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Inspection on 20/12/07 for Tyneview Nursing Home

Also see our care home review for Tyneview Nursing Home for more information

This inspection was carried out on 20th December 2007.

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

People who are going to use the service are given detailed information about what the home can offer so that they can decide it can meet their needs. Staff gathers information about the person before they move into the home to make sure they can meet their needs. Care plans show how the care is being provided. They were clear and up to date regarding peoples health and personal care needs. The staff provide a high quality of clinical care and there is good liaison with clinical specialist and other health professionals.Staff have received the specialist health care needs. Visitors are welcomed at any time.training they need to care for complexMeals are varied and of good quality. The complaints and safeguarding procedure are easily understood and readily available. Robust recruitment procedures are followed to make sure people are protected at all times. The registered manager is experienced and has developed a stable staff team who work well together. There are good arrangements for supporting residents to keep their personal monies in a safe place if they want. The Commission for Social Care Inspection sent out surveys to people who use the service before the site visit and comments included the following: "The matron was very helpful and gave me lots of information about the home and what it has to offer." "Staff are very supportive and when I ask questions if they don`t know they go and find out". "There is always a member of staff in the lounge or office and others are never far away". "When I visit the home always smells of home cooked meals and food always looks very good" "I would be happy to approach any member of staff with any concerns" "I have been very happy with the care my relative has received". Comments from other professionals included: "The staff appear to have the right skills and experience". "Provide a high level of nursing care, staff are always aware of needs and are up to date with issues affecting individuals" "I have placed a service user with a high level of complex needs and their care needs have been met appropriately with attention to detail"Tyneview Nursing HomeDS0000018181.V355157.R01.S.docVersion 5.2Page 7"The manager is responsible for a good team of staff who I feel benefit from her management skills, knowledge and values.

What has improved since the last inspection?

The policy on Equality and Diversity has been added to the Service User information pack. The home has purchased a new fax machine so that they can receive sufficient information from Care Managers about people coming into the home at short notice. After talking to the people using the service the lunchtime meal is later as everyone said it was it was served too early after breakfast. An activities person has been employed so that people can again enjoy events both inside and out of the home. A small private garden area is being developed so the people can get outside and enjoy the better weather in the spring. Risk assessments for bedrails are in place and the use of them replaced by bed wedges. Automatic door closures have been fitted. New carpets have been provided on the stairs There are new chairs in the lounge and new flooring in the shower Windows have been replaced in the main lounge and three bedrooms Two lounges have been redecorated. A loop system has been installed in the lower floor lounge.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Tyneview Nursing Home Cuthbert Street Bensham Gateshead Tyne & Wear NE8 1AF Lead Inspector Irene Bowater Unannounced Inspection 20 December 2007 8:00am 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 Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 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. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tyneview Nursing Home Address Cuthbert Street Bensham Gateshead Tyne & Wear NE8 1AF 0191 477 2835 P/F 0191 477 2835 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) Mrs Beverley Anne Tarplee Mr Martin Lang Ms Elizabeth Malley Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36), Physical disability (1), Physical disability of places over 65 years of age (36), Sensory impairment (1), Sensory Impairment over 65 years of age (24) Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service user category PD and SI refer to one specific service user only. 18th May 2006 Date of last inspection Brief Description of the Service: This home is registered as a care home providing nursing and personal care for older people. It is a building that has been converted to its present purpose as a care home. There are three main floors with some further changes of level within these. The home is built on rising ground and the main entrance is at first floor level. It has a passenger lift giving access to all floors. It is situated in an urban setting close to a busy road junction and is accessible by public transport with several major bus routes running by the home. There are no grounds that can be used as recreational space but it has ample car parking. There are a limited range of facilities, such as pubs and shops, within walking distance of the home and it is a short drive to the town centre. The home’s elevated position provides views of the River Tyne and Newcastle to the North and West. The home charges £370 per week which is Local Authority rates.There are no extra charges and information about terms and conditions is available in the service user handbook. