process. The staff confirmed that residents and their representatives are encouraged to visit the home before admission. Potential residents are able to spend a half or full day at the home getting to know other residents and the staff. Residents have a six-week trial period then a full review before deciding to move into the home on a permanent basis. DS0000040481.V258041.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 The care planning systems provide staff with the information they need to meet residents’ needs. The health care needs of residents are met with evidence of multidisciplinary working taking place on a regular basis. The systems for the administration of medicines are well managed promoting residents good health. The staff have a good understanding of the residents support needs and they promote and protect residents right to privacy, dignity and independence. EVIDENCE: Each resident has a care plan, which is based on the admission assessment. The care plans inspected were generally completed to a good standard. There were minor shortfalls in one care plan and this was discussed with both the manager and deputy manager for remedial action. There was evidence of relevant risk assessments for the prevention of falls, pressure sore and wound care, moving and assisting, catheter care, continence promotion and mental health status. A further screening tool (Malnutrition Universal Screening Tool) DS0000040481.V258041.R01.S.doc Version 5.0 Page 10 has been introduced to monitor residents nutritional status. This ensures that the staff can immediately identify anyone at risk and provide the appropriate care. All residents have access to NHS facilities. GP cover is provided from three surgeries and one GP visits the home weekly. The district nursing service provides the nursing care for residents receiving personal and social care. There are policies and procedures in place to ensure the safe administration of medicines. A random audit of Medicine Administration Records and Controlled Drugs was satisfactory. The storage was safe and there is limited use of controlled drugs. There is a record of all medicines received and disposed of and the home maintains a register of staff who are authorised to administer medicines. Throughout the day the staff were observed to assist residents in a friendly professional manner. The residents and relatives all spoke highly of the staff, saying how well they are looked after all of the time. DS0000040481.V258041.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 Social activities are organised, creative and provide stimulation and interest for residents living in the home. Support from the home and the local community ensures that residents are given opportunities to maintain previous lifestyle links. Residents are supported to maintain their independence and retain control over their lives for as long as they are able to do so. Dietary needs of residents are well catered for with a balanced and varied selection of food available, which meets their taste and choices. EVIDENCE: The home has a designated activities person who organises events according to residents’ wishes both inside and out of the home. There is relevant information about the activities, which is well presented and enjoyable to read. Residents enjoy board games, baking, music afternoons, reminiscence, karaoke, and an artist class. Some of the artwork is available in the home. The home also has access to the Company mini bus and residents enjoy trips out to the shops, coast and countryside. DS0000040481.V258041.R01.S.doc Version 5.0 Page 12 Relatives and other visitors are welcome at any time and they can visit in the communal areas or in the resident’s rooms. The home has contact with the local churches and schools. The staff encourages the residents to maintain control over their lives for as long as possible. Information about advocacy is available and the manager is always available to offer advice if necessary. All of the residents have brought small items of furniture and other belongings with them making the bedrooms highly individualised and homely. All of the residents spoken to were complimentary about the meals. Comments included “the food is good”, “there is always plenty”, and “I get whatever I want”. The home provides menu choices for all meals. Several of the residents said they have a cooked breakfast and others prefer cereals and toast. The lunchtime meal consisted of three courses and all of the meal was well presented and of ample portion size. There were jugs of various juices and fruit available and there were choices of mid morning and fortified drinks. The staff assisted residents in an unhurried and sensitive manner and the problems regarding the deployment of staff at mealtimes is currently resolved. DS0000040481.V258041.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home has a satisfactory complaints system with evidence that residents and their representatives feel their views are listened to and acted upon. Staff have knowledge and understanding of Adult Protection issues, which protects residents from harm. EVIDENCE: The home has policies and procedures in place should residents or their representatives have any concerns or complaints. The records are detailed and show that investigations, actions and outcomes are recorded. Residents and relatives said they would be able to use the procedure should they have any concerns. Two complaints have been received and resolved at home level since the last inspection. The staff have had training in the Protection of Vulnerable Adults and were able to discuss the action they would take should there be any suspicion or allegation of abuse. DS0000040481.V258041.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,26 Recent investment has improved the appearance of this home. There are a number of maintenance matters, which put residents at risk and do not provide a safe environment in which to live. EVIDENCE: The location and layout of the home is suitable for the residents who live there. During 2005 the home has complied with several requirements and the continual refurbishment and redecoration will result in a pleasant place for residents to live. The communal areas and corridors have been redecorated and new furniture and furnishing provided. On the day of the inspection new corridor carpets were being laid. The carpets in the lounges are many years old and are to be replaced as part of the refurbishment programme. The home has three floors with bathrooms and toilets on each floor. There is no assisted bath on the ground floor. Residents are hoisted into a domestic bath with the aid of a mobile hoist and bathing sling. If they wish they could go to the second floor where there is an DS0000040481.V258041.R01.S.doc Version 5.0 Page 15 assisted bath. This had been serviced, however it was then condemned. There is no assisted bath on the third floor and the residents are taken to the second floor for bathing. The