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Before the visit: We looked at: • Information we have received since the last visits of 18 May 2006 and 28 March 2007 • How the service dealt with any complaints and concerns since the last visit • Any changes to how the home is run • The provider’s view of how well they care for people • The views of people who use the service and their relatives, staff and other professionals The Visit: An unannounced visit was made on 20 December 2007 During the visit we: • Talked with people who use the service, relatives, staff, the manager and visitors • Looked at information about the people who use the service and how well their needs are met • Looked at other records which must be kept • Checked that staff had the knowledge, skills and training to meet the needs of the people they care for • Looked around the building to make sure it was clean, safe and comfortable • Checked what improvements had been made since the last • We told the manager what we found. What the service does well: People who are going to use the service are given detailed information about what the home can offer so that they can decide it can meet their needs. Staff gathers information about the person before they move into the home to make sure they can meet their needs. Care plans show how the care is being provided. They were clear and up to date regarding peoples health and personal care needs. The staff provide a high quality of clinical care and there is good liaison with clinical specialist and other health professionals. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 6 Staff have received the specialist health care needs. Visitors are welcomed at any time. training they need to care for complex Meals are varied and of good quality. The complaints and safeguarding procedure are easily understood and readily available. Robust recruitment procedures are followed to make sure people are protected at all times. The registered manager is experienced and has developed a stable staff team who work well together. There are good arrangements for supporting residents to keep their personal monies in a safe place if they want. The Commission for Social Care Inspection sent out surveys to people who use the service before the site visit and comments included the following: “The matron was very helpful and gave me lots of information about the home and what it has to offer.” “Staff are very supportive and when I ask questions if they don’t know they go and find out”. “There is always a member of staff in the lounge or office and others are never far away”. “When I visit the home always smells of home cooked meals and food always looks very good” “I would be happy to approach any member of staff with any concerns” “I have been very happy with the care my relative has received”. Comments from other professionals included: “The staff appear to have the right skills and experience”. “Provide a high level of nursing care, staff are always aware of needs and are up to date with issues affecting individuals” “I have placed a service user with a high level of complex needs and their care needs have been met appropriately with attention to detail” Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 7 “The manager is responsible for a good team of staff who I feel benefit from her management skills, knowledge and values. What has improved since the last inspection? What they could do better: Comments from the surveys included: “New décor is needed although at present some changes are being addressed” “It’s sometimes hard to find your way around” A register of staff who are authorised to administer medicines needs to be introduced. All storage areas including the treatment rooms and laundry need to be de cluttered and made clean and tidy. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 8 The staff need to continue to develop social care plans based on individual preferences and wishes This will result in a more person centred approach to care delivery. The newly employed activities person must develop planned events both inside and out of the home with records kept. The menu choices and alternatives for all meals need to be written in a style that is easy to read. Menus need to be displayed in the dining room. Suitable adaptations such as plate guards and adapted cutlery needs to be provided so that people can eat their meals without help for as long as possible. Staff must make sure that residents’ rights to dignity and privacy are respected at all times. The good practices seen at lunchtime should be followed by all of the staff team. For example not taking cutlery of a person who is finding it difficult to eat and then standing over them putting food into their mouth and then telling another person to “stop using a spoon for the main course and pick up your fork” Areas of the home that need repair, redecoration and refurbishment must be dealt with according to priority need and within timescales given. Infection control polices and procedures need to be revisited to make sure the possibility of any outbreak is minimised. Quality assurance and quality monitoring systems need to be developed further, to promote and continually improve the quality of the service offered. All staff must have refresher training in health & safety, so that they are up-todate with how to keep the home safe for the people who live here. Further refresher training is needed for moving and handling and infection control. The requirements from the Fire Officer visit in December 2007 must be actioned. All health and safety issues must be dealt with, records kept and completed within agreed timescales. All of the requirements identified in the report must be actioned within the timescales given. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 9 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 summary of this inspection report can be made available in other formats on request. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 10 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 Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Good assessments of need are made before moving into the home, people are given detailed information to help them make an informed choice about moving in. EVIDENCE: All of the people who come to live in the home on a long term basis have detailed preadmission assessments which are carried out by care managers, nurse assessors and the home manager. The manager always obtains a summary of the assessment and a copy of the care plan. The manager has added the equality and diversity policy to the information pack that everyone receives when they move into the home. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 12 The home is also contracted for four assessment beds with the local authority. This means that people can be admitted at very short notice. On the day of the site visit one person had been admitted the previous evening. Information had been sent, however this was not detailed. The nursing staff had, within a short periods of time completed an initial care, which clearly set out how this persons needs were to be met. The staff in the home remained concerned about this person’s health care and after consultation with a GP this person was admitted to hospital. Another person who was admitted for a short time said that the home was “fine” and the “staff is nice”. This person had decided not stay on a long-term basis as it was to far for family to visit and she was awaiting a place in another home. A comment from surveys sent out by the Commission said: “When I visited the home the matron was very helpful and gave me lots of information what the home had to offer and the input of various services that were available for example GP and tissue viability nurses.” Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good This judgement has been made from evidence gathered both during and before the visit to this service. Care planning, recording and access to health care services are good, and demonstrates that peoples needs are fully met EVIDENCE: Everyone has a care plan which includes an assessment of their needs and a plan of how these should be met. These were completed in sufficient detail and the reviews were up to date. The assessment tools include pressure sore risk, dependency, moving and handling, nutritional assessments and continence and fall risk assessment. Those who are at risk of pressure damage have risk assessments in place and care plans show how staff are carrying out wound care. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 14 Weights are monitored at least monthly and advice is sought from tissue viability specialists, fall prevention nurses, speech and language specialists and psychologists. The residents have access to all NHS facilities to ensure their healthcare needs can be met. There are regular visits from GP’s and other health professionals including, dentists, opticians and chiropody services. The home has appropriate medication policies and procedures for staff to follow. Storage is in a very small room with very little space to store all medication. Medicines, which are to be disposed of, dressings and some fortified drinks and thickeners are stored in another locked room. Both areas were cluttered and untidy. The home uses a monitored dosage system for administration of medicines that are prescribed. This system is designed to minimise the risk of any errors when used correctly. Medicines are put into individual blister packs by the pharmacy and sent to the home every month. Some medicines cannot be safely stored in the blister packs and they are dispensed in bottles or packets. The Medicine Administration Records (M.A.R.) showed no discrepancies. An audit of Controlled drugs was correct. There is a drug fridge and temperatures are recorded. Staff were unsure of what steps to take should the temperature rise or the fridge break. There were no specimen signatures of staff who are authorised to administer medicines. Discussion with a member of staff confirmed that dressings and “Thick and Easy” are prescribed for individuals. The practice is, that one tub of “thick and easy” is used at a time instead of using all of the tubs separately. This means other people are using individual prescriptions. This is also the case with dressings For example should a person be admitted at short notice and they have a wound that needs dressing the staff use one that has been prescribed for someone else. This practice was discussed and it was agreed that dressings would be bought for emergency use and individual tubs of “thick and easy” used for each person it was prescribed for. The relationships between staff, residents and relatives, were friendly and professional. Care was delivered in private and staff were seen to knock on doors and wait for permission before entering. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 15 Comments from the surveys included: “Quality of care has always been good in my experience” “Provide a high level of nursing care, staff are always aware of the needs and are up to date with issues affecting individuals” “Health care needs appear to be met when reviewing care plans” Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service Daily life experiences and opportunities to take part in activities for people are improving people are not consistently supported to keep full control over decision making in their everyday life. EVIDENCE: The manager has recently employed an activities person and a planned activity programme is being put into place. The staff are now adding into the care plans information about people previous life histories so that a person centred approach to care can be developed. This is still in the early stages of development. Plans include introducing board games, music, chair exercises, and a “walk down memory lane”. There has been a Halloween Party and the Christmas Party was held on the night of the 19 December 2007. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 17 Some people said that their families are always welcomed and others said they regularly go out with their family. The home did receive a grant of money and some of it is being used to create a small patio/garden area to the side of the home. This will be of great benefit as currently there is no outdoor area for people to enjoy in the better weather. On the day of the visit there was little for people to do and most of the staff interaction focused on giving personal care and assisting people to move from lounge to dining room to toilet and back again. There is a three-week menu, which offers choice and variety. This used to be displayed in the dining room on a board but it is no longer there. Menus are displayed outside the dining room. These are pinned fairly high up on the wall and are in very small print. Those who use wheelchairs or have some sight impairment would not be able to read what the daily choices were. The dining tables were set with festive cloths and decorations. Choices for lunch were lamb or pork with carrots, mashed potatoes swede and gravy. Dessert choices were strawberry crumble and custard or banana and custard. Other alternatives were available for example choice of sandwiches and one person had a plate of chips. Cold and hot drinks were readily available throughout the day. Lunchtime was a busy time. Several people need help to eat their food and the majority of the staff sat with them and assisted in a sensitive manner. At lunchtime one person could not use a knife and fork and started to use a spoon, which was managed well. One member of staff said, “to put the spoon down and use the cutlery”. Another person was also finding it difficult to use the cutlery and the same member of staff took the fork off him “mashed” a selection of food and then stood and beside him and put the food in his mouth. This practice does not promote people’s dignity. There was no adapted crockery or cutlery for people to use. If this was available they may have been able to manage their meal and maintain a degree of independence. Comments from the surveys included: “When I visit the food always smells of home cooked meals and when I have visited at mealtimes the food has always looked very good. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Good procedures are in place to protect residents from risk of harm and enable their concerns to be effectively dealt with. EVIDENCE: The home has a complaints policy and procedure, which is displayed and given to everyone when they come into the home. All of the people spoken to said they knew who to complain to although they pointed out that there was little to complain about. Records show that two complaints have been dealt with at home level since the last visit to the home. All of the staff have received Safeguarding Adults training either in house or by attending training with Gateshead Council. The registered manager has recently attended training on the Mental Capacity Act. Staff had an understanding of what constitutes abuse and would be able to use the procedures if necessary. There have been no safeguarding alerts. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 19 People spoken to said the felt safe and knew the “staff would always look after them”. Comments from surveys included: “I would be happy to approach any member of staff with any concerns I have and if they cannot help they would always seek advice. I am also aware of the complaints policy” Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,26. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service Although there have been some improvements to the décor and furnishings the environment needs further attention so that hazards are eliminated and people remain safe, warm and comfortable. EVIDENCE: This is a converted building with bedrooms over four floors and the main communal lounges and dining rooms on the lower two floors. There is a smaller communal area overlooking the car park although few people use this. There are impressive views of the Tyne from the main lounges. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 21 There is access to all areas via stairs and passenger lifts. Signs are posted on each floor level so that people can find their way around the home. Until recently there have been no gardens or grounds that could be realistically used as an amenity area for people living in the home. The home has received a grant and is using some of the money to provide a small private garden area at the side of the home for people to use in the better weather. Other improvements since the last visit include, new carpet on all of the stairs, lounge chairs, some new flooring in the showers, new windows in both main lounges and three bedrooms and decoration to two lounges. A loop system is now available in the lower lounge, which helps those with hearing problems hear the television, which is at the far end of the lounge. There are adequate numbers of toilet and bathing facilities and although floor coverings have been renewed the flooring in one shower was marked and looks unclean. Shower traps were open and unsecured which could allow smells into the room. The