shower is not used, as it is not accessible for anyone with a disability. The problems regarding the bathing facilities were highlighted at the last inspection. Many of the rooms have been decorated and new carpets provided. The carpet replacement is to continue as other bedroom carpets are worn and frayed. One carpet, which was a tripping hazard, was identified and the manager confirmed that a replacement carpet was laid as soon as possible. Profiling beds are being provided for residents who require nursing care .The residents have been encouraged to bring small items of furniture and other items with them making the bedrooms highly personalised and comfortable. All areas were tidy and fresh smelling and high standards of cleanliness are maintained. The laundry was organised and all of the equipment was in working order. There continue to be issues, which have not been addressed regarding infection control. There is damage and wear beneath the soap dispense and the boxing in communal toilets. The flooring in the laundry is lifting and splitting. There is still no provision of liquid soap and hand towels in all resident areas to enable effective hand washing. The practice of using an open sluice hopper and hand washing soiled commodes prior to using the sluice machine is an infection risk. All of the light cords and emergency call cords were grimy, knotted and could not be cleaned. DS0000040481.V258041.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29.30 The staffing levels are adequate to meet the needs of the residents. There is core staff team who are trained and work positively with residents. The procedures for the recruitment of staff are robust offering protection to residents living in the home. EVIDENCE: The home has experienced staffing problems over a considerable length of time. There is an ongoing recruitment drive, which has had some success. The home benefits from a core staff team who have worked at the home for a long time. The staffing levels in the home are: 2 1 7 5 6 4 Qualified Nurses from 8am to 9pm Qualified Nurse from 9pm to 8am carers from 8am to 2pm carers from 2pm to 4pm carers from 4pm to 9pm carers from 9pm to 8am The home employs adequate ancillary staff including an administrator, activities organiser, maintenance, chef, kitchen assistants, domestic and laundry staff. The manager is usually supernumerary and she is well supported by a deputy manager. DS0000040481.V258041.R01.S.doc Version 5.0 Page 17 The problems identified at the last inspection about staffing levels at mealtimes have been resolved. The staff confirmed that NVQ training is ongoing and they are provided with statutory and specialist training. The home has a training and development programme, which is regularly audited and updated as necessary. All of the staff has a training and development file, which contains information about their individual training. Five personal records were inspected and found to contain Criminal Record Bureau checks, two references, proof of identity, medical clearance and terms and conditions of employment. DS0000040481.V258041.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): 31,32,33,35,36,38 The current management of the home is satisfactory and run in the best interests of the residents who are safeguarded by organised financial procedures. There are issues in the maintenance of the building that pose potential hazards to residents, staff and visitors safety. EVIDENCE: The registered manager is a first level registered nurse who has considerable in the care of older people. She has completed the Registered Managers Award. As a qualified nurse she has to up date her skills in order to maintain her registration with the Nursing and Midwifery Council. There are regular staff meetings to discuss all aspects of care and service provision. Minutes of all meetings are available with actions and outcomes recorded. Staff said that the manager is always available and that they are able to discuss any issue with her. DS0000040481.V258041.R01.S.doc Version 5.0 Page 19 Quality assurance systems have been implemented, however the results of the surveys are not available. The manager has introduced a monthly open surgery for residents and relatives. The manager confirmed that attendance and interest has been poor. Relatives said that the manager is readily available and their views about the home are taken into account. The home maintains detailed records for resident’s personal allowances. There are individual transaction records with receipts and two signatures for all entries. A random audit found no discrepancies. The staff files showed that formal supervision takes place six times a year and staff have a yearly appraisal. The staff receives training in safe working practices including fire, moving and handling, first aid, food hygiene and health and safety. The records for maintenance and health and safety were found to be up to date. These include checks for hoists, slings, bed rails and window restrictors. The fire risk assessment has been completed and the accident recording and analysis is comprehensive. There remains tripping and falls risk due to worn, damaged carpets. The kitchen flooring is split and sinking. The fridge is held up with a wooden plinth, there is a tripping hazard where a new piece of vinyl has been laid and the flooring is not easily cleanable. DS0000040481.V258041.R01.S.doc Version 5.0 Page 20 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 1 2 X 2 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 3 2 DS0000040481.V258041.R01.S.doc Version 5.0 Page 21 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 13, 23 Requirement The home must continue to replace the lounge carpets as part of an ongoing refurbishment programme. Timescale of 01/12/05 not met. Review the bathing practices in the home to ensure all the facilities, including the shower room are operational to meet residents assessed needs. Timescale of 01/08/05 not met. There must be sufficient assisted bathing facilities provided to meet the assessed needs of the residents. There must be 1 assisted bath to 8 residents. Continue to replace the bedroom carpets as part of the ongoing refurbishment programme. Timescale of 01/12/05 not met. Review the practices of cleaning the soiled commode pots. Repair the laundry floor. Timescale of 01/09/05 not met. Replace or repair the kitchen DS0000040481.V258041.R01.S.doc Timescale for action 01/06/06 2. OP21 23 01/06/06 3. OP21 14,16,23 01/06/06 4. OP24 16,23 01/06/06 5. OP26 13,23 01/06/06 6. OP38 13,23 01/04/06 Page 22 Version 5.0 flooring. Timescale of 25/11/04 not met. 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 OP26 Good Practice Recommendations It is highly recommended that the home provides liquid soap and paper towels in all resident areas to enable effective hand washing. DS0000040481.V258041.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000040481.V258041.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!