toilet facilities have not been refurbished and are looking worn. Toilet seats, which were black, are now grey. All other sanitary fittings including the flooring in the toilets are worn and not well maintained. All of the bedrooms are for single use, none have an en-suite facility. People have brought small items of furniture and keepsakes with them making the rooms individualised. They reflect their previous lifestyles and religious beliefs. Many of the bedrooms are cluttered with the storage of continence pads and other medical equipment. The furniture and bedding in several of the rooms is becoming tired and worn with bedding becoming faded and thin. Many of the bedrooms are due redecoration as there is damage to walls and paintwork. Since the last inspection the use of bed rails has reduced and risk assessments are in place to make sure as far as possible that no one falls out of bed. Most of the beds are ordinary divans and there are insufficient nursing variable height beds for people use. Two of the bedrooms are next to the laundry and both were chilly untidy and impersonal. Not all of the communal areas including bedrooms and toilets had accessible call cords. Two were missing from bedrooms and some in toilets and bathrooms were either tied up or did not reach floor level. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 22 The laundry has adequate facilities. The area was generally disorganised with lots of unnamed personal items of clothing stored in bags and boxes. The use of a supermarket trolley to store linen or clothing was at least innovative. There was a lack of liquid soap and paper towels in this area so allow staff to wash their hands effectively. The sluices were left open and were smelly. Clinical waste bags were overflowing, bins had no lids, the open sluice hopper was dirty and there were no paper towels or liquid soap. Cleaning buckets were of the galvanised type. These were rusty and difficult to clean. Mop heads were dirty and not cleaned or changed on a regular basis. In general the communal areas and most bedrooms were clean, tidy and had no odours. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. People living in the home are protected by recruitment and selection procedures that are properly followed. Staff are supported through training to provide care to people in a way that meets their individual needs. EVIDENCE: The home benefits from a stable staff team, many of who have worked in the home for some considerable time. The registered manager is generally supernumerary but does work clinically one shift a week. During the site visit the staffing included two qualified nurses, four carers, domestics, cook, kitchen assistant and handyman. The manager has recently employed someone to organise activities for the people living in the home Six staff files showed that job descriptions and roles are clear and each file had an application form completed. There was evidence of Criminal Record Bureau checks, of Vulnerable Adult checks, and proof of identity. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 24 A training programme is in place. This provides an overview of training achieved and required. Staff said that they have done or been offered training. Records show that all staff needs to have refresher training in Infection Control, Moving and Assisting and Health and Safety. The manager is in the process of arranging this training. Specialist training includes resuscitation, care of the syringe driver and palliative care. Over 50 of care staff have a National Vocational Qualification level two and four staff are to start training to level three. Comments from surveys included: “There is always a member of staff in the lounges or office and others are never far away. They always take time to speak to me.” “The staff have the right skills to support individuals social and health care” “They provide a high level of nursing care and staff are up to date with issues that affect individuals”. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While management and administration of the home is good support for the manager is sometimes lacking. This affects the running of the home and quality of care delivered to people using the service. EVIDENCE: The manager is a registered nurse and has many years experience both as a nurse and as a manager. The manager is registered with CSCI. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 26 She is aware of the need to keep up to date with current best practice and tries to make sure all staff are knowledgeable and trained to care for the people who are using the service. The registered manager holds regular meetings and asks the people who use the service and their representatives about how they can improve the service. The comments were very positive about the staff and the care provision. Negative comments were about the building. Records relating to people’s monies were checked. Accounts are held individually. Receipts are kept for all expenditure. Three amounts of money were checked and were correct. Supervision records are very detailed but not everyone one has supervision six times a year. This is mainly because the manager is trying to do everything regarding management, nursing, staffing and health and safety. During the site visit one cupboard was full of old spenco mattresses, activity equipment, cardboard boxes, linen, bits of carpet and floor lino. There was also a hole in the ceiling and the light was not working. The manager made sure that the overflowing debris was immediately removed, as this was a fire hazard as these items were being stored near a fuse box. She is aware that the ceiling needs to be repaired as soon as possible. Maintenance records for day-to-day safety were difficult to follow. For example checking and recording of water temperatures, checking window restrictors and general health and safety checks for the safety of staff .the people who live in the home and any visitor. The manager is doing all of this work on top of everything else. These checks could be delegated on a weekly basis to other staff in the home External certificates were available for hoists and lifts. Other certificates including the 5-year electrical test were not available. The Fire Officer had visited the home on the 14 December 2007 and had left instructions of what the home must do to make sure it was safe. The manager had carried out these instructions. Staff has completed fire training in December 2007. Training in infection control, moving and handling and health and safety needs to be updated. Although accidents are recorded the manager does not carry out any audits to track trends and look at when accidents occur to prevent them happening again. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 27 Comments from the surveys included: “The manager is responsible for a good team of staff who I feel benefit greatly from her management skills, knowledge and values” Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 28 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 2 X 2 X 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 X 3 X 3 2 X 2 Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 29 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 OP9 Regulation 13,17,23. Requirement The registered persons must ensure that there is a register of staff who are authorised to administer medication. This is so people can be identified should there be any discrepancies. Timescale for action 01/02/08 2 OP12 12,16 3 OP15 12,16 The registered persons must ensure that separate stocks of dressings are supplied for people being admitted in an emergency. The registered persons must 01/06/08 ensure that activities and social care plans continue to be developed and interests recorded. This will make sure a person centred approach to care is delivered The registered persons must 01/03/08 ensure that the menus offer a choice of meals in written or other formats, which are readily available and easy to see and understand. The registered persons must ensure that adapted utensils are available for people to use. This is to ensure they retain their rights to choice and independence. DS0000018181.V355157.R01.S.doc Version 5.2 Page 30 Tyneview Nursing Home 4 OP19 13,23 5 OP21 23 The registered persons must 01/06/08 implement a planned programme of redecoration and refurbishment for the home. This will make sure the environment remains safe and comfortable for the people living there. The registered persons must 01/09/08 ensure that the floor coverings in bathroom, toilet and shower areas are appropriate and kept in good repair. As should sanitary fittings. Outstanding from 28/05/07 6 OP22 16,23 7 OP24 23 8 OP26 13,23 The registered persons must ensure that there are accessible alarm facilities in every room. Call cords in bathrooms and toilets need to reach floor level. This will make sure that people can call for assistance should they fall or become unwell. The registered persons must continue to redecorate and refurbish the bedrooms and provide sufficient adjustable beds for those who require nursing care. This will ensure that people live in safe comfortable rooms, which meet their needs. The registered persons must ensure that liquid soap and paper towels are available in all areas to enable effective hand washing. All call cords and light cords must be in easy reach, free from knots and easy cleanable. Suitable bins with lids must be provided to assist with odour and make sure clinical waste bags are appropriately filled and 01/02/08 01/06/08 01/06/08 Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 31 disposed of. The walls and floor in the laundry must be impermeable and easily cleanable. Replace galvanized rusty cleaning buckets with ones that can be thoroughly cleaned. Ensure that all mop heads are regularly washed and dried and replaced on a regular basis. This is to ensure the dignity of people and also to protect equipment from possible crosscontamination. The registered persons must 01/09/08 continue to develop the quality assurance programme so the home contuse to be run in the best interests of the people using the service The registered persons must 01/12/08 ensure that all staff receives supervision at least six times a year. 01/03/08 The registered persons must ensure that all of the storage areas are de cluttered. The holes in the ceiling must be repaired. All sluices must be kept locked when not in use. Record and keep up to date all weekly and monthly health and safety checks including hot water and risk assessments. Ensure that all directions from the Fire Safety Officers visit are carried out. Provide a copy of the 5-year electrical test to CSCI. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 32 9 OP33 24 10 OP36 18 11 OP38 12,13,23 Source training in moving and handling, infection control and health and safety for all staff. Carry out accident analysis on a monthly basis. This will ensure the health and safety of the people who live here. 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 OP10 Good Practice Recommendations The good practice of maintaining peoples dignity should be cascaded to all members of staff. Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 33 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Tyneview Nursing Home DS0000018181.V355157.R01.S.doc Version 5.2 Page 34 - 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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